Determining and Understanding End-Stage COPD
Chronic obstructive pulmonary disease, or COPD, is a progressive condition that gets steadily worse and, over time, causes the body to become less able to take in enough oxygen. Ultimately, this can lead to death. The Centers for Disease Control and Prevention (CDC) says that chronic lower respiratory diseases, including COPD, are the “third leading cause of death in the United States” as of 2014.
Recognizing the end-stage symptoms of COPD can help a person cope and say goodbye to loved ones, make peace with their life, seek hospice care, and discuss their final plans. The following are the signs and symptoms that may indicate that a person is nearing the end of their life.
There are four stages of COPD ranging from mild to end-stage. Until recently, only forced expiratory volume in one second (FEV1) was the test used to show the severity and stage of COPD. FEV1 is a measure of how much air a person can exhale in a single breath. When it falls below 30% of the average amount, a person may be in the end stages of COPD. However, a new standard was adopted after 2011 that examines such factors as shortness of breath, the person's history of acute COPD episodes and the impact of the disease on their life. Per the new stages of COPD, mild stage 1: FEV1, is above 80% -- meaning the individual might not even notice that they have the condition.
Moderate, or stage 2: FEV1, is 50%-80% and is characterized by a chronic cough, excess mucus and shortness of breath. Severe, or stage 3: FEV1, is 30%-50% and is characterized by a chronic cough and struggle to exercise or do daily activities. The individual may also feel tired or sick.
End stage, or stage 4: FEV1, falls below 30%, severely affecting the patient’s daily life. There are two ways to measure this final stage of COPD:
- low blood oxygen, or hypoxemia
- hypoxia, which is low oxygen in the body's tissues
- cyanosis, a bluish hue to the skin due to oxygen deprivation
- chronic respiratory failure, which occurs when the respiratory system cannot take in enough oxygen or release enough carbon dioxide
- difficulty walking
- shortness of breath
- frequent lung infections
- difficulty eating
- confusion or memory loss due to oxygen deprivation
- fatigue and increased sleepiness
- frequent severe flare-ups
- more frequent trips to the hospital
- longer hospital stays
- anxiety or depression
- changes in consciousness
- trouble swallowing
- twitching or muscle weakness
- changes in the way a person breathes, or their pattern of breaths
- increasingly loud breathing
During the latter stages of COPD, a person tends to experience more severe flare-ups. This is often accompanies by more and longer hospital stays.
“Although a person will get a little better between flare-ups, they tend not to return to their previous condition,” Medical News Today reports. Thus, an individual’s health becomes steadily worse with each flare-up, and each flare-up tends to be worse than the last.
Another late-stage symptom is severe limitations in physical activities, including:
