Managing lung disease in late life: a new approach

Advanced pulmonary disease (APD), a progressive, incurable condition, ultimately leading to death, is associated with significant, distressing symptoms. This paper reviews how the hospice approach to care, with its emphasis on treating those symptoms causing the patient the most distress, might be used by physicians in the outpatient setting to improve the patient's quality of life. Important aspects of care include management of hypoxia, malnutrition, osteoporosis, adverse drug reactions, and, especially, the symptomatic relief of dyspnea. Relief of emotional symptoms (depression, anxiety, panic) is also discussed.