End stage COPD - page 3

by rachelgeorgina

33,633 Views | 24 Comments

I was wondering if anyone knew much about the management of end stage COPD (Chronic Obstructive Pulmonary Disease.) I understand that it's a progressive condition with no cure - the patient I'm thinking of is 87 with severe... Read More


  1. 0
    Nebulized morhine helps too.
  2. 1
    One new thought is to give the oxygen they need to provide them comfort. As a former respiratory therapist we were taught 'normal' people breathe to get rid of CO2. COPD patients breathe to get O2. Give them the O2 and they have no reason breathe. The old anoxic drive theory. This theory is no longer considered valid. Morphine and oxygen are clearly indicated in end-stage COPD.
    tewdles likes this.
  3. 0
    Lack of follow up care is something I used to see all the time on the wards. Hospitals just seem to want to shove patients out on the street because the ED is full and theres no beds etc.

    On the other thread I have recommended RDNS service. I found them great, although you may end up with out of pocket expenses it's better than anything the hospital can do...which believe me is not much. I'm guessing its the public system too.

    I would definitely write a letter of complaint to the hospital CEO, speak to the health department about the callous attitude that you've described. Sounds like there is no emotional support given to your grandmother and family. As a RN I believe that your grandmother should be having palliative care right away.
  4. 0
    My mom is 79. She was diagnosed with COPD about 5-6 years ago. Quit smoking 3 years ago. She now can only walk about 10-20 feet with her rolling walker and 3 liters nasal cannula. She took 20 mg prednisone qd prior to last hospitalization, weaning from 40 mg now. They admitted her through ed for pneumo, but it was just the old one they were seeing, they said. She's had two; one in January and one in June. Regardless, they kept her for four days starting on high flow o2 @ 15 liters nasal cannula and weaning back to 3 when she was discharged, five days ago. She remains on 3 liters nasal cannula. Anyway, she is dyspneic throughout the day, but sleeps well. Even the littlest motion with her hands can send her into what she calls a "hair on fire fit". Most times we can bring her out of it by doing pursed lip breathing with her. Normally she breathes just backward, in through her mouth and out through her nose. As a nurse, this is hard for me, since she gets mad at me when I try to gently remind her to take her breaths through her nose. Routinely sats 98% for Home Care (from her hospital stay). I am actively seeking a hospice order from her pulmonologist. Any opinion on how long we might have her?
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    I am so sorry you, your Mom and your family are going through this..........it is especially hard for us medical people to see our loved ones ill. These are the time I know ignorance is bliss. You know as well as I do we have no crystal balls......... although many times I wish I did. I am sending prayers and positive vibes (in case you aren't religious) for you and your family.

    One thing I learned when my Dad was ill....be the daughter. Hospice will help give your Mom the care she needs to make her as comfortable as possible.

    We cannot offer any medical advice here at AN....thread closed.


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