Use of Oxygen at the End of Life: Attitudes, Beliefs, and Practices in Wisconsin

Oxygen therapy for the management of breathlessness remains controversial and little information is available regarding the practice of using oxygen at end of life. Oxygen use in end-of-life care is increasingly being questioned, while the use of oxygen for routine "comfort care" at end of life continues. The purpose of this study was to investigate the use of oxygen at the end of life and to understand its role in contemporary palliative care practice. The project involved a survey to learn about medical facility practices regarding the use of oxygen at the end of life and attitudes and beliefs regarding these practices, specifically the opinion of whether or not oxygen prolongs the dying process at the end of life. Questionnaires were mailed to 42 directors, coordinators, or managers of palliative care services in hospitals throughout Wisconsin. Twenty-five surveys were returned for a response rate of 59.5%. Forty-three percent of respondents believed that oxygen use at the very end of life affects the timeline of natural death by prolonging the dying process. Ninety-six percent of the respondents' facilities had a standard "comfort care" protocol for end-of-life patients that offered oxygen, regardless of whether patients had breathlessness or not. Respondents cited reasons that staff might use oxygen for these patients: patient comfort, family request, emotional comfort of family, prolongation of life when that was a patient goal, emotional comfort of staff. Respondents also cited reasons that staff might not use oxygen for these patients: oxygen did not seem to bring comfort, oxygen was an irritant to patient, prolongation of natural death was not a patient/family goal, oxygen use did not add to the emotional comfort of patient/family/staff. Current practice on oxygen use in palliative care was identified and the information helps to determine how decisions are made regarding oxygen use. The research adds to palliative care practice knowledge and supports continuing research and dialogue on practice issues.