Chronic obstructive pulmonary disease (COPD) is a medical term used to describe a collection of lung diseases that include emphysema and chronic bronchitis. Doctors at the Mayo Clinic report that COPD is the leading cause of death throughout the world. There is currently no cure for lung damage caused by COPD, and symptoms continually worsen as this disease progresses. End-of-life symptoms associated with COPD can be severe, but may be managed by palliative care treatments recommended by your doctor.
Breathlessness
The most common end-of-life symptom experienced by patients with COPD is breathlessness---a condition also referred to as dyspnea. Symptoms of breathlessness can cause COPD patients to feel frequently out of breath or winded and can occur in conjunction with cough. Patients can also experience wheezing or chest tightness, which can cause discomfort. In a study published in the May 2004 issue of the journal Respiratory Medicine, Dr. Helena Elkington and colleagues reported that end-of-life breathlessness symptoms significantly impacted the ability of COPD patients to move about normally or provide self-care. Such symptoms lead many COPD patients to be housebound or chairbound during the end stage of this disease.
Pain
Pain can develop as an end-of-life COPD symptom in some patients. Symptoms of pain can be mild to severe and typically affect the muscles involved in respiration. COPD patients can experience painful sensations within the chest or abdomen (diaphragm), which may worsen upon inhalation. These end-of-life symptoms are typically controlled through the use of analgesic medications.
Drowsiness
Decreased levels of oxygen in the body caused by COPD-related breathlessness can interfere with the body's ability to generate energy. Poor oxygen levels in the blood can lead to damage of the internal organs, which can cause them to begin to stop working normally. When these symptoms develop during end-stage COPD, patients can experience severely decreased energy levels, leading to significant fatigue or drowsiness. You may notice that a patient with end-stage COPD sleeps for long periods during the day or struggles to perform certain tasks, such as lifting a cup to her mouth, due to low energy levels.
Disorientation
Insufficient oxygen levels within the body can interfere with normal brain function in COPD patients near the end of life. You may notice that an end-stage COPD patient appears frequently confused or disoriented. He may not acknowledge your presence or may have difficulty remembering who you are---even if you are a close family member.
Decreased Body Temperature
Poor blood circulation due to low oxygen levels within the body can cause the body temperature of COPD patients to decrease. If this occurs, you may notice that the patient's hands or feet are cold to the touch, explain Tim and Paul Nuccio in a February 2009 article published in RT for Decision Makers in Respiratory Care, a leading informational resource for respiratory-care practitioners.
References
- Respiratory Medicine: The last year of life of COPD: A qualitative study of symptoms and services; H Elkington, et. al.; 2004
- RT Magazine: Give Them Comfort --Controlling COPD Symptoms at the End of Life
- The Mayo Clinic: COPD
