Oxygen, Morphine and Air Hunger

QUESTION: What do you think of use of oxygen at the end of life? – Does it hasten or prolong death?

I consider use of oxygen at end of life a possible comfort measure. In most situations it does not prolong life and it is even questionable if it can ease the “air hunger” that is part of the dying process.

In the days to hours before death when our body is shutting down the heart is unable to pump the blood normally through the body. Circulation is slowed, breathing is slowed, so oxygen exchange between the lungs and the blood is slowed. Nothing in the body is working right, oxygen is not getting where it should throughout the body. Giving extra oxygen may or may not increase the amount of oxygen reaching the organs and cells. It is really questionable as to how much oxygen will be received and utilized but I don’t see a down side to trying to increase the oxygen levels. It will not prolong the dying process, it will not shorten the dying process but it may bring a little more comfort to the physical body.

What we have learned that seems to be more helpful than administering oxygen is to give a small amount (the operative word here is “small”) of Morphine. The Morphine can actually bring comfort from “air hunger” at end of life. It slows down the number of times a person breaths in and out.

In the days to hours before death we need to remember that the “labor” to leave this world is harder on us the watchers than it is on the person dying. Think of the chick working laboriously to get out of its shell, to free itself of the cumbersome shell that contains it. That is what is happening as we watch someone exiting this world. The body is shutting down, nothing works as it normally did, nothing feels as it normally would, there are no normal physical sensations or responses.

Most of the time the person is doing exactly what they are suppose to do when dying. It is we, the watchers, who don’t know what that normal process is. We are the ones who are scared about what is happening. We want the process to stop, to be like it is in the movies--no agitation, no uncomfortable sounds, no smells, just say a few memorable words and close your eyes. Unfortunately, that isn’t how our final act of living unfolds.

In most situations Mom is doing exactly what she is suppose to do to get out of her body. Nothing bad or pathological is happening. It is very sad being with someone we care about when they are dying. Understanding the normal happenings as death approaches neutralizes the fear we bring to the experience. Knowledge reduces fear.

Something more...

My mother used oxygen in last few weeks of her life. She had cancer of the lungs. I have a vivid memory of taking Mother to the mall, oxygen tank in tow, in the final weeks of her life. That story, along with a detailed chapter on multiple tools to help with approaching death are in The Final Act of Living.



Thank you for this post as I lost my grandmother on 1/28/24..I was in the room with other family members when she passed..The hospital placed her on oxygen and nothing else per her request..she said she wanted to go peacefully,but from what I saw I don’t feel like it was and it’s riddled me with guilt ..After they removed the nasal oxygen she passed away with ten minutes…did the oxygen prolong her death or was she just waiting for us all to there in the morning…Her labored breathing even with the oxygen was nothing I’ve seen before or would want to again…I like to think she heard me when I talked to her about the beach and said I love you but she didn’t even respond…I am so hea I didn’t get one last goodbye she’s been to the hospital numerous times, mom said let her rest tonight so I did…. got a call at six am to come now…drive an hour and saw her again not like the beautiful lady I knew…it was scary even say traumatic…bless you for all you do…..
BK Books replied:
Hi Melissa, to answer your questions: I don’t think the oxygen was keeping your grandmother alive. I think she was waiting for you all to be with her. I do believe she could hear you but as if in a dream. The labored breathing was just part of the struggle to get out of her body. You might write her a letter. Say all the things you still need and want to say to her. Burn the letter and scatter the ashes to the wind. Let how well you live your life be the gift of love that you give her. Blessings to you and your family. Barbara


Hi Barbara,
My Mother passed on Friday afternoon a few hours after our email exchange. I am trying to regain my footing but I am struggling. I know having some answers would help and hopefully help others who are reading this and going through something this difficult.

I have two questions please, if you would help.

1. My Mothers eyes turned from hazel (her original eye color) to ice blue to gray. This happen within the last 24 hour of her life and was very frightening. Do you know anything about this? I think it would be beneficial for others to know of this and why it happens.

2. When my Mother was struggling (fighting) at the end the oxi pulse displayed no numbers. The hospice nurse said ’She’s gone.’ However, my Mother still ‘breathed’ these abrupt, jolted exhales for about 30 minutes and then these stopped. I want to know, please, did she die when the nurse said ’She’s gone.’ or when the last breathe was exhaled? I know this might seem insignificant but it does matter to me. And, if this type of breathing is a residual type of thing, I think others would benefit from knowing this as well.

Thank you for sharing your expertise.
BK Books replied:
Davis, about your two questions: your mom’s eye color changing I have not noticed before. Most eyelids are at “half mast”, or one eye partially open, the other closed, so I didn’t see a lot of really open eyes and no one asked me about a color change. That said doesn’t mean it hasn’t happened to others. As the energy leaves the body there are so many unexplained changes. The continued breathing after the oxy meter displayed no numbers: most often there will be no readings from the blood pressure cuff and you can’t get a pulse reading by machine or by hand. Yet the heart is still beating, getting slower and slower and breathing getting longer and longer between breaths. Not getting a reading to me doesn’t mean she was dead. It tells me she was very close but as long as she was taking occasional breaths I personally think she had not finished her labor. All that said I have had, after a person was presumed dead (no heartbeat, no breaths) make sounds, gurgling, even gasps. It is just air or fluids releasing from the body. LIfe is gone, just the shell reacting to gravity and external movement. I hope this eases your mind as to how your mother died. You might write her a letter, put your thoughts and concerns, tell her everything that is in your heart. Burn the letter and scatter the ashes to the wind. Let how well you live your life be the gift of love you give her. Blessings! Barbara


Good Morning Barbara~
I thought I was ready, ‘at peace’ with this. This being my Mother’s passing but I am struggling. I sit next to my Mother as I type this comment. It is Friday, she has been NPO since last Friday, her breathing is labored, put on oxygen this morning, eyes have gone from hazel to ice blue to gray in color, halfed masted. Over the past week I have searched and searched topics regarding the dying process. Searches to gain knowledge to assiting with witnessing this. Your documentation is the most touching and helpful thus far. Especially this: ‘In the days to hours before death we need to remember that the “labor” to leave this world is harder on us the watchers than it is on the person dying.’

I am an educator so I am a true advocate of: ‘Knowledge reduces fear.’ ~Especially now

Thank you for propagating knowledge and reducing fear~
BK Books replied:
Hi Davis, now is the time to talk with your mother (even though she won’t respond she can hear you). Talk about the good times and the challenging times. Tell her how you love her and just hold her hand or even crawl in bed with her and hold her (if that feels like that is what you need to do). This is a special time. My thoughts are with you and your mom. Blessings! Barbara

If our body for whatever reason isn’t getting any oxygen it will die. But if we give the body oxygen using machines it won’t. How can you say that doesn’t prolong death?
BK Books replied:
RPS. Giving oxygen as end of life approaches is controversial. Some say it does not prolong life or provide any comfort while others (like me) say “why not use it if family requests. It will bring the family comfort if nothing else”. Blessings! Barbara
Lisa Garrett

Thanks for the info. I shared it with my husband Billy so he would know what to expect at the end of my journey. I’m on oxygen all the time seen 2021 I had COVID an if left my lungs in bad shape. Before that I was fully active remodeling my Dad’s houses to sale after I retired. Then came COVID again THANKS
BK Books replied:
Lisa, my blessings are with you during this challenging time. Barbara

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