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Severe COPD and the transition to a palliative approach
Amanda Landers1, Rachel Wiseman2, Suzanne Pitama3
1Nurse Maude, Christchurch, New Zealand.
Breathe (Sheffield, England)
|December 7, 2017
Summary
Identifying a specific transition point for severe chronic obstructive pulmonary disease (COPD) patients nearing death is challenging. Clinical milestones and patient-reported triggers are suggested for better palliative care referrals.
Area of Science:
- Pulmonary Medicine
- Palliative Care
- Geriatrics
Background:
- Patients with severe chronic obstructive pulmonary disease (COPD) often face unpredictable end-of-life trajectories.
- Early identification of patients who could benefit from palliative care is crucial but difficult.
Purpose of the Study:
- To explore the challenges in pinpointing a transition point for severe COPD patients.
- To review existing literature on identifying end-of-life in COPD.
- To propose a model for recognizing patients needing palliative support.
Main Methods:
- Literature review on identifying end-of-life transition points in severe COPD.
- Analysis of clinical challenges in recognizing patient decline.
- Development of a model based on clinical milestones.
Main Results:
- A distinct transition point for severe COPD is hard to define.
- Physicians can utilize available tools to identify at-risk patients.
- Patient perspectives and self-identified triggers are vital for initiating palliative care.
Conclusions:
- Accurate identification of end-of-life transition in severe COPD remains complex.
- A combination of clinical assessment and patient-reported events aids in timely palliative care referral.
- Specialist palliative care is essential for a subset of patients whose needs exceed primary care capabilities.
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