Dear Barbara, Could you address the use of oxygen as a comfort measure? I don’t mean as a result of measuring the SATs, but as a source of comfort to the patient.

There is research saying that administering oxygen as the end of life approaches doesn’t prolong life or even have any beneficial effects. It states that the physical body is so compromised due to decreased circulation and lung congestion that there is no effect. The body is shutting down, nothing works right, so it can’t process the oxygen that is being pushed into it.

My opinion? We need to ask why we are thinking about giving the oxygen. Is it because the person looks like they are having difficulty breathing? Well, as death approaches a person has difficulty breathing. There is congestion (depending upon how hydrated or dehydrated they are). There are the mouth movements that look labored, restlessness. Often there are sounds as breath goes in and out of the mouth. These are part of the normal way a body dies. Remember “nothing works right, everything is shutting down”. We are watching a “chick getting out of its shell”. There is labor involved in getting out of our body.

For us it is very difficult to see our loved one struggling. Most of us are at the bedside of someone who is dying because we are emotionally involved. We are watching with our hearts and emotions, not our intellect, our minds. When we have knowledge of the dying process, when we can understand that what we are seeing is normal, our mind can tell our heart “nothing bad is happening here. It is sad but nothing bad”.

Now back to oxygen--what do we have to lose by administering oxygen as end of life approaches? A few dollars to set it up and pay for it, and it probably won’t be of any help in easing the breathing challenges. Basically that is the downside. The up side is MAYBE it will bring a bit of ease to the patient and for sure it will bring comfort to the watchers. The watchers will feel they are doing something and that they tried to make their loved one more comfortable.

End of life work is not about just taking care of the patient. It is about caring for the family and significant others as well. Oxygen at the end of life can be considered a comfort measure for the family.

Something More about Oxygen at End of Life: In my book The Eleventh Hour, the companion book to Gone From My Sight, I go over the use of oxygen in the final days of life. There is special care for the mouth that needs to be given when oxygen is used which is outlined in the book.