Palliative care for COPD patients

Palliative CareCenter and Hospice of Catawba Valley recently developed a program for patients in advanced stages of Chronic Obstructive Pulmonary Disease, also known as COPD.
Caron Tucker, RN and PCHCV vice president of outreach, said the specialized program is designed to meet COPD patients' unique needs while maintaining and improving their qualities of life.
According to the Center for Disease Control, COPD is a group of diseases that causes airflow blockage and breathing-related difficulties. COPD also includes emphysema and chronic bronchitis.
Tucker said COPD is the fourth leading cause of death in the United States and COPD patients account for about 12 percent of the Hospice census. With that large number of COPD patients, constant hospital care can be costly and time consuming.
"By working together with area physicians, hospitals, respiratory therapists and durable medical equipment companies, our goal is to provide a top-notch service, meeting the needs of those with a serious lung condition," Tucker said.
In the United States, tobacco use is a key factor in the development and progression of COPD, according to the Center for Disease Control. Other risk factors include air quality, genetics and frequent respiratory infections.
The COPD program is offered in two ways at PCHCV. The first option is a Life Transitions program called At Home with COPD.
"In our research about disease-specific needs, we found that patients with COPD were, at some point in their illness, having to make frequent trips to hospital emergency departments to receive treatment for distressing symptoms associated with the disease," said David Clarke, PCHCV CEO. "We discovered that with proper training and protocols, palliative care physicians and nurse practitioners could provide many of these treatments in the home, relieving the patient and family of the burden of frequent, time-consuming trips to hospitals."
PCHCV's COPD program, however, is designed to maximize quality of life without sacrificing service or care.
"This approach saves all involved in the process time and money, but the best part is realized in the improved quality of life for the patient," Clarke said.
In the At Home with COPD program, doctors recommend visits by palliative care doctors or nurses to a patient's home. The palliative care medical professionals manage COPD symptoms, which can include shortness of breath, infections and anxiety.
With At Home with COPD, patients receive care for acute situations and disease symptoms without having to leave the place they call home.
"That's where they want to be -- at home," Tucker said.
The second component of PCHCV's COPD program is a Hospice program for patients with advanced stages of COPD. Through the Hospice program, COPD patients work with a team consisting of medical professionals, a social worker, a chaplain and others trained for disease management.
PCHCV staff members completed specialized training with the help of Dr. Kathy Wilson, a hospitalist and pulmonologist with Catawba Valley Medical Center.
The program also helps COPD patients' caregivers with their changing roles in the lives of their loved ones.
"(Caregivers) often don't have the resources and education to feel comfortable," Tucker said, adding caregivers are often faced with difficult questions and situations after a primary care physician's normal business hours. "(Caregivers) feel like they have a resource. They have someone they can call."
Tucker said PCHCV staff recently had a patient with COPD and heart complications whose health complications made it difficult to lie in bed.
Staff members worked with the man to manage his illness and encouraged him to wear an oxygen mask while resting. A CNA nurse was assigned to his care, and now the man's quality of life has improved, Tucker said.
"He's able to carry on knowing that he's got someone to help him," Tucker said.
PCHCV serves six counties, including Alexander, Catawba, Burke, Caldwell, Lincoln and Iredell counties. Anyone can refer a patient for PCHCV COPD program services, and once the referral is made, staff members will contact the patient's primary care physician to determine which program best suits the patient's needs.
"We find that a lot of times, these programs are out here, but these families don't have access to information," Tucker said.
To refer a patient, call (828) 466-0466.