The occupational therapist will evaluate the person in your care's ability to perform activities of daily living, the therapist will consider not only the things the care receiver must be able to do but also things he would like to be able to do.

As part of the evaluation, the care recipient will perform a task such as bed-making or washing the hands and face and brushing the teeth. The therapist will look to see how much effort is needed by the care recipient to perform the tasks and if he becomes short of breath. The therapist will also monitor the heart rate, breathing rate, and oxygen saturation (amount of oxygen in the blood) of the person in your care. The therapist will also be looking for ineffective breathing patterns.

Some ineffective breathing patterns are--

• holding breath during activity
• forcing the exhalation
• short gasping breaths
• raising the shoulders or throwing back the head to take in a breath

Coordinate Breathing with Exercise

For our bodies to perform strenuous activity most easily, it is important to coordinate breathing and moving. For those who have trouble breathing, this coordination can be difficult but will become easier with practice. Put simply, one should exhale when doing the more strenuous part of the activity. For example, to climb stairs, take a breath before lifting the foot, then exhale as the leg is lifted. Breathe again, then exhale as the next stair is climbed. Take vacuuming as another example: Exhale as the vacuum is pushed, inhale as the vacuum is pulled back. Or, if getting our of bed, exhale as the body is raised up. If the person in your care becomes short of breath while performing any of these activities, have the person stop and then slowly breathe in and out.

Diaphragmatic and Pursed-Lip Breathing

Diaphragmatic breathing, also known as belly breathing, helps a person to relax and get more air out of the lungs. Have the person in your care practice this breathing technique by sitting in a comfortable chair or lying down. Have her put one hand on her abdomen and one hand on her chest. As she breathes in, have her notice how the abdominal muscles relax and then as she exhales, tell her to tighten the abdominal muscles to help push air out. The chest should not move. The exhalation (breathing out) should always take longer than the inhalation (breathing in). It is very important that the person in your care do these exercises while calm and relaxed so she will be able to get into the habit of breathing this way.

Diaphragmatic or belly breathing

Pursed-lip breathing helps to keep the breathing tubes open during exhalation and to improve the ability to slowly get more air out of the lungs. This type of breathing is used mainly for people with COPD. To practice, this technique, have the person in your care take a breath in through the nose and slowly let the breath out through pursed lips (as if she was whistling). Pursed lip breathing and belly breathing are done together.

Huff coughing is a special technique used to help with mucus clearance. It is done along with diaphragmatic and pursed-lip breathing. Ask the therapist to show you how to do this technique. Pulmonary rehabilitation (rehab for lung issues) uses both occupational and physical therapy, as well as other members of the health care team, to improve the physical and emotional well-being of the person in your care so as to help him return to his highest possible level of activity.