COPD and Shortness of Breath

What to Do When Someone With COPD Is Short of Breath

The classic and most common symptom of COPD is shortness of breath, especially with activity. If your loved one has been diagnosed with COPD and you're worried about shortness of breath, consider the following steps.

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Figure out if urgent or emergency medical attention might be required.

New or substantially worse shortness of breath can signal a serious medical problem affecting the heart and/or lungs. This is often a dangerous flare of COPD, but shortness of breath can easily be caused by other common conditions, such as pneumonia, coronary artery disease, heart failure, and anemia, just to name a few.

If your loved one is significantly more short of breath than usual, don't delay in seeking medical attention.

For more on whether to call 911 or seek same-day medical attention, click here.

For more on what doctors should evaluate when someone with COPD comes in with worse symptoms, click here.

Make sure your loved one has tried his or her short-acting inhaler.

Virtually everyone diagnosed with COPD has been prescribed a short-acting inhaled medication, to be used as needed for shortness of breath. This type of medication, called a "bronchodilator," helps open up the airways and ease breathing. The most commonly prescribed short-acting bronchodilators are albuterol and ipratropium; some inhalers contain both bronchodilators in one inhaler.

If your loved one is complaining of shortness of breath, make sure he or she has tried using a short-acting inhaler. The directions usually are for two puffs every four to eight hours, as needed for shortness of breath.

Call the doctor's office for advice if your loved one:

  • Doesn't feel much better after using the short-acting inhaler.

  • Is using or is tempted to use the inhaler more often than prescribed per the directions.

  • Has run out of short-acting inhaler or has lost it.

Make sure your loved one is properly implementing his or her COPD treatment plan.

People with stage II or worse COPD usually need to use long-acting inhalers every day to minimize COPD symptoms. These inhalers work best when used every day as prescribed, and they generally should not be used just "as needed." However, many people find it hard to keep up with a daily regimen of inhalers.

If your loved one with COPD complains of shortness of breath and you've already evaluated whether it's an acute problem requiring urgent care, check on how your loved one is doing with his or her daily inhalers. To do this, you'll need to find out what the doctor has prescribed and make sure your loved one is using the medications as directed.

For those with more advanced COPD, additional therapies such as pulmonary rehabilitation and oxygen may have been recommended. In this case, you'll want to check on those as well.

If your loved one is using inhalers as directed and is otherwise following through on his or her treatment plan but still is often short of breath, it may be time for a doctor visit to consider stepping up the management plan. You should also ask the doctor or a pharmacist to check and make sure your loved one is using proper inhaler technique.

Last but definitely not least, if your loved one with COPD is still smoking, take steps to help him or her quit, or at least cut back. Even with severe COPD, quitting smoking can improve breathing.

Learn more about how to manage COPD.

Make sure your loved one's shortness of breath isn't caused or worsened by another medical condition.

Although all COPD eventually causes shortness of breath, not all shortness of breath is COPD. Even in those with a well-established diagnosis of COPD, it's common to simultaneously suffer from other chronic medical conditions causing shortness of breath.

For that reason, it's important to make sure you're aware of all other diagnoses affecting breathing in your loved one (known among doctors as "comorbidities"). Common comorbidities causing shortness of breath include the following:

If your loved one has been diagnosed with any of the above conditions and is complaining of shortness of breath, check to see if the care plan for those conditions seems to be on track.

Regardless of what chronic conditions your loved one has, if shortness of breath becomes worse than usual over a period of hours to days, it's essential that you consider getting same-day medical advice. Often a medical visit is necessary to rule out a new acute problem, such as heart attack or a COPD exacerbation.

Learn What Doctors Should Evaluate if COPD Symptoms Worsen.

What to do when your loved one is still persistently short of breath despite maximum COPD therapy.

Even with maximal medical therapy, people with severe COPD eventually reach a point at which they're short of breath virtually all the time.

If you're caring for someone with stage IV COPD, know that this is a difficult situation with no easy solutions. Depending on a patient's age and other factors, options include surgery, hospice, or simply choosing to live with the discomfort of chronic shortness of breath. For those who choose hospice, opiate medicines such as morphine and oxycodone act on the lungs and can help relieve some of the labored breathing.

Learn more about caring for someone with severe COPD.

Dr. Leslie Kernisan

Leslie Kernisan is a clinical instructor in the University of California, San Francisco, Division of Geriatrics, and maintains a popular blog and podcast at BetterHealthWhileAging. See full bio