Shortness of breath in serious illness: what eases it

Feeling that you can’t catch your breath is one of the most frightening symptoms of serious illness, for the person and for the family watching. It can almost always be eased. This note explains what helps, with and without medicine.

What it is

Shortness of breath, or dyspnea, is the feeling that you can’t catch your breath or can’t breathe in enough air.¹ In serious illness it can come from the illness itself, fluid around the lungs or heart, pneumonia, treatment, COPD, heart failure or anemia, and anxiety can make it worse.¹

Treat the cause when you can

Some causes can be treated directly, such as draining fluid or treating an infection. When they can’t, the goal is comfort.¹

Medicines that help

Oxygen can help some people.¹ Opioids such as morphine, in small doses, can ease the feeling of not getting enough air.¹ Other medicines can help when breathlessness comes with panic or severe anxiety.¹ Used for breathlessness and adjusted carefully, these medicines are about comfort.

Without medicine

A fan blowing cool air across the cheek helps many people.¹ Pursed-lip breathing, meditation, relaxation training and talking with a counselor about anxiety can help too.¹ Families can help by staying calm, opening a window, and helping the person sit upright if that feels easier.

How palliative care and hospice help

Palliative care can improve comfort at any stage of illness.¹ A palliative care or hospice team can plan ahead for bad moments, keep comfort medicines in the home, and teach the family what to do. If breathing suddenly gets much worse and you’re not on hospice, call 911; on hospice, call the hospice line any hour.