BREATHING DIFFICULTY
Shortness of breath may be a symptom of a chronic lung condition, or a sign of acute changes in the course of a progressive illness. Noticeable rapid or labored breathing may also be accompanied by coughing, congestion, and anxiety or restlessness. "Air hunger" may be a frightening experience for both the sick person and the observer.
Determine if shortness of breath is related to unrelieved pain or other unmet physiological or emotional needs. Rapid, shallow breathing may be due to pain. Oxygen requirements will be increased during anxiety and restlessness. Pain medication has a calming effect and helps to lessen air hunger and the sense of distress. If oxygen is available, keep it on at all times at the prescribed flow rate.
During episodes of acute shortness of breath, do the following:
 | Remain calm. |
| Remain with the sick person and offer reassurance. |
| Maintain bedrest and raise the head of the bed to a 45 DEGREE or upright position. |
| Promote air circulation in the room (use of fan if available). |
| Encourage deep breathing: inhale through the nose and exhale slowly through pursed lips. |
| Offer medication as prescribed. |
| Maintain oxygen as prescribed. |
| Use room humidifier or vaporizer to help loosen secretions if necessary. |
Labored breathing commonly occurs in the end stages of a terminal illness. This may be the most difficult aspect of the dying process, for the observer/care-giver. Generally, the dying are less aware of this symptom due to the diminished level of consciousness that prevails at this stage. Oxygen may be prescribed as a comfort measure during consciousness; it is not always a necessary treatment, and it does not prolong life.