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Thursday, October 14, 2021

COPD and Congestive Heart Failure-Management at Home

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COPD (Chronic Obstructive Pulmonary Disease) and CHF (Congestive Heart Failure) affect many older adults. Both pose significant challenges to those diagnosed and their families, as they require ongoing management. They can lead to various health crises, overall decline, and generally impact your ability to remain safely at home. But, they don’t have to…if managed well. 

Today, we’ll share a bit more about these conditions and the resources to help. If you’ve just been diagnosed with COPD or CHF or are struggling with these conditions, we want to reassure you that they can be managed at home. Life can be good again.

COPD (Chronic Obstructive Pulmonary Disease)

  • About one in seven older adults suffer from lung disorders such as COPD. 
  • COPD is a chronic inflammatory lung disease that causes obstructed airflow from the lungs.
  • The most common of these diseases are emphysema and chronic bronchitis. Many people with COPD have both of these conditions.
  • Symptoms include breathing difficulty, cough, mucus (sputum) production and wheezing.
  • It’s typically caused by long-term exposure to irritating gases or particulate matter, most often cigarette smoke.
  • People with COPD are at increased risk of developing heart disease, lung cancer and a variety of other conditions.
  • Chronic bronchitis is inflammation of the lining of the bronchial tubes, which carry air to and from the air sacs of the lungs. It’s characterized by daily cough and mucus production.
  • COPD is a progressive disease that gets worse over time.

The good news is that COPD is treatable. With proper management, most people with COPD can achieve good symptom control and quality of life. They can also reduce their risk of developing associated conditions.

How COPD Affects Individuals

Symptoms:

  • Shortness of breath, after even mild forms of exercise and daily tasks
  • Mild but recurrent cough
  • Needing to clear your throat often, especially first thing in the morning
  • Wheezing, which is a type of higher-pitched noisy breathing, especially during exhalations
  • Chest tightness
  • A chronic cough that may produce mucus–may be clear, white, yellow or greenish
  • Need to clear mucus from your lungs every day
  • Frequent infections – colds, flu, or other respiratory infections
  • Fatigue and weakness
  • Reduced ability to exercise 
  • Swelling in legs, ankles and feet (edema)
  • Weight loss 

What does this mean for clients’ daily lives? 

They may be less able to do the things they used to and tire more easily. It often becomes difficult to keep up with household duties. Clients will often get less exercise and be more sedentary, which causes them to lose strength and balance. They can become prone to falls and general decline in mobility and abilities. The condition also causes dizziness at times, so falls are a real danger. They may find it difficult to stand for long periods, to cook or take a shower for example. COPD often leads to anxiety, due to the feeling of being unable to breathe. 

Many clients with COPD face exacerbations and crises (911 calls, hospitalization, rehab. stays). They’re prone to getting sick more easily. Nutrition often suffers due to the symptoms and lack of energy. Unfortunately, this coincides with the need for better nutrition to support the immune system and health. When the person isn’t eating well, their energy is further sapped and this all becomes a vicious cycle.

Within 5 years of hospital discharge for a COPD exacerbation, the rehospitalization risk is 44%, and the mortality rate is 55%. Within 30 days of being in the hospital, about ¼ of patients find themselves hospitalized again.

Managing COPD at Home

The EasyLiving team works with your care team to develop a care plan and help you manage COPD at home. This allows you to live life on your own terms, reduce risks and crises, and stay healthier. Here is some of what we do to help:

  • Educate patients, families, and care team members on the condition, what to watch for, and how to manage.
  • Monitor symptoms. Report persistent coughs or feelings of shortness of breath. Note key symptoms that may indicate a change in condition and get medical attention for signs of a crisis. Track daily weigh-ins, if designated.
  • Help with activities. Allow for periods of rest during and after activities to reduce the stress on the lungs and help return blood flow to normal levels. 
  • Assist with safe ambulation. Help clients with activities of daily living such as transfers, bathing/dressing, and maintaining the house to reduce the risk of falls. 
  • Help clients elevate their feet. Check that socks and shoes are not too tight. Report any signs of sores or redness on feet or legs via changes in conditions using our care technology system.
  • Assist the client with ways to feel most comfortable when resting, such as elevating their head with extra pillows or using a recliner.
  • Keep the client calm when they experience shortness of breath and related anxiety. Provide emotional support and reduce isolation and fear.
  • Help with healthy meal preparation and tips for good nutrition with this condition. Provide coaching if eating meals makes the client feel uncomfortable/
  • Ensure clients get plenty of hydration.
  • Make sure clients take their medications properly.

COPD Management at Home: Results

Intervention programs have been shown to drastically reduce the 30-day rehospitalization rate for COPD patients. Some interventions have resulted in a 0% readmission rate. And, many studies using a bundle of interventions such as EasyLiving provides show significant reductions in hospitalizations.

We track the results from those in our COPD management program to continue developing the best evidence-based interventions. Additionally, we follow up closely with clients and their families about how the services have affected their quality of life. Families express relief, knowing that loved ones have support and someone watching out for them. They no longer experience the anxiety of constant crisis. 

Clients express much of the same relief. They’re also able to resume many favorite activities now that they’re eating and resting well. They get the help they need around the house and with personal care. This leads to feeling like themselves again, even with the continued symptoms of such a progressive condition.



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