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COPD National Strategy Quick Reference Guide
End-of-Life Care
 The burden of diseaseCOPD carries an extensive morbidity and mortality and people with advanced COPD should be fully supported in the final stages of their disease. Breathlessness is the most important problem to people with advanced COPD and should be addressed even before they can be defined as having reached the terminal phase of the disease (see Figure 4. Breathlessness ladder). Palliation of symptoms in advanced COPD should not be confused with terminal care at the end-of-life. Prognostic uncertaintyIt is difficult to make an accurate prognosis at the end of life in COPD: even indicators known to be associated with a poor prognosis are unhelpful on an individual patient basis. The ‘surprise question’ (“Would I be surprised if the patient died in the next year”) may be useful. End-of-life care pathways for people with COPD require development and evaluation (see Figure 5. End-of-life care pathway). Carers Carers play a significant role in the care of people with advanced COPD often for considerable periods of time, and often receive little formal support. COPD has social ramifications beyond the affected individual. Information and support requirements of carers need to be better understood. The British Lung Foundation has some advice on coping with the final stages of chronic lung disease, and generic advice for patients and their carers about end of life care is available from NHS Choices.  Further resources
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Author: Dr Hilary Pinnock, University of Edinburgh, and Whitstable Medical Practice, Kent |
Editor: Dr Mark Levy, Kingsbury, London
This COPD National Strategy Quick Reference Guide is provided to you by the Primary Care Respiratory Society UK (PCRS-UK) and is an interpretation of the document Consultation on a Strategy for Chronic Obstructive Pulmonary Disease (COPD) in England (February 2010) written by the Department of Health. This Quick Reference Guide has been supported by an educational grant from Allen & Hanburys, the specialist respiratory division of GlaxoSmithKline, AstraZeneca UK Ltd and Boehringer Ingelheim Ltd/Pfizer Ltd. The views expressed in the materials are not necessarily those of either the Department of Health, the sponsors or the Primary Care Respiratory Society UK (PCRS-UK). © PCRS-UK |
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End-of-life Care Resources