AboutMargot 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 15+ 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
Past/Present clients Hundreds of Long Term Care Residents as well as hundreds of Cleitns and families in the community (including my Mother and Grandmother).
Question The nursing home is releasing my Mom to come home but I am wanting to know what the next stages will be. She has copd for the last 5 years and her fev is less than 30 percent now. She is on 3 liters of o2 24/7. What are the next stages for copd normally? I know you can't tell me for sure but will she steadily grow weaker and just sleep more or will she start gasping for air? I just don't want any suprises. I can't find any info online about the end stages for this disease and no one seems to want to talk abiut it including her Dr.
Answer Hi Barbara 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.
