Chronic Obstructive Pulmonary Disease or COPD is a serious, progressive lung disease that makes it difficult to breathe, to get enough oxygen into the body and to remove enough carbon dioxide from the body.
- Umbrella term for two most common forms of non-cancerous lung disease:
- Chronic bronchitis
- COPD is now the 3rd leading cause of death in the U.S. behind only heart disease and cancer
- More than 12 million Americans currently diagnosed with COPD
- Women are 2x more likely than men to get COPD
- COPD is a common reason for hospitalizations and re-hospitalizations
- Treatment costs for COPD in the United States exceed $14.5 billion annually
COPD Risk Factors
- Smoking is the primary cause of COPD
- Environmental factors, e.g., exposure to:
- Air pollution (including indoors)
- Second hand smoke
- Occupational dusts and chemicals
- Family history of chronic lung disease
- History of childhood respiratory infections
Other Contributors to Worsening Symptoms and a Poor Prognosis
- Non-compliance with pharmaceutical therapy and prescribed treatments
- The home environment
- Episodic care
- Lack of a caregiver
- Malnutrition occurs in as many as 70% of COPD patients in the U.S.
- Air swallowing and/or physiologic changes to the diagpraghm contribute to patient’s feeling too full too soon
- COPD patients are often too tired to fix themselves a meal
- COPD patients expend more energy in their labored breathing and, as a reesult, need to consume more calories to prevent weight loss
- Dyspnea (shortness of breath (SOB) or breathlessness)
- Frequent coughing
- Tightness in the chest
- Frequent Colds
- Nose and throat infections
- Blue lips or fingernails
Enter Home Health
Because of the progressive nature of COPD, your doctor may refer you to home health care services to try to achieve any number of individualized goals to improve your current status. This most often happens after a recent hospitalization as your physician will try to help you to improve by establishing goals and expected outcomes on those things that may have caused you to go to the hospital, such as dyspnea (shortness-of-breath) for example.
Possible Goals and Outcomes for a COPD Patient
“By the end of the projected episode of care, the patient and/or family/caregiver will:”
- Demonstrate the ability to administer oxygen as ordered and manage equipment safely. (The doctor may prescribe oxygen therapy to help increase oxygen levels in a COPD patient’s blood)
- Demonstrate pulse measurement and signs/symptoms which require physician notification.
- Maintain patient’s airway and mobilization of secretions by use of respiratory treatments, medications and effective cough
- Optimize functional capacity while minimizing hospital admissions/re-admissions within the limits of the disease process
- Demonstrate effective diaphragmatic breathing techniques, purse lipped breathing to decrease SOB for maximum functional activity level
- Teach about and observe for side effects of steroid
An Interdisciplinary Approach
Different members of the home health care team will focus on different aspects of your care at your home that ties to their areas of expertise.
Skilled Nursing – Your RN might focus on goals #1, #2, #3 and #6. Additionally, the nurse will conduct a safety inspection of the home to ensure that the patient is safe and not a fall risk due to exposed electrical cords running across the floor for example. The nurse will also conduct a prescription reconciliation to make sure that only the currently prescribed drugs are being taken and that a schedule of what to take daily and when to take it is also provided.
Physical Therapy – Your PT might focus on goal #5
Occupational Therapy – Your OT may focus on goal #4
And if you are struggling with any aspect of your activities of daily living (ADLs), the home health aide will be utilized to assist with things like bathing, feeding or dressing for example.
Your team will assess your progress during your treatment episode and report to your physician on how you are doing and what progress is being made.
Benefits of Home Health Care
Yes, it is the obvious…you get all of your treatment and care in the comfort of your own home. You avoid trips to the doctor’s office and avoid trips to a rehabilitation facility. Your also being taught on how to navigate and ambulate around your own home, so the education and training are more relevant and effective.