Breathlessness AND RELAXING

POSITIONS

By
Dr shaheen khanum,PT
Breathlessness
 Breathlessness
• Breathlessness is an uncomfortable sensation or
awareness of breathing.
• Subjective – measuring lung function does not correlate
with sensation or severity of breathlessness
• A complex experience of mind and body that is likely to
progress with disease severity
• Significant correlation with impaired quality of life and poor
survival. Effects Patients and Carers.
• A common complex distressing symptom at the end of life
• What are the Causes of
Breathlessness?
Psychological Aspect of
Breathlessness
 Assessment of breathlessness
• Listen/Observe
• What does it mean to the patient / carer?
• Onset
• Triggers / What eases it?
• Levels of significance – during activity, in
• different positions, at rest
• Pattern of breathing, colour, respiratory rate
• Are they anxious?
• Oxygen saturations
Manage reversible causes optimally
according to patients CONDITION
• Consider active treatment of:
• Infection
• Pleural effusion
• Pneumothorax
• PE
• Airway obstruction
• Anaemia
Non Pharmacological
Management
• Positioning
• Airflow - use of fan /window
• Relaxation / Distraction/ Reassurance
• Energy conservation / Pacing
• Controlled Breathing techniques
• Loose clothing
• Mouth Care
Comfortable Positions if short of breath
 sitting 1
These positions are helpful when you have 
shortness of breath during activity, emotional
excitement, exposure to adverse weather
conditions or when you feel tense and need to
relax.
Sitting
Sitting
Rest your feet flat on the floor.
Lean your chest forward slightly.
Rest your elbows on your knees or rest
your chin on your hands.
Relax your neck and shoulder muscles.
• sitting 2
• Rest your feet flat on the floor.
• Lean your chest forward slightly.
• Rest your arms on a table.
• Rest your head on your forearms
or on some pillows.
standing 1

Stand with your feet shoulder width apart.

Lean your hips against a wall.
Rest your hands on your thighs.
Relax your shoulders, leaning forward slightly and dangling
your arms in front of you.
-OR-
• Rest your elbows or
hands on a piece on
furniture, just below
shoulder height.
• Relax your neck,
resting your head on
your forearms.
• Relax your
shoulders.
Sleeping

Lie on your side with a pillow between your legs and your head
elevated with pillows. Keep your back straight.
Lie on your back with your head elevated and your knees
bent, with a pillow under your knees
Breathing Techniques
• Start with position of ease
• Relax shoulders / upper chest
• Diaphragmatic ‘tummy’ breathing

• Breath out twice as long as breath in

• Pursed lips on breathing out if needed
•
Relaxation
• Time and calm environment essential
• Relax and Breathe
• Visual imagery
• ‘Calming hand’
• Distraction
. Pacing activities
• Encourage activity
• Allow time for tasks
• Starting and stopping with rest intervals
• Inspiration: expiration ratio during activity
• Use of aids – stair lift etc
• Adapting functional tasks, e.g. Ironing sitting
down
References
• DAVIS.C(1998) Breathlessness,cough and other
respiratory problems.In: FALLON.N.O’NEILL.B(eds)ABC
of Palliative Care BMJ Books. London pp 8-15
• MUERS.M. ROUND.C (1993)Palliation of symptoms in
Non –Small Cell Cancer:A Study by the Yorkshire
Regional Cancer Organisation Thoracic Group.
Thorax.48 (7) 339-349
• Sheffield Palliative Care Formulary 3rd Edition
Thank you for listening