Management Alternatives for Respiratory Symptoms in End-of-Life Care

dying person

There has unfortunately been an increase in terminal conditions in recent times. Though there is no particular factor that can be attributed to this increase, the impact the diseases have on people’s lives is devastating. You have different care options when facing a terminal illness diagnosis.

Palliative care is, nonetheless, the best choice. This is an interdisciplinary specialty focusing on the prevention and relief of unnecessary suffering in patients. This guarantees the best possible end-of-life care for patients, along with their loved ones.

The primary goal of palliative care for Indiana clients, whether at home or admitted in a care institution is symptom management. Enrolling in care immediately after a diagnosis is the ideal choice for optimal outcomes though you can start at any point.

Early palliative care has been proven by several studies to boost the mood and quality of life of patients, prolong their median survival, and minimize their need for IV chemotherapy. One of the symptoms addressed in this care is respiratory distress.

This affects up to 70% of patients. It is connected to the increased respiratory secretions and at times, malignant metastases that cause the compression of airways and varying levels of breathlessness. Here are the management alternatives for respiratory distress in palliative care.

Psychological Care

Calming patients is essential to alleviate respiratory distress since panic and fear will worsen it. Psychological care starts immediately; a patient is enrolled in palliative care.

This minimizes the risk of anxiety, panic, and fear and thus reduces the risk of respiratory distress. The classes also feature various techniques of calming the mind when breathless to get a regular breathing pattern.


lung problems

Physiotherapists can help patients master beneficial positions, breath control techniques, and exercises that will alleviate or minimize the incidences of respiratory distress.

Other than symptom control and prevention, physiotherapy techniques are designed to alleviate panic and fear. They allow a patient to take an active role in their symptom management and thus improve their quality of life.

Neuromuscular Electrical Stimulation

NMES, as this treatment is abbreviated, comprises the stimulation of the lower limb muscles. This way, it increases muscle bulk and relieves breathlessness or reduces its occurrence.

NEMS is a relatively new management alternative and generally used in those who cannot actively engage in physical exercises. Its effects are evident after 4–6 weeks of its regular use that includes 3–5 weekly sessions lasting 15–30 minutes each.


This is often used as a last resort to minimize the pill burden in patients under palliative care. Opioids are the choice of drugs for the management of medically intractable breathlessness as they calm a patient.

Their dosage is much lower than that used for pain management. Steroids, antidepressants, and benzodiazepines are, at times, also prescribed. Oxygen administration is essential in patients that have marked hypoxemia.

Respiratory distress is as disturbing to patients as it is to their loved ones. Most people will associate this symptom with impending death and often do nothing about it. The above management alternatives will thus also go some way in calming a patient’s loved ones.

Most centers now offer community education on what is normal in terminally ill patients and how to respond to boost palliative care outcomes.

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