End Stage of COPD

  1. Overview

    • With 12 million diagnosed cases and estimates of another 12 million undiagnosed, chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States, according to the National Heart Lung and Blood Institute (NHLBI). COPD claims more than 120,000 lives per year and "causes serious, long-term disability." A 2004 survey of U.S. nursing homes revealed 13% of the patient population suffered from COPD.

    • COPD is an umbrella term that includes those suffering with emphysema, chronic asthma and bronchitis. The alveoli (the tiny air sacs responsible for gas exchange in the lungs) become misshapen and unable to work properly. Breathing becomes more difficult as the disease progresses.

    • Respiratory and drug therapy can help deliver some relief to the patient, but COPD is not reversible. Prevent acute episodes by avoiding contaminated air, such as smog or smoke from wildfires. Stay indoors when poor air quality warnings are in effect or protect your nose and mouth with a mask if you must go outside. Stay in touch with your doctor and follow instructions. Get a flu shot to help reduce the possibility of compromising your system with influenza. Discuss pneumonia vaccine with your doctor.

    • Relax as much as possible. Tightened muscles increase breathing difficulties. Practice deep breathing techniques as directed by medical practitioners.

      End stage COPD sufferers suffer a decreased quality of life. Diminished airflow limits their activities. Episodes of shortness of breath (dyspnoea) can result in frequent trips to the emergency room and hospitalization. Undesired weight loss occurs when diminished appetite overrules the increased caloric needs of breathing problems.

    • "As with most COPD patients who have more than mild disease, management is more effective when pharmacological and nonpharmacological approaches are combined," according to Ambrosino and Goldstein in the European Respiratory Journal. Utilize self-help groups in addition to medical avenues; take control of treatment by staying informed and involved.

    • Depression is a natural outcome of the rigors of end-stage COPD. Discuss such feelings with health care providers. Help is available. Patients may require in-home oxygen as lung capacity declines. Inhalers or nebulizers can ease tightened lungs and provide temporary relief. For a very few patients, a lung transplant may be a possibility. End-stage COPD can continue for several years if there are no other complicating factors. The gradual fading of the patient is a slow process.

    • Make health care providers and family members aware of end-of-life wishes before the time comes. Choose the protocols that are acceptable and advise loved ones as to those choices. Place an Advanced Directive in the hands of those who will be making decisions on your behalf.

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References

  • Photo Credit Clarite/Morguefile.com

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