Breathing exercises and pulmonary rehab — what actually helps

This article is for educational purposes only and does not constitute medical, legal, or financial advice. Every family situation is different, and you should consult with appropriate professionals about your specific circumstances.

Your parent is sitting in the kitchen looking tired. They just walked up the stairs and they're breathing harder than they should be. They say they're fine, they're just out of breath, it's normal. They're getting older, so of course they get out of breath more easily. It's not something you can do anything about.

Except there might be things that actually help. Not cures. Not magic. But real, measurable ways to maintain lung capacity and make breathing easier. The thing is, these things require your parent to actually do them, which means that first you have to help them understand why it's worth the effort.

Lung capacity naturally declines with age. Starting around age thirty and continuing throughout life, most people lose about one percent of their lung capacity per year. It's not fast enough that anyone notices year to year, but over a decade it starts to matter. Add in any lung disease like COPD, and the decline is steeper. Add in smoking history, and it's steeper still. For your parent, just sitting around and doing nothing means their lungs are getting a little weaker every year.

Breathing exercises don't reverse that decline. They can't. Once lung tissue is damaged by smoking or disease, it doesn't repair. What exercises can do is slow the decline. They can help your parent use the lung capacity they have more efficiently. They can teach the body to breathe in a way that reduces breathlessness. They can help with anxiety, because when people feel short of breath, they get anxious, and when they're anxious, they breathe more shallowly, which makes them feel more short of breath. Breaking that cycle helps.

Pursed Lip Breathing

This is the simplest breathing exercise, and it's the one that most people find immediately helpful.

Your parent breathes in through their nose, normally, for a count of two or three. Then they purse their lips like they're about to blow out candles on a birthday cake, and they exhale slowly through the pursed lips for a count of four or five or six, making the exhale longer than the inhale. That's it. Inhale through the nose, exhale through the pursed lips over a longer period of time.

Why this works is actually pretty clever. The resistance created by exhaling through pursed lips creates back-pressure in the airways. That back-pressure keeps the small airways open a little longer during exhalation, which means more carbon dioxide gets out and your parent doesn't feel as trapped or short of breath. It also naturally slows down the breathing rate, which is calming. Most people, when they're anxious or short of breath, breathe too fast and too shallowly. Pursed lip breathing forces a slower, deeper breath pattern.

Your parent should do this during normal activities, not just as a formal exercise. If they're walking and start feeling short of breath, they slow down and do pursed lip breathing. If they're climbing stairs and getting winded, they pause and do a few counts of pursed lip breathing before continuing. If they're feeling anxious and their breathing is getting rapid and shallow, pursed lip breathing can interrupt that pattern.

People often find that pursed lip breathing becomes almost automatic once they practice it for a few weeks. When they start feeling short of breath, their lips purse naturally and they're exhaling slower without having to think about it.

Diaphragmatic Breathing

This is a bit more involved but worth teaching because it's actually how most people should be breathing all the time.

The diaphragm is a muscle that sits below the lungs, and it's the primary muscle of breathing. It's supposed to do most of the work. But a lot of people, especially stressed or anxious people and people with poor posture, develop a breathing pattern where they use their shoulders and chest instead. They lift their shoulders when they inhale. Their chest moves but their belly doesn't. Their diaphragm isn't working the way it should.

Diaphragmatic breathing is retraining the body to use the diaphragm. Your parent starts by sitting or lying down in a position where they're comfortable. They put one hand on their chest and one hand on their belly. As they breathe in, the hand on the belly should rise more than the hand on the chest. That means the diaphragm is moving down and creating space for the lungs to fill. As they exhale, the belly hand falls.

At first, this feels weird. Your parent has probably been breathing with their chest and shoulders for decades, so breathing with the belly feels wrong. But with practice, it becomes natural.

The benefits are real. Diaphragmatic breathing is more efficient. It uses less effort to move more air. It's calming because the parasympathetic nervous system, the one that does the opposite of fight-or-flight, responds to slow, deep diaphragmatic breathing. Your parent might notice they're less anxious if they practice this regularly.

A good way to practice is to have your parent do it for five or ten minutes a day. They can do it first thing in the morning or before bed. They can practice it while watching television. The goal isn't to be perfect, it's to retrain the habit so that diaphragmatic breathing becomes their normal pattern instead of chest breathing.

When to Practice

Most of these exercises are most helpful if your parent does them regularly as a habit, not just when they're in crisis. If they practice pursed lip breathing and diaphragmatic breathing when they're well and calm, it becomes easier to access those skills when they're anxious or short of breath.

Some research suggests doing breathing exercises for five to ten minutes a day has benefits. Your parent doesn't have to do them all at once. Five minutes first thing in the morning and five minutes in the evening is fine.

Beyond that, breathing exercises are very helpful for anxiety. If your parent feels anxious, sometimes before they even realize they're becoming anxious, they can use pursed lip breathing or diaphragmatic breathing to interrupt the anxiety response. Slow, deep breathing signals to the nervous system that everything is okay, you don't need to be in fight-or-flight. Your heart rate comes down. Your breathing naturally slows. The anxiety decreases.

Before exertion, your parent can do some diaphragmatic breathing to warm up their breathing muscles, kind of like stretching before exercise. And if they feel short of breath during exertion, they slow down and use pursed lip breathing to help manage the breathlessness rather than pushing through and getting into panic.

The Limits

Here's the honest part. Breathing exercises help, but they're not a cure. If your parent has moderate to severe COPD, exercises won't make that go away. If they have a respiratory infection, exercises won't treat it. If they have significant anxiety disorder, exercises alone probably aren't enough.

Breathing exercises are one tool in a bigger toolkit. For your parent with early lung disease or just normal age-related lung changes, exercises can slow decline and improve quality of life. For your parent with significant disease, exercises can help them manage their symptoms and feel a bit less trapped. But they're not a substitute for medical treatment.

That said, the fact that they're simple, free, have essentially no side effects, and actually do help makes them worth doing. Your parent doesn't need any special equipment. They don't need to buy anything. They just need to remember to do them and actually do them, which is often the hardest part because they don't feel like they're doing much.

Teaching your parent these breathing exercises means you might need to be the reminder at first. "Did you do your breathing today?" might sound annoying to them, but it's how habits form. Do it with them. Practice diaphragmatic breathing together. Use pursed lip breathing when you're walking together and they get a little winded. Make it normal and regular. After a few weeks, it becomes habitual. Your parent finds they're naturally breathing from the diaphragm instead of the chest. They naturally purse their lips when they feel short of breath. The exercises work because they've been practiced enough to become automatic.

Your parent can't undo aging. They can't repair lungs damaged by smoking decades ago. But they can slow the decline. They can feel less short of breath. They can manage anxiety better. That's worth something. That's worth doing, even if it doesn't feel like much.

How To Help Your Elders is an educational resource. We do not provide medical, legal, or financial advice. The information in this article is general in nature and may not apply to your specific situation. If you are concerned about a loved one's cognitive health or safety, consult with their healthcare provider or contact your local Area Agency on Aging for guidance and support.