Tips For Managing End
As the family caregiver, you have a very special role in managing the end-stage symptoms and signs of your loved ones COPD. One of the most important things that you should be doing is remaining in communication with their doctors, nurses, and healthcare professionals. Its important to keep the physicians informed of the patients symptoms, as well as administering medicine if need be. Additionally, you can help ease your loved ones anxiety by talking with them, watching their favorite movies with them, or some other activity that will help keep their spirits up.
Try not to get frustrated or upset with them if they forget to take their medicine, or try to perform an activity on their own that youve told them not to do. We know how trying and stressful this time is for you, and it can seem like your loved one is actively trying to make it harder. But accepting their mistakes, their confusion, even their anger is all part of being a caregiver.
Also consider palliative care. Separate from hospice care, which is for someone no longer pursuing curative treatment, palliative care can be administered at any time, and actively treats the pain, discomfort, and other symptoms of COPD, to make life better.
Recognizing Serious Copd Complications
What is chronic obstructive pulmonary disease?
Chronic obstructive pulmonary disease refers to a collection of lung diseases that can lead to blocked airways. This can make it hard to breathe and cause coughing, wheezing, and mucus production.
People with COPD can often develop other conditions and diseases related to COPD.
For those living with COPD, every breath can be difficult. People with COPD can be at risk for serious complications that can not only put their health in jeopardy, but also be fatal. Here are a few of those complications, along with some tips for preventing them.
Pneumonia occurs when germs like bacteria or viruses enter the lungs, creating an infection.
According to the Centers for Disease Control and Prevention , common viral causes of pneumonia are the influenza virus, which causes the flu, and respiratory syncytial virus . The CDC also notes that a common cause of bacterial pneumonia is Streptococcus pneumoniae.
Pneumonia is ranked evenly with influenza as the eighth leading cause of death in the country. The illness is especially dangerous for those with a weakened pulmonary system, such as those who have COPD. For these people, it can cause further inflammatory damage in the lungs.
This can lead to a chain reaction of illnesses that can weaken the lungs even further and lead to a rapid deterioration of health in people with COPD.
If You Think You Have Heart Failure
Because the symptoms of heart disease and heart failure frequently overlap with symptoms of COPD, it’s important that you pay close attention to your body and report any of the following findings to your healthcare provider:
- Chest pain or discomfort
- Fatigue, lethargy, or daytime sleepiness
- Dyspnea, orthopnea, or paroxysmal nocturnal dyspnea
- Swelling in the lower extremities
Just like COPD, early diagnosis of heart disease or heart failure is important. The earlier you’re diagnosed, the earlier you can seek treatment.
Untreated heart problems can worsen your COPD symptoms and your overall prognosis. In fact, people with both conditions often fare worse, having longer hospital stays and a higher mortality rate than people who have COPD or heart problems alone.
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Social And Community Care
The numbers receiving financial help due to their illness were similar . A higher proportion of patients with COPD than with NSCLC felt that the financial support received came late in their illness and was delayed from when they had first become eligible . Similar proportions of respondents in both groups had aids and appliances to help cope with their illness .
Proportion of each group receiving various aids and appliances.
Although for most aids and appliances patients with COPD received more than those with NSCLC, just over half of the COPD respondents received an Orange Badge , 16% had a chairlift , 34% received bath aids, and only one patient had bed aids. These figures should be set against the fact that most of the patients with COPD were housebound and nearly a third were chairbound. Furthermore, more of the patients with COPD than with lung cancer felt that they could benefit from a better provision of aids and appliances. Finally, 72% of patients with COPD and 52% of those with NSCLC reported a lack of information regarding the possible social benefits and services they could receive. This often resulted in delay in receiving the support to which the patient was entitled.
Proportion of each group receiving various community care services. RSN = respiratory support nurse SW = social worker.
Follow Your Treatment Plan
Both COPD and CHF are serious chronic conditions that can affect your breathing and your quality of life. They are similar in terms of symptoms and outlook, and many patients do suffer from both conditions. While they can occur independently, it’s important to understand how they are connected too.
Your best bet if you have both COPD and CHF is to follow your treatment plans to the best of your ability, practice a healthy lifestyle, and keep in close contact with your health care team. All of those things can help prevent exacerbations. Plus, take action right away if you start to notice your symptoms worsening at all or if new symptoms arise. That can help flare-ups from spiraling out of control.
Copd And Chf Often Occur Together
Experts are not entirely sure exactly why people with COPD can also have heart failure. But as mentioned earlier, the lung damage from COPD does place extra stress on the heart. In the end, both conditions result in respiratory symptoms. When they occur together, studies show that the risk of negative outcomes is much increased4
What Are The 6 Criteria For Hospice Care For A Patient With Copd
Approximately 16 million Americans have COPD , and millions more have it but have not yet been diagnosed.
If you or a loved one has COPD, you may be wondering about the hospice guidelines for COPD and when hospice care is necessary.
Weve got the answers along with more information about the stages of COPD and what it means to have hospice care.
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Early Diagnosis Can Make A Difference
An early diagnosis can also greatly improve your life expectancy. “Probably half the people with COPD had the disease for a number of years before they were diagnosed,” Rizzo says. “They didn’t bring it to the attention of their physician because they thought the cough and the shortness of breath were related to being overweight, out of shape, and still smoking.”
Also, doctors have to diagnose COPD correctly by ordering the right tests, he says.
Rizzo also points to studies under way figure out why some people are more likely to get COPD than others. A study started this year by the National Institutes of Health and supported by the American Lung Association will look at lung function in 25-35-year-olds and figure out what changes over the course of their lifetime. âWe want to notice when an individual develops findings of COPD, what may have led to it, and what we can learn from that to improve survival,” he says.
For Advice On How To Have These Discussions Visit End
Finally, one of the most important things that family and friends can do is to simply be there for their loved one. Sit with them and share memories. Listen to anything they want to tell you. Hold their hand, play music, or read to themwhatever brings comfort. If you cant be there in person, call or video chat. Your time and attention are priceless gifts to those with COPD at the end of life.
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Support Them To Make Decisions About Treatments
As well as having an advance care plan, patients should be given the chance to discuss the following issues:
- Whether to deactivate an implantable cardioverter defibrillator , if they have one. This can prevent the ICD activating at the end of life, which can be distressing.
- What the patient would want to happen if they had a cardiac arrest. They may decide they do not want to have cardiopulmonary resuscitation .
- When to stop medication that no longer reduces symptoms or improves their quality of life. This can be a difficult conversation and it’s best carried out sooner rather than later. Make sure the patient and the people important to them understand what changes are being made to their medication and why.
Both Are Chronic And Have Periodic Flare
Each of these conditions is chronic and cannot be cured. But you can have periods of relative stability when symptoms are not too bothersome. At times, though, the symptoms can worsen or flare-up. This is called an exacerbation.
The difference is what causes these exacerbations. With COPD, triggers are often environmentally-related:
- Exposure to germs that cause respiratory infections
- Breathing in cold dry air
- Exposure to air pollution
- Inhaling strong fumes or smoke
With CHF, factors that cause flare-ups are often more related to lifestyle or other health issues.
- Eating the wrong foods, for example, too many salty foods
- Drinking too much water
- Having a heart attack or stroke
In both cases, exacerbations can also occur when medications are not taken as prescribed.
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End Stage Heart And Lung Disease
Here at UT Health San Antonio, we treat all forms of end stage thoracic disease, including chronic obstructive pulmonary disease / emphysema, interstitial lung disease, idiopathic pulmonary fibrosis, congestive heart failure, cardiomyopathy, and pulmonary hypertension.
We were the first program in North America to perform a single lung transplant for COPD / emphysema when Dr. J. Kent Trinkle performed it in January 1988.
We were also the first program in the world to perform a lung transplant for pulmonary hypertension which Dr. Trinkle performed in 1989.
If you would like to know more about our Lung Transplant Center, including the program, the team, patient education, referral criteria, and more, please
Current State Of Acp Our Recommendations And Future Directions
Despite the varied reviews that have addressed the importance of ACP and its barriers, there are few updated studies on how ACP can improve outcomes in patients and provider-patient relationships.
Patients with COPD are an often overlooked population that would benefit from ACP conversations. Several factors, which include communication skills, use of multidisciplinary teams, and the lack of a trigger for early discussions, seem to contribute to the lack of system implementation. Although
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Prevalence And Prognosis Of Heart Failure And Chronic Obstructive Pulmonary Disease
The prevalence of GOLD stage II or higher COPD is 510% of adults. One-year mortality in the community is relatively low , but higher following hospitalization ., Future projections have wide uncertainty intervals, depending on statistical methodology, estimates of prevalence, and associated mortality. Nevertheless, the Global Burden of Disease study anticipates COPD to become the third leading cause of death globally by 2020.
Heart failure is less common, affecting 13% of the general population, but carries a worse prognosis. Annual mortality in stable community patients approximates 57%, while median survival following hospitalization remains just 2 years. Approximately half of patients have HF with preserved ejection fraction and half left-ventricular systolic dysfunction . The prevalence of the latter is thus around 1% of the general population.
Read About The Benefits Of Hospice Care At Home
Various treatments can help control symptoms and enhance comfort for people with COPD at the end of life. These therapies can be given by hospice as well as non-hospice providers:
- Inhaled medication to relieve shortness of breath during regular activities
- Medications to reduce airway inflammation and breathlessness
- Education and exercise for pulmonary rehabilitation
- Nutritional counseling
- Relaxation techniques
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Prepare For The Weather
In addition to taking these steps, you should avoid or minimize known COPD triggers. For example, you may have greater difficulty breathing during extreme weather conditions, such as high heat and humidity or cold, dry temperatures.
Although you cant change the weather, you can be prepared by limiting the time you spend outdoors during temperature extremes. Other steps you can take include the following:
- Always keeping an emergency inhaler with you but not in your car. Many inhalers operate most effectively when kept at room temperature.
- Wearing a scarf or mask when going outside in cold temperatures can help warm the air you breathe in.
- Avoid going outdoors on days when the air quality is poor and smog and pollution levels are high. You can check the quality of the air around you here.
What Is Heart Failure
Heart failure, a chronic condition in which the heart pumps inefficiently over a long period of time, often leads to a host of related symptoms and complications. Similar to COPD, people with heart failure can be relatively stable, or they can experience exacerbations of heart failurewhen the heart doesn’t function properly and symptoms worsen.
Heart failure is among the most prevalent of all heart conditions, occurring when the heart is no longer able to pump an adequate supply of blood to the cells, tissues, and organs of your body. There are many heart conditions that can lead to heart failure, including coronary artery disease and valvular heart disease.
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Should Patients With Chronic Obstructive Pulmonary Disease Be Screened For Heart Failure
Asymptomatic LVSD fulfils the WilsonJunger criteria for successful screening: the condition is medically important and clearly defined, with effective treatment, an established natural history and early asymptomatic stage, detectable by an acceptable and safe, valid and reliable test applicable to the target population, resulting in cost-effective screening for which adequate resources exist. The predictive value of screening is critically dependent on disease prevalence. The high prevalence of LVSD in patients with COPD thus favours success. Sequential peptide testing and then echocardiography may counter the inherent limitations of peptides or echocardiography alone in pulmonary disease. Robust randomized trials are required to determine the efficacy and cost-effectiveness of such screening. Such a trial is currently being planned.
Signs And Symptoms Of End
End-stage COPD is marked by severe shortness of breath , even when at rest. At this stage, medications typically dont work as well as they had in the past. Everyday tasks will leave you more breathless.
Pulmonary hypertension is also common in end-stage COPD, which can lead to right-sided heart failure. You may experience an accelerated resting heart rate of more than 100 beats per minute. Another symptom of end-stage COPD is ongoing weight loss.
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What Are The Symptoms
Some are easy to confuse with normal aging or other diseases. The more advanced your heart failure, the more likely you are to have many symptoms, or the changes that youâve noticed in yourself will worsen.
These are common ways that heart failure can affect you:
Shortness of breath. Heart failure can make it hard to breathe when you walk up a flight of stairs. With advanced heart failure, you may get winded in a shorter period of time, or you may have trouble even when youâre sitting still.
Sleep problems. Heart failure can make it hard to breathe or catch your breath when you lie in bed. You may have trouble nodding off to sleep, or you might wake up in the middle of the night gasping for air. Try sleeping while propped up on two or more pillows instead of lying flat. Advanced heart failure makes it even more likely youâll have trouble breathing when youâre at rest. That means your bedtime problems will probably get worse, too.
Coughing. You may already have a dry cough that acts up when youâre lying in bed. You might cough often during the day, and your phlegm could have a slight pink tint to it. That means thereâs a bit of blood in the gunk youâre coughing up. Advanced heart failure can make that cough worse, especially when youâre lying down.
Fatigue. Heart failure can make you feel worn out. Things that wouldnât have tired you out in the past suddenly do. Youâre more likely to feel tired all of the time with advanced heart failure.
Prognosis Of Concurrent Heart Failure And Chronic Obstructive Pulmonary Disease
Concurrent COPD independently predicts mortality in patients with reduced and preserved ejection fraction ,, even following adjustment for beta-blocker utilization. Furthermore, greater airflow obstruction is associated with worsening survival.,, In those studies with sufficient sample size to examine the cause of death, excess non-cardiovascular death predominated., However, a clinical diagnosis of COPD was also associated with sudden death in the Valsartan in Acute Myocardial Infarction Trial.
A single study has examined the prognostic implications of concurrent HF in patients with COPD. Following extensive investigations including echocardiography and pulmonary function tests, 83 of 405 elderly community patients with COPD were diagnosed with HF . Patients with HF had double the mortality of those without HF over a mean follow-up of 4.2 years .