Morphine, concommitant with monitoring of respiratory status with pulse oximetry readings, relieve both pulmonary
congestion and anxiety.
When pulse oximetry readings and heart rate begin to deteriorate significantly, a significant other should be consulted as to whether comfort or extended life are most important with regard as to whether additional morphine is to be given (as morphine causes both heart rate to decrease and respirations depth and frequency to decline).
Along with morphine, atrophine can be given to relieve congestion. However, atrophine can result in increased heart rate.
Thus, it is probably, in general, a good idea to alternate morphine with atropine to ameliorate the above side affects of both which counter act each other.
Low blood sugar levels and dehydration are often present with the dying patient with COPD.
Thus, ensure and water should be given via straws or some other mechanism that minimizes the possibility of choking.
By raising the patients blood sugar level and addressing dehydration, the patient may be able to sleep.
Both dehydration and low blood sugar levels can cause that distress which keeps a patient awake.
The best end for a patient with COPD is to fall asleep and go into a coma during and before that period of the severe physical deterioration that immediately proceeds death.
By doing the above, the suffering of the patient can be ameliorated considerably.
However, the dying COPD patient can not expect the slow peaceful death that patients without chronic respiratory disease, especially the very elderly, often experience.