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COPD (Chronic Obstructive Pulmonary Disease)

End stage COPD??



My 86-year-old mother was diagnosed with COPD in 1997 and has been on 2L oxygen ever since. In Dec. she had a bout of pneumonia and was hospitalized for 3 days before returning to her Assisted Living Facility. She has been progressively getting more and more short of breath and her pulmonologist has been keeping her on 20 mg Prednisone ever since her discharge. When we saw him yesterday for a checkup and told him mom gets out of breath now if she just has to pick up the phone to answer it, he increased her oxygen to 4L and said she is hanging on by a thread. I am frustrated because I don`t know how thin that thread IS!? Can you please tell me what signs to watch for that might denote that the end is near? What will be the next step of deterioration? Is her life expectancy now measured in months? or weeks? I want her to be as comfortable as possible but also want her to stay as independent as possible so I don`t want to have her bed-ridden any sooner than necessary, but also don`t want to push her beyond her capabilities. Additionally, I would like her to be able to see the grandchildren again..

Thank you for your answer. It is very difficult to get an answer with any substance from her doctor.


Without knowing more of the details of her medical history, including her lung function parameters it is difficult to estimate how end stage she truly is. However, if her functional capacity is impaired to the point of becoming short of breath by picking up the phone to answer it and requiring 4 l/m of oxygen are signs indicating a poor prognosis. Since there is a great deal of variability in life expectancy in patients with COPD, the issues you bring up are best discussed with the treating physician in a direct fashion, with very specific questions.

If she continues to do very little activity, she will become progressively deconditioned, making it even more difficult to do activity. Depending on what she and the family desire, this may be appropriate - it may be too hard for her to do anything. If that is the case, consideration of hospice care may be appropriate. Signs of deteriorating status include frequent hospitalizations, more confusion and loss of weight/appetite.

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Response by:

Mahasti   Rittinger, RRT Mahasti Rittinger, RRT
Clinical Program Manager of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University

Phillip T Diaz, MD Phillip T Diaz, MD
Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University