Breathlessness – supporting somebody

Breathlessness is the uncomfortable feeling of having difficulty breathing and feeling short of breath. It’s also called dyspnoea. Everyone feels breathless at times, such as when you’ve gone up stairs too quickly or if you have an infection affecting your lungs. However, some people often feel breathless and then it’s called having chronic breathlessness.

Breathlessness is a common symptom of many long-term (chronic) conditions, such as COPD and some cancers and heart conditions.

If you’re a carer of someone with breathlessness, you can understand what it feels like by trying one of the following:

• Take a deep breath in and then breathe out halfway. Then breathe in again. Now breathe at that level for a few more breaths.
• Take a deep breath in and hold it as long as you can. 

Imagine you had to go up some stairs breathing like that. This is what breathlessness can feel like. 

Breathlessness can be triggered by:

• a certain activity, such as getting washed or dressed
• a hot or cold environment, aerosols or dust
• infections
• emotions, such as feeling stressed or upset.  

Sometimes, there’s no obvious trigger. 

Read more about breathlessness.

If the person you’re caring for is having an episode of breathlessness there are things you can do to help.

• Reassure them and find out how they like to be supported normally – for example, they might find it comforting if you hold their hand. Speak to them in a calming manner and reassure them that the episode will pass. Not everyone wants help when they’re breathless. Sometimes, they just want to be given some space to get better on their own. Some people may find it useful if you say encouraging and reassuring things.
• If they’re out of breath, encourage recovery breathing by asking them to find a comfortable position, relax their shoulders and gently breathe out. They can also try breathing in from their stomach.
• If they can, ask them to rate how breathless they feel on a scale of 0 to 10 (0 being not breathless at all and 10 being the worst breathlessness). This might help you both decide the best way to manage their breathlessness episode.
• Sit them near an open door or window or use a handheld fan to cool their face. Cool air may reduce breathlessness by helping them feel calmer. Hold the fan about 15 centimetres away and direct it towards their face and move it from side to side.
• Help them with breathing exercises that can help them control their breathing.
• Help them to use their inhaler when they’re out of breath (if they have one).
• Try acupressure, which involves stroking down either one of their arms all the way to the end of their thumb using the palm of your hand. Rubbing the top-middle of their back may also help.
• Remember that if the person you’re caring for suddenly becomes more breathless or if they have worsening symptoms of their underlying condition, seek medical help in the usual way.

If they’re having an episode of breathlessness, see how to help in the section above on what to do when the person I’m caring for is breathless now.

If you’re caring for someone with chronic breathlessness, there are many ways you can provide ongoing support.

• When they’re not breathless, agree on hand signs or signals so you can communicate with them when they’re out of breath and can't speak.
• Talk to them about what activities are most important for them to do and support them to do those activities at their own pace.
• Help with, or take on more, household tasks such as cooking and cleaning.
• Support them to do their breathing and relaxation exercises.
• Ask them if they’d like you to go to appointments or group exercise or rehab sessions with them.
• Keep rooms well-ventilated by opening windows or using a fan.
• Encourage them to talk about any fears or worries they have. They may struggle with difficult emotions and slowly withdraw from their daily life as their condition progresses. You can encourage them to talk through their feelings with you, other family members and friends, a trained counsellor or one of their healthcare team members. You can ask their healthcare provider for a referral to a trained professional.
• Learn about their condition, eg, if they have COPD find out what symptoms they have if their condition flares up, what medicines they need to take and when, and what to do in an emergency.
• If you’re living with a partner who has chronic breathlessness, find activities that you can do together as well as things you can do separately. Try and support each other to make things enjoyable.

There are things you can do to help reduce how often the person you care for is breathless. Help them to do the following things. 

Image credit: Healthify He Puna Waiora

Manage stress and panic

It’s common for someone you’re taking care of to feel upset and frightened when they’re out of breath. Also, if they’re feeling stressed, that can make their breathlessness worse. Use the support techniques above to help them relax and feel calmer.

As a carer, you can't take away the stress from people, but you can help by exploring ways to help them manage their stress levels. Read more about managing stress – you can also use these tips for yourself when you’re under stress.

Manage infections

Infection can be one of the triggers for breathlessness. It’s important that you help the person you care for to keep an eye out for symptoms and signs of an infection so it can be managed and treated in time.

Here are some ways to help prevent or manage infections.

• Be alert to signs of infection – don't assume it's the person’s illness getting worse. Read about symptoms of respiratory tract infections (RTIs), including upper RTIs (such as colds) and lower RTIs (such as pneumonia).
• Be aware of what the person is like when they don’t have an infection or flare-up so any change from this is noticed.
• The person you care for may have a self-management plan you can follow if their breathlessness gets worse or if they have other signs of infection. If they don't have one this can be discussed with their healthcare provider. The plan will include what medication to take, who to contact if you’re concerned and the next steps to take when they’re out of breath.
• Encourage the person you’re caring for to attend a rehabilitation course – their healthcare provider will be aware of courses available in your area.
• Take yourself and the person you’re caring for to get an annual flu vaccination, and pneumococcal vaccination (the pneumococcal vaccine may not be funded).
• Make sure you both wash your hands regularly with hot water and soap or use hand gel often and avoid touching your eyes and nose.
• Avoid visitors with coughs, colds or fever.
• Don’t smoke around the person and avoid places with smoke. 
  
  

Help them to stay active 

• Keeping active can help strengthen muscles to help manage daily activities, including helping them to boost recovery after infections. Being fit also improves heart and lung function, which helps to provide the body with the oxygen it needs.
• You can help by encouraging the person with breathlessness to attend an exercise class designed for people living with the same condition. You can also try and help them with some useful strengthening techniques(external link), which they can do at home when it’s hard to get out. 

Supporting someone with breathlessness due to a long-term condition can be rewarding but also very challenging. It’s important to understand that your relationship with the person you’re caring for may change as their condition progresses and they need you to help them with more activities. It’s common that you as a carer might feel drained and upset about what’s happening.

If you’re struggling, talk to your healthcare provider about how you’re feeling or if you need support for yourself. You can also talk to your loved one’s healthcare team or others involved in their care, to get the support you need to help care for them.

Read about how carers need care too, including ways you can look after yourself, and find out about support for carers. Take time to do things you enjoy and stay connected with your own friends and whānau.

If someone you care for dies, make sure you get the support you need. You may even have feelings of grief beforehand. Talk to your healthcare provider if you have difficulty coping with daily life and if you’re having feelings of grief for longer than expected. Read more about when someone dies(external link) and about grief and loss.

There are asthma and COPD societies(external link) around the country that offer support groups for people with respiratory conditions and their family/whānau.

The Cancer Society Cancer helpline(external link) (0800 226 237) puts you in touch with a cancer support nurse and there also support groups(external link) throughout the country.

See also our page on support services for carers.

Apps reviewed by Healthify

You may find it useful to look at some carer support apps.