My mom is has end stage COPD, I have to put her in a home but what should I expect?

5 answers | Last updated: Oct 06, 2016
Mommysgirl asked...

My mom is only 56 years old. She has end stage copd and also chronic bronchitis and also emphysema. Since August 2010 she has just gotten worse and worse by the month. She has been in and out of the hospital, they put her on 02 in augsust non stop 02. She has to do breathing treaments every 4 hours and still smokes. She looks horrible. She signed her power of attorney over to me yesterday while laying in the hospital. This last sunday i went into her room and knew something wasnt right she was having so much troubles breathing which she has for almost a week not but this was bad she could barely talk to me and didnt know what was going on at all so i called 911. She is in the icu on a bpap machine and they told me she is in her final stage of copd and that the only thing they can do for her is make her comfortable. They wont give her but some hydrocodone for the pain which she keeps saying isnt working. I am so scared and dont know what to expect i know i am gonna have to have her put in a home because i cant take care of her i have 3 young daughters at home and when they get sick it makes her sick and they doc said one of these times it could really kill her.

Expert Answers

Audrey Wuerl, RN, BSN, PHN, is education coordinator for Hospice of San Joaquin in California. She is also a geriatric trainer for the End-of-Life Nursing Education Consortium (ELNEC), which promotes education in geriatric nursing and end-of-life care.

COPD, chronic obstructive pulmonary disease, develops over time and includes several diseases such as chronic bronchitis and emphysema. As the disease progresses, the patient has difficulty getting air into (and out of) their lungs. Sadly, smoking only makes the situation worse. You have seen this first hand.

This disease pattern, from a hospice perspective, is especially difficult because the patient has periods of stress (we call that exacerbations) where they end up in the hospital, and periods of "remission" where they appear to improve. There are a lot of ups and downs. It is especially hard for a physician to determine a six month prognosis, which is needed to refer to hospice services, because the patient keeps getting "worse" and then, "better."

You state your mother is now in ICU on a BiPap, or Bi-level Positive Airway Pressure, machine. The BiPap is helping her get more air into her lungs, as she is unable to do so herself. The mask is usually not comfortable for the patient and generally, the oxygen liter flow is quite high. This means she needs to be where she can get the amount of oxygen her body requires, and not every facility (except the hospital) can provide that. Add to that the exhaustion and fatigue and frustration she must feels, we get a sad picture for end of life.

You might speak to your mother's doctor, or nurse, regarding providing morphine for her pain and to help her breathing. This would be part of comfort care. This would also be an appropriate drug at this point. Keeping her comfortable and safe may be the best course for her now.

Community Answers

Mjo answered...

my partner is on 6 liters daily but still gets around. I do not know if I should force him to walk around. I hear it is good for him.

Belllenl answered...

SO VERY SORRY, Above all take care of yourself it is a very sad thing to have to deal with for both you and your mother Please read the following: like all of you before me, I Have no set answer to give. I lost my husband two years ago come Aug. And I guess this is more a Thank-you to all of you for sharing all you are going thru or have gone thru. For this is the first time I have even allowed myself to reflect on all he and I had to endure, In and out of the hospital for the first year. Then he went in for a cold and stayed. A year hooked to machines to feed him to help him breath. Doctors said he would never get off them,he had surgery Doctors gave him a 5% chance. What his Doctor said to me was you know we are going to lose him today. ''He made it''. Tubes in a hole in throth ,stomach,and arms, In a hospital care unit he stayed a year. They said he would never be able to go home . I would leave work and drive 30 miles to see him every night,and he would cry and beg me to take him home, I would tell him soon, soon. Somehow he would make clicking sounds and I was able to know what he wanted to say, or needed. One day when he looked at me so sad,I said to him " THE ONLY WAY YOUR GOING TO GO HOME IS IF YOU GET OFF THAT DAMM THING AND BREATH ON YOUR OWN" 72 Hours later he was!very weak but off the ventalator. He could not walk or talk but he was home just waiting...... He learn to walk and talk again he also drove our car a few times. So many times he would tell me he didn't want to go on anymore for everyday he was in pain, and I tell him I didn't want him to leave me, The last week he said to me Honey I don't think I can do this any more but I'll try. 4 years he stayed for me. So for the ones that want to know how long till your love one is gone. There is no time frame to follow ,But given a reason and a will to live, His doctors said is what kept him alive so long after all medical reasoning was gone. Again thank you maybe now I can grieve and start my life again. He was only 60years old. P.s ask about reducing the size of her lung the doctor can explain it better then I can

A fellow caregiver answered...

Check out Hospice in your area...they do so much at the end of life. My husband also has end stage COPD and they have really made a difference. You can also use them even if she is in a nursing home.

Stopsmoking answered...

My mother has copd, empheiza, and high blood pressure she is 65 years old and Im the only child (Im scared). She has never been to the hospital since she was 21 years old and now that day has come. She gets out of breath just eating fruite, she is becoming unable to walk even short distance like to the bathroom. This desise sucks and I just want her to get well soon I love her so much and just needed to express that. Please STOP smoking people because your family will feel the heart ache in the end..