When to Stop Giving Oxygen at End of Life: Who Does It Comfort?

There is research saying that administering oxygen as the end of life approaches doesn’t prolong life or even have any beneficial effects. Studies have shown that the physical body is so compromised due to decreased circulation and lung congestion that there is no effect. The body is shutting down, nothing works right, so it can’t process the oxygen that is being pushed into it.

When a loved one reaches the end of their life, comfort becomes a top priority. But when exploring oxygen use and when to stop giving oxygen, we need to ask why we are thinking about giving oxygen in the first place. Is it because the person looks like they are having difficulty breathing?

Well, as death approaches a person has difficulty breathing. There is congestion (depending upon how hydrated or dehydrated they are). There are the mouth movements that look labored, restless.

Often there are sounds as breath goes in and out of the mouth, which are a normal part of the dying process. It’s very difficult to see our loved one struggling. However, there comes a time when even oxygen therapy no longer provides comfort or has little impact on the patient’s quality of life. This can lead families to wonder: when is the right time to stop oxygen therapy? In this article, we’ll explore the factors to consider when making this decision, and how to ensure your loved one’s final days are spent in peace and comfort.

Who is Oxygen Really For at the End of Life?

You may approach oxygen therapy at end of life by telling yourself, what do we have to lose by administering oxygen as death approaches? It may bring a bit of support to the patient and will definitely comfort loved ones, but it often won’t ease the patient’s breathing challenges.

End-of-life work is not about just taking care of the patient. It is about caring for the family and significant others as well. Oxygen at the end of life can be considered a comfort measure for the family. In Barbara Karnes’ book, Gone From My Sight, I discuss using oxygen at the end of life, including special care for the mouth that is required when using oxygen.

Signs to Consider Stopping Oxygen Therapy

Deciding when to stop oxygen therapy at the end of life can be difficult, especially when families want to do everything possible to keep their loved one comfortable. While oxygen is often introduced to ease breathing and reduce discomfort, there may be signs that it is no longer effective or necessary. In these moments, it’s important to prioritize the patient’s comfort and recognize when oxygen therapy might not be offering the relief it once did.

Some signs that it may be time to consider discontinuing oxygen therapy include:

• Restlessness or Agitation: If the patient seems more restless or agitated while using oxygen, it could indicate discomfort or that the therapy is no longer improving their well-being.
• No Improvement in Breathing: In some cases, despite using oxygen, patients may continue to experience labored breathing without feeling significant relief. This can be a sign that the therapy is not providing the intended comfort.
• Declining Oxygen Saturation Levels: As the body naturally begins to shut down in the final stages of life, even high levels of supplemental oxygen may not improve oxygen saturation. When this happens, the focus should shift to other comfort measures.
• Increased Drowsiness or Unresponsiveness: Patients nearing the end of life often become less responsive or more drowsy. In these cases, oxygen may no longer be necessary or helpful as breathing becomes naturally more shallow.
• It’s important to keep in mind that these signs do not necessarily mean oxygen therapy should be stopped immediately. Instead, they can serve as indicators that it may be time to have a conversation with the care team about whether oxygen is still benefiting your loved one. The goal should always be to maintain comfort and dignity during this time.

Balancing Comfort and Medical Necessity

At the end of life, every decision centers around one goal: comfort. Oxygen therapy is often introduced to make breathing easier, but there may come a point when its role shifts. It’s essential to remember that oxygen at this stage is primarily aimed at providing comfort, not prolonging life. As a result, the decision to continue or stop oxygen therapy should always focus on what is most beneficial for the patient’s overall well-being.

For some patients, oxygen therapy may initially provide relief, helping them feel less breathless and more at ease. However, as their condition progresses, the medical necessity of oxygen often diminishes, and it may no longer have the same impact on comfort. In fact, sometimes, continuing oxygen can cause more distress than relief. For example, masks or tubes can feel restrictive, and constant adjustments can be uncomfortable for patients who are becoming less responsive.

Families often face the difficult question: is oxygen still helping, or is it causing more harm than good? In these moments, it’s important to consult with the care team, who can assess whether oxygen is still necessary based on the patient’s physical state and comfort levels. When oxygen therapy no longer serves its intended purpose, other methods—such as medications or repositioning—can help ease discomfort without the potential drawbacks of continuing oxygen use.
Ultimately, balancing medical necessity with comfort means focusing on what makes your loved one feel most at peace. Oxygen therapy is just one tool in end-of-life care, and there are many ways to ensure your loved one is comfortable and cared for in their final days.

Patient and Family Perspectives

Deciding when to stop oxygen therapy is a deeply personal and emotional choice for both patients and their families. For many, the thought of discontinuing oxygen may seem unsettling or even frightening, especially when it has been a key part of care for so long. However, understanding the patient’s wishes and focusing on what brings them comfort can help guide the decision-making process.

From the patient’s perspective, some may express a desire to stop oxygen therapy if they feel it no longer makes them comfortable. Others may not be able to communicate these feelings directly, but their body language—such as removing the mask or showing signs of discomfort—can provide important clues. At the end of life, honoring the patient’s dignity and comfort becomes the central focus, which may mean adjusting or discontinuing interventions like oxygen that are no longer helpful.

For families, this decision can be equally challenging. The desire to do everything possible to help a loved one is natural, but it’s important to remember that stopping oxygen therapy doesn’t mean giving up on care. Rather, it’s a step toward ensuring the patient’s final days are spent in peace, free from unnecessary interventions. Families can find comfort in knowing that other methods—like pain management, soothing the environment, or simply being present—can provide relief in more meaningful ways.

It can also be helpful to hear from others who have gone through similar experiences. Many families find that once they shifted focus away from medical interventions and toward emotional and physical comfort, they were able to create a more peaceful and meaningful end-of-life experience for their loved one. This change in perspective can provide a sense of relief and reassurance in an otherwise difficult time.

Above all, the decision to stop oxygen therapy is a shared one, made in consultation with healthcare providers and based on the patient’s needs and family’s support. While it’s never easy, focusing on comfort and quality of life helps ensure that every choice is made with love and compassion.

Learn More About End of Life Care with Barbara Karnes

Deciding when to stop oxygen therapy at the end of life is never easy, but it is an important step in ensuring your loved one’s comfort and dignity during their final days. By focusing on their needs and working closely with healthcare providers, families can make informed decisions that prioritize peace and well-being. Remember, the goal of end-of-life care is to provide comfort, not prolong suffering, and stopping oxygen therapy can sometimes be the most compassionate choice.
If you’re looking for more guidance on navigating the end-of-life journey, we recommend exploring the wealth of resources offered by Barbara Karnes, an expert in hospice and palliative care. Her educational courses provide invaluable insights into end-of-life care, helping families and caregivers feel more prepared and supported during these challenging times. Learn more about her courses and find the information you need to provide compassionate care for your loved one.

Additional End of Life Resources

• Let’s Talk Poop-Bowel Movements and End of Life Care
• End-Of-Life Expert Barbara Karnes Explains How to Handle Family Stress and Drama
• “People Don’t Die Like They Do In The Movies” Explains Barbara Karnes“