Hospice & Palliative Care for Late-Stage COPD

Shortness of breath

Patients with end-stage COPD often tell us that extreme dyspnea, or shortness of breath, contributes most to their distress and poor quality of life. We work together with doctors to manage dyspnea through:

• Oxygen therapy
• Breathing exercises
• Relaxation techniques
• Medications
• Body positioning while sitting or sleeping
• Support and education for caregivers

When treating symptoms associated with COPD, prescribing more medications is not always better. In fact, later in the disease process, medications that once provided relief from shortness of breath may no longer work, resulting in frequent hospitalizations. Choosing the appropriate COPD medication delivery system, the appropriate medications for symptom management as well as focusing on prevention of COPD exacerbations is well understood by palliative care and hospice providers. 

Patients with COPD have good days and bad days, but pain medication works best on a regular schedule to stay ahead of the pain. Palliative care and hospice providers have extensive experience managing pain associated with COPD.

Reducing anxiety and depression

Extreme shortness of breath can have devastating emotional burdens. Symptoms may keep people from the simple joys of life, leading to social isolation.

A lot of anxiety comes from feeling helpless or uncertain about the future. Hospice social workers and chaplains are available to talk and address the most pressing concerns of patients and their families. For diagnosed clinical depression, hospice doctors can offer treatment options coordinated with a patient's preferences.

You may be thinking palliative care is only for someone who is close to death. This is not true. Palliative care enables you access the medicine and therapy you need, while working to manage symptoms affecting your quality of life.

Palliative care also helps you establish goals for end-of-life care. Accepting the limits of treatment for COPD is difficult. There is no cure for COPD, but families often miss the benefits of early comfort care because they wait until a medical crisis. Palliative care should begin whenever a life-limiting diagnosis is made.

Patients who choose hospice typically have advanced disease and want to avoid unnecessary or aggressive medical treatments. Their wish is to die on their own terms and in the comfort of their own home. At Compassus, we empower patients and families to control their end-of-life decisions. 

End-of-life support for both patients and families:

• Care to reduce episodes of distress and unwanted hospitalizations
• Managing depression and anxiety to a level that meets your goals
• Nurses available 24/7
• Pre-emergency plans
• Comfort care at home, nursing home or wherever the patient lives
• Respite care (relief) for family caregivers
• Hospice aides for personal care and homemaker services
• Hospice social workers to help with transitions in care
• Hospice chaplain for spiritual care and support
• Hospice volunteers for companionship and support

Hospice and palliative care both offer relief from the pain and symptoms of COPD. Both can address the mental, social and spiritual needs of a patient. In fact, hospice is a type of palliative care during the final stage of life.

Medicare benefits limit hospice care to patients with a life expectancy of six months or less. Only a doctor can make a clinical decision about life expectancy. It’s important for patients to share their goals for care, especially during times of frequent hospitalization or in palliative care.

• Hospice vs. palliative care
• Benefits of palliative care
• Hospice eligibility guidelines for COPD and other lung diseases
• Hospice for pulmonary fibrosis
• American Lung Association COPD information

Reviewed by Daniel Ward, D.O., HMDC, February, 2022