Give Them Comfort: Controlling COPD Symptoms at the End of Life
Posted May 01 2009 11:38pm
MORTALITY OF COPD IS INCREASING—COPD is the only leading cause of death that is increasing.
by Tim Nuccio and Paul Nuccio, RRT, FAARC
Patients’ last days of COPD can be characterized by depression, anxiety, pain, and dyspnea. Clinicians must be alert to patient discomfort and offer appropriate palliative care and reassurance
Considered as a long course of chronic disease that is characterized by repeated exacerbations and remissions, chronic obstructive pulmonary disease (COPD) indisputably leads to a clear and steady decline. For the purposes of this paper, focus will be given to the two diseases that are considered to be the hallmark of COPD: chronic bronchitis and emphysema. More specifically, this article will explore various methods for controlling the sometimes devastating symptoms associated with COPD toward the end of life.
When the patient gets to these “last days,” careful attention to symptom control can prevent, minimize, or eliminate distress, thus improving the quality of life until the time of death. In addition to exploring methods of reducing the suffering that is experienced by the patient, attention will also be directed at the importance of considering family members and loved ones during this difficult stage of the deadly disease. Since COPD is a progressive disease as opposed to a curable one, focusing our energies and resources on symptom control is the best way that we as health care providers can serve these patients.