If your loved one is having trouble breathing and is short of breath, signs include restlessness, rapid, short, shallow breaths and anxiety. This can be very frightening for both of you but there are some things you can do. Keep the patient's room cool and well ventilated. Allow the patient to rest between meals and after a bath. If the patient is in bed, raise the head of the bed or have them sit up. Put pillows behind them and make sure they are well supported. You can ask them to lean forward and encircle their arms around a pillow or over an over-the-bed table. Place the patient in the position they identify as most comfortable. Stay calm and reassure the patient. Place a small oscillating fan at the patient's bedside to help the patient feel as if they are receiving more air. Check the patient's temperature and notice any changes in mucous (especially thickness). Offer warm fluids and a room humidifier if mucous is thick. Remove all highly scented items from the patient's living area. Eliminate smoking from the patient's immediate area. If oxygen is in home, administer it until shortness of breath subsides. At this time, keep supportive family and friends at a minimum. One to one support is best. Take turns if necessary. If all interventions are unsuccessful, contact hospice nurse. Have the patient do deep breathing exercises. This will help them to get more oxygen and calm their breathing. The steps are as follows: Breathe in and out slowly through the nose, using the stomach muscles. Feel the abdomen rise and fall with each inhalation and exhalation.
Pursed-Up breathing Breath in slowly through the nose. Hold this breath and count to three. Purse the lips as if to whistle. Breath out slowly through pursed lips, to the count of six. Oxygen therapy There may come a time when oxygen is needed. The doctor will decide on the best time and the appropriate amount. The company that supplies the equipment will give you initial training on how to use it when it is delivered to your home. You can call your Hospice nurse if you are having any problems with the oxygen. The supplier may also leave you a number to call. Here are som things to remember. Keep the mask or cannula clean, using a wet cloth to wipe it out. Check the nose, ears and cheeks for reddened areas caused by the elastic and tubing. Use soft cotton pads between tubing/elastic and the skin. (Baby powder works well in small amounts behind ears). Oxygen can dry out the mucous membranes in the nose, so you may want to check the nostrils and mouth for dryness. You can put water soluble jelly such as K-Y Jelly on the lips and nostrils to help keep them moist. If you can't tell if the oxygen is flowing, check the tubing for kinks, blockages or disconnection. Make sure the oxygen has been turned on. You can put the prongs of a nasal cannula in a glass of water. If you see bubbles, the oxygen is flowing. Remember to position the prongs of the nasal cannula in the nostrils, facing upward and following the curve of the nostrils.
Safety tips Do not smoke or allow others to smoke in the same room as the oxygen. Signs should be posted on doors. Do not use the oxygen or keep the equipment near open flames or heat sources such as stoves or radiators. Make sure a fire extinguisher is handy. Make sure you can see the tubing at all times. Don't hide it under blankets or rugs. Turn the oxygen off whenever it is not being used.
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