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Life Support Issues/my mom 85 yr old end stage

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Question
"The dr did say that the copd and Emphysema would take her before i really had to worry about the vascular dementia She has had alot of weight loss and mussle mass she is 5ft and weighs 99.5 she does have shortness of breath all the time and constantly coughs and she is not going to quit smoking if nothing else she smokes more we have not had any infectios that she has had to be hospitilized for but we are very careful about where and who she is around. she has bad bouts of diarheea now but this is something that has just started. she cnat walk with out completely tiring out and her body start to sway to the left  SHE TAKES ALOT OF MEDICATION FOR ANGINA ,THYROID, BLOOD PRESSURE ANXIETY AND FLUID RETENTION  she is also having slurred speech  are these signs of the end being close"

Answer
Hi Morgan and thank you 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

Life Support Issues

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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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