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Oxygen care may not be best at home

25 September, 2012

Despite widespread community beliefs, home oxygen is not always the best treatment for people in the final stages of lung or heart disease or cancer, Flinders University palliative care specialist Dr Katrina Breaden said.

Dr Breaden, a senior lecturer in the discipline of Palliative and Supportive Services, is undertaking a new study to explore caregivers’ expectations about the use of home oxygen for the long-term treatment of refractory breathlessness, with the wider aim of helping carers understand the limitations of such therapy.
 
Funded through a $15,000 Early Career Researcher Grant from the Faculty of Health Sciences, the project will ultimately result in an online education resource for caregivers.
 
Dr Breaden said the study would target carers who were not receiving publicly-funded oxygen.
 
"The clinical aim of funded oxygen is to prolong life by months or even years, whereas in the cohort in this research oxygen is generally given to relieve the sensation of breathlessness with no expectation that life expectancy will change," Dr Breaden, who is based at the Repatriation General Hospital, said.
 
"Therefore, the caregiver’s concerns in this cohort are likely to be substantially different," she said.
 
Dr Breaden said contrary to widespread community beliefs – largely influenced by mass media – home oxygen was quite "burdensome" on both the carer and patient.
 
"The overwhelming community experience with oxygen is that it works because as soon as the oxygen mask goes on the patient appears to feel better but it could just be the air flowing over their face, not necessarily the oxygen itself that makes the difference," Dr Breaden said.
 
"For carers it can be very distressing to watch their loved one gasping for air and if they go into hospital it is usually the first thing the doctors or nurses put on.
 
"Family members see the benefit of this intervention in the short term and frequently put pressure on health providers to install oxygen concentrators in the home.

"But there are many significant limitations with home oxygen, including the risk of falls created by the tubing, the high electricity costs to run the concentrator and there’s a social burden as well because it can be quite isolating for the person concerned."
 
Dr Breaden said the online educational toolkit would include information for carers on alternative treatment options that could be explored before home oxygen was initiated, including simple hand-held fans, relaxation techniques and medications.
 
"While it’s perceived in the community as the best thing, oxygen is not without its limitations so if we can help caregivers to understand the benefits and risks they might not be so insistent that’s it’s the most beneficial course of treatment for their loved one," she said.
 
"Often once carers have that information they usually feel better and aren’t so insistent on oxygen."

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Coralie Brannelly | Wednesday, September 26, 2012, 11:07 AM
your article is so valid. i am a respiratory nurse and many clients and families belive that the oxygen will improve their overall health and extend thier life. When the Shortness of Breath is not improved they do become extreamly distressed. It is important to reinforce at each visit that oxygen will not prolong life but will help with improving the quality of life it will also not stop shortness of breath.
Allan F Ellis | Friday, September 28, 2012, 8:48 PM
As carer for my partner who passed 2012, she had both oxygen in home and portable to go out, the concentrator in home was able to cope with enough tubing to even allow access to yard etc, we were lucky the WA Govt, contributes annually towards the cost of electricity, even though it was not ideal, both sources gave my partners the choice to be able to move around. In the end neither machice or even even hospital oxygen was enough, but we with home care resources manage and my partner was able to be at peace in her home with her family, oxygen, medication and dedication of Silver Chain as pain free as possible for all this I am grateful