Will Respiratory Therapy Help at End of Life?

In short, yes. It increases comfort and quality of life for hospice patients in the weeks, days and hours leading up to death. Respiratory Care Week is October 20-26 this year, raising awareness of the many unique benefits and care that respiratory therapists bring every day to their patients. If you have a loved one in hospice in Santa Clara and elsewhere, you may have heard the doctors and nurses talk about respiratory care and how it may help the patient even at the end of life. Let’s explore what respiratory therapy is and how it can help with quality of life.

What is Respiratory Therapy?

Respiratory therapy involves the assessment and treatment of patients with both acute and chronic dysfunction of the cardiopulmonary system. Respiratory therapists are the professionals who practice this branch of therapy, handling the demanding responsibilities related to patient care and serving as important members of the healthcare team. Many work within the hospice care setting as part of the care team.

Respiratory therapists possess a broad knowledge of the pathophysiology of the cardiopulmonary system and the complex procedures that are needed to properly diagnose and treat patients. According to the American Association for Respiratory Care, a respiratory therapist will:

• Diagnose lung and breathing disorders.
• Recommend treatment methods.
• Interview patients and perform chest physical exams to determine the best type of therapy for the patient’s condition.
• Consult with physicians to recommend a change in therapy if needed.
• Analyze breath, tissue, and blood specimens to see levels of oxygen.
• Manage ventilators and artificial airway devices for those who have trouble breathing on their own.
• Respond to emergency situations and urgent calls for care.
• Educate patients and families so they can maximize their loved one’s quality of life.

Respiratory Therapy at End of Life

Respiratory therapists help patients in hospice breathe more easily on a daily basis. But when the end of life is imminent, respiratory therapists are again right there at the bedside to ease the situation. The dying process is never easy, and most health care professionals often find it difficult to take patients off life support because they’re trained to keep patients alive. In the same vein, respiratory therapists are trained to have a laser-like focus on the breath of life, and understandably have a difficult time letting that breath go.

They are the ones to tell family members when it’s time to take the patient off life support, letting them know their loved ones may not pass as soon as they are taken off. Part of their job is to remain by the patient’s side throughout the process and deliver any medication they may need for comfort. They also work hard to make family members as comfortable as possible as well. Comforting words, tissues, cookies, and coffee…these may all help the grieving family say goodbye.

It’s certainly a delicate situation, one that should be handled with the utmost respect. That’s what a respiratory therapist is trained to do, particularly in palliative and hospice care settings.

Respiratory issues can be very distressing to a patient as they approach the end of life, and it’s often difficult for others to watch. And with up to 70 percent of all hospice patients experiencing respiratory issues as they near the end of life, specifically in the form of dyspnea (shortness of breath), this can be exacerbated by anxiety. In fact, many hospice patients say that dyspnea is even more distressing than physical pain, which is why the management of both respiration and anxiety is critical in avoiding intensification of symptoms.

Morphine is often the most reliable relief option for patients suffering from dyspnea, but it does come with its side effects, from nausea to drowsiness to constipation, which in turn increases their distress. Researchers have found that nebulized morphine (delivered via oxygen line to the patient’s respiratory tract) was much faster in relieving dyspnea than oral administration and with no side effects.

Support for Respiratory Therapists

The education and recognition of death anxiety are vital for respiratory therapists. A big part of respiratory therapy is to manage mechanical ventilation and addressing death and dying in a compassionate way. Respiratory therapy is a critical component in any rapid response team, code team or trauma team in a hospital setting. But it’s also critical in the hospice setting as well. Removal of mechanical ventilation is the primary duty of the respiratory therapist. Exposure to death on sometimes a daily basis can take an emotional toll, leading to burnout, stress, and high turnover rates.

Managers and leaders in the hospice care setting, then, should provide counseling and education to support respiratory therapists and their ongoing exposure to the death and dying process, suggests the National Institutes of Health.

Contact Pathways Home Health and Hospice

To learn more about the role respiratory therapists play in your loved one’s end of life care, contact Pathways Home Health and Hospice today at 888-978-1306.