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Caring For Someone with Lung Disease

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What is Chronic Obstructive Pulmonary Disease(COPD)?

CODP refers to a disorder or disease that limits pulmonary function Since COPD is a group of different lung diseases, it can affect people’s lungs differently, especially in geriatric patients who are at a higher risk.

COPD causes a gradual and progressive decline of lung function. The lungs are made up of air sacs, which inflate and deflate while someone is breathing. COPD can also block airflow because of inflammation and damage to the air sac’s walls, or excess mucus. 

 

What are the different types of Chronic Obstructive Pulmonary Disease?

There are multiple types of COPD. Some of these include chronic bronchitis, emphysema, and refractory asthma. The two main and most common forms are emphysema and chronic bronchitis. It is even possible for COPD patients to have both types at the same time.  

 

Chronic bronchitis

Chronic bronchitis causes the lung’s bronchial tubes to become inflamed. This makes it harder for those with chronic bronchitis to breathe properly. Also, because the bronchial tubes are inflamed, there is more mucus produced which makes it harder for the lungs to move oxygen. 

 

Emphysema

Emphysema refers to when the lung’s air sacs are damaged. This causes the walls of the lungs to become weaker and stretched out, not allowing as much oxygen to go into the bloodstream. It also prevents the lungs from taking in enough fresh air, because the air gets trapped in the enlarged gaps caused by emphysema.

 

What are the causes of Chronic Obstructive Pulmonary Disease?

There are multiple risk factors when it comes to COPD. However, it is possible for individuals to lessen their chances of being diagnosed with COPD with certain lifestyle changes. Elderly patients have an increased risk because of their age.

Smoking is the largest cause of COPD. Smokers are 85-90% more likely to be diagnosed with COPD. Cigarettes have thousands of chemicals that are harmful to the lung, when burned. Smokers are less likely to be able to fight off infections and have weaker lungs in general. Secondhand smoke can also weaken the lungs. Even if someone doesn’t smoke, inhaling cigarette smoke can be just as dangerous. Anyone who smokes should stop smoking, especially older adults.

There are also a few other causes such as genetics, environment, and having a lung related medical history. If someone has experienced lung related medical conditions such as respiratory infections, then they are at a higher risk for COPD. There are also a few people who lack the alpha-1 protein and this causes a specific kind of emphysema. The absence of the alpha-1 protein has a negative effect because this protein is needed to protect the lungs. 

Environmental factors are also a large part of preventing COPD. Inhaling fumes and chemicals in the workplace, or at home can put individuals at a higher risk for COPD. This is why it is important to be aware of any fumes or chemicals at work so the proper steps can be taken to protect against any lung damage. 

 

Symptoms of Chronic Obstructive Pulmonary Disease?

COPD symptoms include but are not limited to, shortness of breath, frequent lung infections, and having a chronic cough. There are all early symptoms that should be taken seriously when noticed. 

Some other symptoms are blueness in the nails or lips, wheezing, and fatigue. While these symptoms may not be as noticeable, it is important to look out for them in older patients. These are all signs that there is not enough oxygen reaching the bloodstream and airway obstruction. If symptoms are caught early on, then treatment can be more effective later on.

If a patient is experiencing these symptoms then their doctor will likely suggest a spirometry test, one type of pulmonary function test. This simple test will determine the patient's FEV1 value which is how much air can be forced out of the lungs in one second. The patient's FEV1 value is compared to those of healthy individuals in their age group and helps to determine the severity of their COPD.

 

Treating Chronic Obstructive Pulmonary Disease

COPD can’t be cured, but there are multiple available treatments to slow down progression and manage symptoms. One of the most important treatments is smoking cessation. All COPD patients are encouraged to stop smoking because of all the harmful effects that cigarettes have. If a COPD patient continues to smoke, then an intervention might be extremely useful. This is the first step in preventing any current symptoms from worsening.

Another step in treatment is avoiding activity that will cause a COPD exacerbation. An exacerbation is an infection where there is excess mucus, swelling, and inflammation in the respiratory system. There are acute exacerbations which cause patients to feel fatigued, have increased coughing, thicker mucus, and increased shortness of breath. There are also more severe cases of exacerbation where patients will experience blue or gray lips, trouble speaking, and extreme difficulty with breathing. Some ways to prevent an exacerbation is by getting your annual flu-shot, never smoking, and frequently hand-washing to prevent infection.

 

Bronchodilators and Inhaled Corticosteroids

Bronchodilators are one way to treat COPD. These are inhalers that help to open up the lung’s airway and make it easier to breathe. This is a very common treatment that is also used on those who have asthma.

There are long-acting bronchodilators and short-acting ones. Short-acting inhalers provide quick relief and start acting within minutes and can relieve symptoms of COPD for 4 to 6 hours. While long-acting ones take a little longer to work and are meant to be used only once or twice a day. Long-acting inhalers are used to control symptoms. Bronchodilators can also have side-effects such as trouble sleeping, upset stomach, and rapid heart rate.

Another treatment that is somewhat similar to bronchodilators are inhaled corticosteroids. Inhaled steroids  are released into the lungs to help reduce inflammation and possibly the risk of hospital admission.

 

Oxygen therapy

Oxygen therapy is another option when it comes to treating COPD. People need different amounts of oxygen depending on how severe their symptoms are. Doctors take this into account when prescribing oxygen treatments to COPD patients.

There is also different equipment that oxygen therapy can be received through. There is a standard oxygen concentrator which runs on electricity or batteries. It also is 10 pounds and can be wheeled around. There is also a portable oxygen concentrator which is similar to the standard option, but is smaller and runs off batteries. It makes it possible for patients to run errands without wheeling around a 10 pound concentrator.

There are also other options such as a liquid oxygen tank, which is safer but more expensive. When using oxygen therapy for treatment it is important to be cautious with the oxygen tank. Always keep it a few feet away from sources that radiate heat, and never smoke while utilizing an oxygen tank. It is also important for patients to inform their local fire department and electric company that they have an oxygen tank in their home. If a COPD patient is looking into treatments then it is best to consult their healthcare provider.

 

Surgery for Chronic Obstructive Pulmonary Disease

There are three different kinds of surgeries to help treat Chronic Obstructive Pulmonary Disease. However, these are used for patients with severe COPD and doctors will suggest using less invasive treatments before surgery.

A bullectomy is used to remove bullae. Bullae are extremely large and damaged air sacs that interfere with the function of healthy air sacs. The only way to remove these damaged air sacs is with the bullectomy surgery. Another surgical option is a lung volume reduction surgery. This option removes diseased tissue from the lungs. The third surgery is a lung transplant, which requires a lung donor. In general, elderly patients over the age of 70 are not candidates for a lung transplant. 

 

Coping with Chronic Obstructive Pulmonary Disease

Having COPD means being more at risk for complications. These complications include heart failure, lung cancer, cardiovascular disease, and depression. Pulmonary rehabilitation can help COPD patients live and breathe better. Some activities included in pulmonary rehabilitation are education, supervised exercise, behavioral interventions. These can all help to somewhat improve the day-to-day life of COPD patients.

Some may feel that their quality of life has decreased after being diagnosed with COPD. This is why it is important to find support, whether that be from a caregiver, or a support group. It is also encouraged that COPD patients maintain a healthy diet and continue exercising to help with symptoms. These are all important parts of maintaining a stable health status and making sure any symptoms don’t worsen. To find out more, visit the Global Initiative for chronic obstructive lung disease.

 

Frequently Asked Questions about COPD

COPD can be difficult to navigate and because of this it is important to know as much as possible as a caregiver.

 

How does COPD affect the elderly?

COPD tends to be more dangerous in the elderly. It is possible for older patients to have COPD and along with another severe diagnosis. This is considered a comorbidity which puts older patients at a much higher-risk for complications.

 

Can COPD cause death in elderly?

COPD is known for making it difficult to breathe. Those who are 65+ make up for 86% of all COPD deaths. Treatments can help to slow the progression of the condition, but COPD cannot be cured and because of this it is possible to have an early death.

 

What is the most common treatment for COPD?

While there is no cure for COPD, treatment helps control symptoms and slow down progression of the disease. Bronchodilators are the most frequent forms of treatment for COPD. Patients can start with a short-acting bronchodilator which can help to open the airway up. Depending on the severity of a patient’s COPD they might be given a long-acting bronchodilator or another form of treatment.

 

What are the newest treatments for COPD?

Bronchoscopic Lung Volume Reduction (BLVR) is one of the newest treatments for COPD, specifically severe emphysema. This is an alternative for the lung volume reduction surgery. With this procedure, tiny airway valves are placed in the most inflamed and emphysematous parts of the lungs. The one-way valves make sure that air doesn’t escape into the diseased part of the lungs and helps patients to breathe better.

 

How does COPD affect the elderly's mental health?

Patients with COPD have a higher chance of developing anxiety and depression. COPD can force patients to completely change their lifestyle. It can be harder to move around and be hopeful because there is no cure. This is why it is important to not only have a good support system, but also reach out for pulmonary rehabilitation to receive more help.

 

Suraya Hammoudeh, PharmD

A clinical Pharmacist with a decade of experience working with health conditions, including Alzheimer’s disease, diabetes, high blood pressure, and heart disease. 



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