Breathing exercises to improve lung function in older people

Improving lung function in older people through breathing exercises.

Lung function is an important element to consider when looking after an older adult, particularly if they suffer from a health condition that could impact breathing. Here, we are breaking down what caregivers need to know about lung function, why it could be a concern for older people, what can be done to help, breathing exercises to improve lung function, other methods of breathing support, when to seek medical help for breathing issues, and how a home carer can help monitor and support breathing in older adults. At Home Instead, our aim is to help people age positively and in place by bringing expert care to their home. For nearly 20 years, we have been providing the highest standard of care, and creating industry-leading training programmes for our Care Professionals that are accredited by nursing and medical professionals. Today, we are the world’s largest global domiciliary care network, supporting over 100,000 older adults with personalised, tailored care at home. So whatever questions you have about breathing monitoring and support, we can help. 

Why might lung function be a concern for older people?

For older adults, maintaining optimal lung function becomes even more critical. The ageing process often leads to natural declines in certain bodily functions due to general wear and tear over many years, and lung capacity is one of those functions. This could mean changes to the bones and muscles in the chest and spine, lung tissue, nervous system, immune system, and more. As a result, older adults may have less lung elasticity, reduced mobility as a result of breathlessness, and are more susceptible to respiratory infections and complications. According to NHS data, respiratory disease affects 1 in 5 people and is the third most common cause of death in England after cancer and cardiovascular disease. Conditions like lung cancer, pneumonia and chronic obstructive pulmonary disease (COPD) are some of the most common lung-related conditions that can negatively impact the life of an older person. In fact, with a reduced ability to fully expand and contract the lungs, an older individual may be receiving less oxygen. Studies have found that reduced lung function is associated with overall mortality, so preserving this in older people can help to promote longevity, encourage independence and improve quality of life, making the measurement and management of lung function highly beneficial for this age group. 

What breathing exercises can be effective? 

There are a number of benefits to breathing exercises, including reduced stress and anxiety, reduced blood pressure, improved sleep, and of course increased lung capacity and oxygenation. Studies even show the positive effects that have been found on using Inspiratory Muscle Training (a type of resistance training designed to strengthen breathing muscles) to improve inspiratory muscle performance in older people. Without regular breathing exercises, older individuals may start to notice things like a stiff feeling in the ribcage, muscle weakness around the lungs and shallow breaths, leading to a poor oxygen supply. Here are a few breathing exercises that could be effective for improving lung function in older people:

Deep Breathing

Perhaps the easiest exercise to start with is to inhale deeply through the nose, filling the lungs with air as much as comfortably possible, then exhale slowly to release. Repeat this between 2 and 3 times daily and aim for 5-10 minutes of this per session. 

Diaphragmatic Breathing

Otherwise known as Belly Breathing, this exercise requires inhaling deeply through the nose and allowing the abdomen to rise, then exhaling slowly through pursed lips while the abdomen falls back to the starting position. Older people can set aside around 5-10 minutes each day to try this, and gradually increase duration. It can also help to lie down for this exercise if possible.  

Pursed Lip Breathing

Start by inhaling through the nose, then exhaling slowly through pursed lips as if blowing out a candle. This type of breathing helps to keep the airways open for longer and reduces shortness of breath. It can be done around 4-5 times a day, taking around 10-15 breaths per session. Doing this during activities that tend to cause shortness of breath can help to reduce this sensation.

Alternate Nostril Breathing

Often used in yoga practice for relaxation, this can also help to control breathing. Use a finger to push one nostril closed and inhale deeply through the other. With lungs full, switch the finger to the other nostril and exhale. Repeat this for several breaths for around 5-10 minutes each day, and try to focus on smooth, controlled breaths.

Complete Breathing

For this exercise, breathing can be considered in 3 parts. First, breathe in slowly, focusing on expanding the stomach. Once this feels full, expand again to inhale into the ribcage. Lastly, exhale and engage the core muscles to release all air from the lungs. By regularly practising these exercises, older adults can continue to maintain their current lung function or improve it, but always speak to your nurse or GP before starting a routine like this to ensure you are doing suitable exercises for you, particularly if you suffer from a respiratory condition. Also, if you require surgery for any reason, sometimes Inspiratory Muscle Training may be recommended for a few weeks after the surgery to help keep your lungs healthy. This exercise requires a resistance device that helps to strengthen the inhalation muscles used to breathe in, improving respiratory muscle strength and endurance as a result. Medical professionals visiting the home may be able to provide this device during visits, so speak to them about this option. It can be used for 2-3 sets of around 10-15 breaths up to 2-3 times a day.

What breathing support options are there for older adults? 

Breathlessness is thought to be an issue for around 9-11% of the general population (with varying levels of severity recorded), however this increases with age, and is thought to be around 25% in people over 70 years old. The reasons for this include conditions like:

• Heart failure
• Angina
• Valvular heart disease
• Cardiac arrhythmias
• Chronic obstructive pulmonary disease (COPD)
• Asthma
• Lung cancer
• Pulmonary vascular disease
• Anxiety
• Depression
• Obesity

While breathing exercises can help to improve lung function in some of the above conditions, often older people will rely on other interventions alongside this, or instead of. Various devices and techniques can be tailored to the respiratory needs of older individuals, and there are a number of options for breathing support, including: 

Ventilation

The word ‘ventilation’ in a healthcare context tends to suggest that a person would be unconscious and rely solely on a device to breathe, however non-invasive ventilation (NIV)devices can help to deliver controlled air pressure to aid breathing without the person relying on only this. A common example of a non-invasive ventilation device is a CPAP machine (Continuous Positive Airway Pressure) which is often used for conditions like sleep apnoea, motor neuron disease (MND), and multiple sclerosis (MS). 

Oxygen Therapy

Oxygen therapy is another intervention for those who cannot gain enough oxygen on their own through breathing. This method delivers supplemental oxygen through nasal cannulas, oxygen masks or a portable oxygen concentrator to ensure adequate oxygen levels in the bloodstream. These interventions require assessment and consultation with a healthcare professional, but can be arranged for use within an older person’s own home if needed for breathing support, as well as having a fully trained Care Professional visit the home to provide assistance with breathing monitoring and other respiratory needs.

How do you know if breathing is not sufficient?

For older people and their caregivers, it is important to recognise when breathing may be insufficient, as this can mean not enough vital oxygen is being brought into the body. Understanding this involves paying close attention to subtle cues and symptoms. You should seek the advice of a GP if you notice:

• Shortness of breath (known as dyspnoea)
• A feeling of not being able to get enough air, or finding it difficult to breathe 
• Rapid breathing
• Shallow breaths
• Difficulty breathing when at rest 
• Difficulty breathing along with swollen ankles 
• A bluish tint to the lips or fingertips 
• Wheezing
• Frequent coughing (for 3 weeks or more) 

If you are caring for an older adult, monitoring their respiratory rate is an important part of vital sign monitoring, and you can learn more about this in our guide to monitoring and vital signs ranges for older adults.You can do this by observing chest movements and assessing their overall comfort during breathing. If you notice any persistent or worsening breathing difficulties, it is always best to seek a medical evaluation to help identify the underlying causes and ensure their health is not being affected. Remember, you should call 999 or go to hospital if your loved one experiences severe difficulties breathing (gasping or choking), chest pain, pain that spreads to the arms, back, neck and jaw, blue or pale skin, or sudden confusion. 

How can a home carer help to monitor breathing?

If breathing is becoming a problem for your loved one, you may feel worried about effectively monitoring any changes and ensuring health is not compromised by a lack of sufficient oxygen intake. One way to put your mind at ease and monitor breathing is to enlist the help of a trained home care worker. Home care workers can monitor breathing, note any changes or signs of distress, support an older person in performing regular and consistent breathing exercises to increase lung function, and help with non-invasive ventilation procedures if necessary. Ventilator care at home allows older individuals to benefit from non-invasive ventilation in the comfort of their own home. At Home Instead, our Care Professionals are trained to the highest clinical standards and can work alongside an older person’s own doctors and health teams to support their breathing needs. Whether you require hourly care for a few hours a week, a couple of hours daily, or live-in care to support the needs of your loved one, we can help provide bespoke, person-centred care. Reach out to your local Home Instead team to discuss your needs and allow us to create a personalised package to support you. We’re an award-winning home care provider and part of a worldwide organisation devoted to providing the highest-quality relationship-led care for older people in their own homes. Arranging care for yourself or your loved one shouldn’t be stressful, so whatever questions you would like answered, feel free to reach out to the Home Instead team to discuss your needs.