Self Directed Learning Package - University of Queensland

75 • Self Directed Learning Package - Advanced Registered & Enrolled NurseDyspnoeaDyspnoea is an awareness of uncomfortable breathing. Itcan also be called breathlessness or shortness of breath.The evidence suggests that 70% of people receiving a palliativeapproach experience dyspnoea in the last six weeks of life. 5 Inthe terminal phase of ageing and/or illness, fear of suffocationmay be the most troubling symptom. This may significantlyaffect the ultimate place of death. The experience of dyspnoea(i.e. breathlessness) may not be directly attributed to a disease,because other factors such as anxiety exacerbate the symptoms.• Shortness of breath becomes more frequent in residentsas their disease progresses. It is associated with a poorerprognosis, and is usually multi-factorial in people withadvanced disease.• Dyspnoea frequently worsens as death approaches.• Dyspnoea can impair a resident’s activities of daily living, limitmobility, increase anxiety, and can leave them feeling fearfuland socially isolated.• It can also be a sign of a deteriorating condition in residentsreceiving a palliative approach.• Shortness of breath (dyspnoea) is frightening for patients.They may fear suffocation, and they often associate dyspnoeawith impending death. Dyspnoea can be both longstandingand progressive (related to the disease progression), or it canbe an acute problem appearing suddenly.• Dyspnoea triggers panic, and panic exacerbates dyspnoea, sothe pattern becomes cyclical.• Dyspnoea may also be a distressing and frighteningsymptom for the family. This can lead to increased anxietyfor the resident which may increase their dyspnoea. Familymembers’ perceptions of a resident’s suffering can influencehow the family makes meaning of, and come to terms with,the dying experience of the resident.