Like pain, dyspnea often goes unrecorded and untreated. Programs that care for the dying need to make the assessment of dyspnea a routine part of patient care. Assess dyspnea by asking patients:
Some dying patients are unable to report distress because of changes in consciousness from either acute or chronic illness. In these patients, dyspnea may be untreated because it is not recognized. However, a number of behaviors signal distress, such as:
To improve management for patients with dyspnea, the team from Hospice Care of Rhode Island wrote guidelines and standing orders.
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This online version of the book Improving Care for the End of Life: A Sourcebook for Health Care Managers and Clinicians is provided with permission of Americans for Better Care of the Dying [ www.abcd-caring.org ] and Oxford University Press. All rights reserved.
For further information on quality improvement in end-of-life care visit The Palliative Care Policy Center [ www.medicaring.org ].