July 20 2015
Written By
Barbara Karnes, RN
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Oxygen, Morphine and Air Hunger

Oxygen, Morphine and Air Hunger


barbara - August 25 2020

Hi Ann, about your comment of your mother’s difficulty breathing during the time before she died: think about how a little chick works to get out of its shell, that is what we are doing as we work to get out of our bodies.  For us the watchers it is frightening but know that what your mother was doing is part of the labor, the work, to leave. With or without the oxygen she would have worked to be free of her heavy, non-functioning body.Thank you for reaching out to me. I hope this has offered some comfort. Blessings! Barbara

Ann - August 24 2020

Thank you very much for your post .It has helped me a lot . I am feeling so guilty that I had failed my mother when she died 2 days ago by keeping her oxygen on and prolonging her last hours . It was such hard work for her using the accessory muscles to breathe . Everything had gone well up until those last 12 hours . I feel I failed her by her having to struggle to the very end , exactly what I hoped it would not be .

barbara - June 06 2020

Hi Kate, you are right, there is no right or wrong decision. The results of some decisions may be more challenging than others but isn’t that how life works? My hope is that decisions made are based on knowledge gained and information considered.
My blessings to you and your mom. Barbara

Kate - June 06 2020

Thank you for posting this useful information. My 97-year-old mother is on her end-of-life journey. It is hard not to feel guilty and/or confused about these decisions about oxygen (life support that prolongs agony or palliative assistance?) and morphine (a pain reliever or expediter?). In previous centuries, we did not have much information and no hospice care (people just died). Now, we are blessed with amazing resources (assisted living, memory care, palliative care, hospice). And, yet, even with amazing resources it is no easy task to hold incredible respect for the family member and care givers and hospice workers, and doctors, while at the same time wonder if I, as the decision maker, am doing the “right thing.” Your post is something very comforting to me. My take away is that “there is no right or wrong thing,” and that my mom is very fortunate to be in such a peaceful and natural place doing her own thing.

Barbara - February 21 2020

Hi Sylvia, If the oxygen is causing more discomfort and agitation then benefit, discontinue it. Seems contrary to keeping him comfortable if it is causing him to be more agitated. Giving him a small amount of morphine is probably easing his respiratory distress as much, if not more, than the oxygen is. Blessings! Barbara

Barbara - February 21 2020

Hi Irene, from what you have described I think it will be blessing for your mom to sleep through her final days. She has told you she is “ready to go” and is agitated and stressed as her body is shutting down. I see sedating her as giving her a gift from the obvious discomfort she is in. I see no need to discontinue the oxygen. It is a comfort measure while not necessarily extending her dying process.
My blessings are with you both. Barbara

Sylvia Golden - February 21 2020

Hello, my husband is at home in hospice. 2001 he had a heart transplant. Hospice just started oxygen. Should we continue because he pulls it out of his nose & gets tangled in the cords. I’ve given him a small amt of morphine & adavant every 4 hrs.

So sad to watch.

Look forward to a response.

Thank you,

Sylvia Golden

Irene - February 21 2020

My 94yo mother lived alone until 4 mos ago and only had O2 at night. She has CHF and pulmonary hypertension. After the fall rehab resulted in extreme edema bc she couldn’t wear the brace and they wouldn’t let her out of bed wo it. She was discharged bc she wasn’t compliant. Days later back into the hospital and they got 15 lbs of fluid off her. We moved her to assisted living. 4 wks later she got pneumonia. Back into the hospital and now is in hospice. Throughout this time we’ve had numerous O2 deprivation events. Combative and harmful to herself and others. She was on morphine but has been refusing it for the last 72 hrs. If left alone she takes the cannula out and then we’re back to the deprivation behavior and she accuses everyone of everything. She has said over and over she’s ready to go. Our question is whether or not it’s right to keep her sedated and take her off O2. Thank you in advance for your response.

Barbara - June 05 2019

Hi Mary, the research on oxygen prolonging life as death approaches is unresolved. Some say yes, some say no.
I, personally, consider oxygen a comfort measure and do not believe it extends life. If it eases the difficulty of breathing then we want to do that particularly if we are talking months to live (which from the description of your mother she does). In the days to hours before death it really doesn’t have much of a benefit even for comfort.
Hope this helps make your decision. Blessings to you and your mother. Barbara

Mary Griffin - June 05 2019

95 year old mother. advanced dementia, otherwise very healthy.
Expressed wishes not to prolong life, DNR, has experienced a full life, ready to go.
Hospice recommended nasal oxygen therapy because low stats.
Only medicine currently prescribed is risperidone.
Is the oxygen prolonging life?

Barbara - September 20 2018

Hi Lori, to answer your question I do not think oxygen is prolonging your mother’s life. I agree with your hospice nurse oxygen is a comfort measure. Blessings to you and your family. Barbara

LORI A PAAPE - September 20 2018

Hello my Mom is 82 and has Alzheimer’s, she has been going down hill for the last month I am her POA and she has a active DNR we have Hospice working with us and I would like to know as her POA knowing that she wanted nothing to keep her alive , is the oxygen prolonging her life or not hospice says it’s only for comfort I am second guessing it all the time.

Barbara - August 21 2018

Hi Jennifer, I do not have enough medical information about your grandmother to know about the cause of her “trouble breathing”. I would suggest you call her doctor and ask your questions. Ask “Why is she having trouble breathing and what can we do about it”. Is she on hospice? If not also ask if she is appropriate for hospice care. With a hospice referral you will have some support and guidance as you care for your grandmother. Blessings! Barbara

Jennifer - August 21 2018

My grandmother said she is having trouble breathing. Ismorphine for that. We had to give it to her twice.

Cyoa - June 05 2018

Thank you for writing this.

Martha - April 19 2018

You have given a beautiful and compassionate explanation of part of the dying process. What comfort this brings to many. Thank you very much.

Barbara Karnes - March 02 2018

Hi Diana, hospices often differ in their use of oxygen and morphine. There are federal guidelines to follow but there is a bit of interpretive leeway when we address “comfort measures.” The bigger issue here is will her physician sign the hospice paper stating a six month prognosis.
I have no problem trying oxygen although am not sure it will actually help. Her body is wearing out. I know you want to keep her as comfortable as possible but SOB on activity may not be something you can fix for her. A little bit of morphine for the SOB, it may help or not. Can’t hurt to try and see.
Thank you for reaching out to me. I will keep you and your aunt in my thoughts. Blessings! Barbara

Diana Jaycox - March 02 2018

I have an 90 year old aunt I am caring for who has CHFand ERSD as part of her chronic complications of Type 2 DM. She has opted to not have dialysis and to seek only comfort care. However, she is bothered by severe SOB with any exertion. Her O2 sats remain above 94% and she does not meet Medicare guidelines for O2 use. I am trying to help her deal with the frustration of taking longer to do simple tasks due to need for energy conservation. As a RN I understand her SOB is related to her chronic anemia and fluid overload. I understand that oxygen may not really help. My question is if she was a hospice patient, could I get her oxygen as a comfort measure as well,, as anxiety and morphine for comfort, as her current MD States she does not meet Medicare guidelines for these now.

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