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.

18 comments

Barbara

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

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

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

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

Cyoa

Thank you for writing this.

1 2 3 4

Leave a comment

Please note, comments must be approved before they are published