John W. Walsh

With the Centers for Disease Control and Prevention reporting that chronic obstructive pulmonary disease (COPD) has become the third leading cause of death in the U.S. — 12 years earlier than predicted — the days when COPD symptoms were dismissed as “normal” signs of aging are well behind us.

In fact, a national COPD awareness campaign, which includes national TV commercials, is underway to get the message across: COPD is a growing threat. As a result, more Americans are beginning to understand the disease and develop greater expectations regarding prevention, diagnosis and treatment of family members in long-term care facilities.

This means that managers of long-term care facilities, physicians and care providers need to be prepared to meet these expectations by putting comprehensive COPD programs into place.

The key to preventing more lung damage in patients, and slowing the progression of COPD, is to encourage them to join a support group that will help them quit smoking. In addition, medications and rehabilitative treatment can help alleviate COPD symptoms and control the disabling effects of the disease.

Treatment for COPD in senior patients can be challenging due to their poor vision and impaired mental and memory functions. Healthcare providers in a community setting need to be able to recognize the signs of acute COPD and know what interventions will lead to successful self-management based on the patient’s condition and abilities. For the most part, this goes beyond traditional health education, requiring official guidelines for diagnosis and treatment of COPD, research updates, access to resources for patients and professional educational credit-earning opportunities.

These programs should include advance care planning and a comprehensive pulmonary rehabilitation program, which can improve quality of life and exercise capacity for patients with mild and moderate COPD. Those with moderate or severe COPD require inhaled steroids to help reduce swelling in airways. With the right treatment, previously inactive patients can gain renewed self-confidence and begin participating in community activities. 

Severe cases of COPD greatly limit a patient’s daily life with breathlessness, exhaustion, pain, anxiety and depression. For these patients, a more tailored exercise program under supervision can improve physical activities and self-management. Oxygen therapy improves shortness of breath, protects the heart and other organs from damage, improves sleep, raises alertness during the day and allows for better quality of life.

Palliative care for COPD patients can be an opportunity to open up an avenue of communication with patient, family and physician in order to plan the best treatment strategies, including advance care planning and patient preferences with regard to withholding or withdrawing medical treatment and hospice care. In addition, the multidisciplinary nature of palliative care can encourage COPD patients to self-manage the disease to improve their energy and quality of end-of-life care.

It’s important that community healthcare providers, as well as patients and their families, understand that COPD is not a hopeless condition. With caregiver education and effective disease management, COPD patients can increase their quality of life, especially with the support of a group setting.

John W. Walsh is the co-Founder and president of the COPD Foundation, a not-for-profit organization dedicated to developing and supporting programs, which improve the quality of life through research, education, early diagnosis and enhanced therapy for persons whose lives are impacted by Chronic Obstructive Pulmonary Disease (COPD). He is also the co-founder of the Alpha-1 Foundation (a research organization) and AlphaNet, Inc. (a unique, not-for-profit disease management services company run by and for patients). He can be reached at [email protected].