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Life Support Issues/my mother COPD Emphysema

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QUESTION: My mom has had copd Emphysema for a while now is 85 years old and still smokes and is not going to quit. She is not on oxygen but uses the nebulizer every 4 hours can not walk far with out complete exhaustion dressing just exhaust her to the point of having to rest. and is disoriented confused and has memory loss the doctor says has vascular dementia. she has a constant cough and darking under her nails of the skin. when I ask about her time he just states he doesnt know she has surprized him he did not think she would still be here i am just wondering what to expect this is a disease i have never known anyone with.

ANSWER: Hi Deborha and thanks for writing,

This is very general and may not be the course your Mom follows, but I can tell you how an average COPD patient may proceed.

Basically the COPD deprives the body of oxygen and the patient becomes short of breath, tires easily and will rest more and more as they grow weaker. Occasionally Blood Transfusions will provide temporary relief if the Haemoglobin falls too low, this can also cause Angina (chest pains).

Eventually the patient will be so weak they don't want to move around too much and may stay in bed or sit in an easy chair most of the day; just washing and dressing will be exhausting. They often lose their appetite due to decreased energy so it's a vicious circle: low oxygen causes low energy & weakness which decreases appetite, and decreased appetite leads to weakness.

Treatment is generally "Comfort Measures" like oxygen to ease shortness of breath, maybe some medications to ease the heart's workload, and some puffers to open the airways, but it's not typically aggressive treatment as COPD is progressive and irreversible.

In the end the patient is often weak and bedridden and simply slips away quietly after a slow peaceful decline. The patient will feel weak and will be short of breath after exerting themselves, but do not "gasp for breath". Low oxygen levels can cause confusion though and occasionally the confused patient can become agitated. The most common symptom of COPD is Anxiety related to feeling of not being able to catch your breath doctors often prescribe anti-anxiety medications such as Ativan for their COPD patients, but use these only as required as these medications are sedating and can increase weakness and increase the risk for falls in the elderly.

I hope this has helped to answer your questions and I wish you both all my best; please write again if I can be of any more assistance.

Margot


---------- FOLLOW-UP ----------

QUESTION: she has been having some problems with diarheea off and on and seems to crave sweets it is getting more difficult to find foods she is intrested in eatting but will eat sweets she has lost alot of weight and weighs about 99.5 lbs and is 5ft tall. I am letting her have anything I can just to get her to eat sweets and all. SHE WILL NOT DRINK THE ENSURE DRINKS AT ALL SAYS SHE DOESNT LIKE THEM. wHEN WALKING ITS LIKE HER BODY SWAYS TO ONESIDE. I HAVE TOLD HER DR ABOUT THESE THINGS AND AM TOLD ITS ALL PART OF THE PROBLEM. sHE DOESNT WANT ANY EXTREME LIFE SAVING MEASURES AND HAS GOTTEN ALL OF HER PAPER WORK FILLED OUT FOR THIS. i JUST DO NOT KNOW WHAT STAGE THIS IS THEY SAY END STAGE AND I GUESS THAT IS MY QUESTION HOW LONG IS END STAGE AND IS SHE CLOSE

Answer
Ensure & Boost etc have a consistency that many people do not enjoy and it turns a lot of people off the supplements all together.  I have found that most clients actually enjoy Ensure/Boost when it's frozen as it's both refreshing and tastes good.  I would advise you try freezing 1/2 cup of Ensure in some custard bowls and offer it as a refreshing snack.  Try a few different flavours and your Mom may just enjoy them.

As for "how long", it truly is very difficult to guess as I have seen people pass away quietly when they were still fairly healthy and looked like they had 3-6 months to live, and I have seen others hang on for weeks and even months past the time their body appears ready to slip away. I really cannot guess with any accuracy at all, but it does not sound like death is imminent by what you have described.

Sorry I can not be more specific - you should ask one of the healthcare professionals who know her and are aware of her health history and current condition as they should be able to provide a more realistic prognosis.

Wishing you well,
Margot

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Margot RN BScN CGN

Expertise

I nursed my own Mother and Grandmother at home when they were dying so I have personal experience with the emotions involved. I have also spent the last 20 years as a Registered Nurse caring for The Elderly and Terminally Ill and it has brought me great satisfaction. I am willing to answer any questions I can.

Experience

27 years Geriatric Nursing and working with palliative care clients and their families both in facilities and the community.

Education/Credentials
Registered Nurse, Bachelor of Science in Nursing and Certified Gerontological Nurse

Past/Present Clients
Hundreds of Long Term Care Residents as well as hundreds of Clients and families in the community (including my Mother and Grandmother).

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