Palliative Care in COPD

This case study discusses the significance of palliative care in chronic obstructive pulmonary disease (COPD) and its effects on patient quality of life and mortality. It emphasizes the need for open and sensitive communication between patients and healthcare professionals to develop a palliative care plan based on patient preferences. The study also highlights the role of specialist nurses in providing supportive and palliative care for COPD patients. The use of programs like pulmonary rehabilitation and outreach nurses can improve the quality of life for patients with moderate COPD. The study concludes by emphasizing the importance of further research and development of new pathways and practices to ensure timely and appropriate palliative care for COPD patients.

Running Head: CASE STUDY
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CASE STUDY 2
Mrs Brown wants to undergo immediate acute treatment because she has the chronic
obstructive pulmonary disease (COPD), which is the chronic life-limiting disease characterised
by the persistent airflow blockade as well as progressive dyspnea (Tavares, Jarrett, Hunt &
Wilkinson, 2017). COPD is also linked with the nervousness, depression, and lack of energy,
anorexia as well as inconvenience (Hadfield et al., 2012). The discussion and conversation
between the patient and the nursing care team ensure a palliative care plan based on patient
preferences. Therefore, supportive and palliative care could promote the active managing of
these patients and acute care (National Hospital Care Committee and Specialist Palliative Care
Services Committee, 2002).
The palliative care approach takes into account the patient's past life experiences and
current adaptations to their situation, emphasising open and sensitive communication and
alleviating pain. This approach of palliative care is the focus of is to prevent and alleviate
suffering through early identification (Bai et al., 2017). However, patients with severe COPD
may experience a very poor quality of life and are generally relatively unfavourable. The
therapeutic relationship is critical to assessing the need for supportive and palliative care
(Crawford, 2010). Due to the deterioration of Mrs Brown's condition, she withdrew from most
activities. She feels that her quality of life is very poor now and she is afraid of the future.
The specified role of specialist nurses has been demonstrated to advance care satisfaction,
in addition, improve patient training, but is not effective in reducing the acute exacerbations.
Though, specialist outreach breathing care has not been confirmed for patients with severe
illness. Some patients, as well as caregivers, will be benefited from the assurance and
supervision that clinicians, as well as specialist nurses, could provide. Nevertheless, for
numerous people, when communal care with major palliative factors is considered more suitable,

CASE STUDY 3
there will be one point. Determining this transition opinion requires the experience, sensitivity as
well as open communication between hospital clinicians and general practitioners. When this is
achieved, patients and caregivers will not be misplaced in the community, as long-term support
programs are important (Momen, Hadfield, Kuhn, Smith & Barclay, 2012).
The usage of programs, for instance, pulmonary rehabilitation as well as outreach nurses
could improve the certain quality of the life of the patients with moderate COPD. Recognising
the necessity for the supportive care initially in the palliative management cycle may help Mrs
Brown as well as her family solve problems with treatment options and may help them better
cope with disease progression. More and more people recognise that the patients with the non-
malignant, incurable, life-limiting diseases require supportive as well as palliative care.
Nevertheless, there are presently very few specialist facilities available (Harris et al. 2017).
One of the most important somatic techniques for palliative treatment is treatment of
hypothermia. When they reach the palliative sight, most patients get the widest treatment for
bronchitis and should recover from aspiration aspiration. If they do not, they should support a
group of long-acting experimental drugs, inhaled with long-acting stimulants and hills.
Theophylline may be useful in some patients, but it has a restricted registry and many forms of
cooperation, which may limit its use. Most patients in the later stages of the disease will be
limited to pulmonary recovery and regardless of whether these patients work in the network, it
will be difficult to pay attention to the program. Other non-medical hoods can be given, for
example, jaw systems, air humidification and barrier-free representation (Lilly & Senderovich,
2016).
Since depression is common in patients with COPD, it is considered as the most
important strategy to dynamically seek the diagnosis in addition actively treating the condition.

CASE STUDY 4
Dealing with depression is one of the top priority strategies for dealing with this disease. Even
before the end-stage, COPD is closely related to anxiety and depression, especially those who
suffer from hypoxia or severe breathing difficulties like Mrs Brown. Symptoms are
incapacitating and painful; patients frequently become publically isolated in addition have to
relinquish their favourite deeds. The low mood may exacerbate the psychosocial effects of the
disease. (Khan at al. 2017). The NICE guidelines for COPD recommend that patients with
depression or anxiety should receive conventional medications, but for the antidepressant
management to be efficacious, it takes time to explain why depression requires simultaneous
treatment of physical illness (National Collaborating Centre for Chronic Conditions. 2004).
For dealing with depression, good communication is an essential part of the palliative
approach because it is one of the most important skills for doctors who provide appropriate
hospital care. However, most studies evaluating eminence of the ending life report that the
patients with COPD have a lower quality assessment. Even after using interventions to advance
the frequency as well as the quality of certain discussions, the quality of the communication
seems to be deprived as the patients approach their termination of life. Interventional studies
have shown that the quality of conversation can be improved, but only in two areas: the patient's
perception of deterioration as well as spiritual beliefs (Janssen et al. 2015). The quality rating of
the quality report is lower, mainly because most nursing home topics have not been discussed.
These topics include talking about the spiritual as well as religious beliefs that what deaths might
be as well as other predictions. However, when discussing, the quality is also rated as moderate
to virtuous (Curtis et al. 2011).
Dealing with depression also requires interventions that support spiritual philosophies or
the religious practices and the other dignity-protected tracks have not been found to be more

CASE STUDY 5
significant to other studies in the entire sample or subsample of nurses, which sees mental care
the utmost important issue in refining the last years of life. Lundberg and Kerdonfag in (2010)
found that mental care is the focus of overall care delivered by the intensive care unit of nursing.
The difference found may be due to how to define mental care. In a similar study, mental care
was demarcated as the supportive spiritual principles as well as rituals, providing spiritual
support, presenting respect, as well as communicating with the patients and the families
(Lundberg & Kerdonfag, 2010).
Specialist nurses working in areas such as respiratory diseases, heart disease and
community care can develop their supportive and palliative care skills. They have the
opportunity to promote the application of palliative care concepts in non-malignant diseases, but
they need professional training as well as education (Tanuseputro, Budhwani, Bai & Wodchis,
2017). Providing supportive in addition to palliative care, as well as acute and long-term
treatment of the non-curable and non-malignant respiratory diseases, will certainly advance the
quality of the life and mortality of patients with COPD (Lilly et al. 2016).
In summary, although there is evidence that it is beneficial in the implementation process,
the frequency, as well as quality of the palliative care dialogues among patients and health care
professionals, are meagre. Patients and doctors cited the number of obstacles and did not discuss
maximum topics. In the discussion, they do so in the late stages of the disease, usually in the
busy, acute as well as stressful atmosphere, and regularly with the clinicians who may have no
association with the patient. In addition, empirical differences among COPD patients suggest that
the long-term inequalities established on the diagnosis which continue to exist (Zwar et al.,
2017).

CASE STUDY 6
Given that the relationship among care conversations in addition to patient preferences,
the lack of optimal communication between clinicians and patients can affect the quality of care,
patient satisfaction, as well as likelihood of eventual "good death." Additional research is needed
to the director the development as well as testing of the new pathways as well as practices to
ensure a timely and the appropriate assimilated palliative care as well as advance care plan
through open negotiations with the healthcare professionals to improve the prognosis of patients
with COPD.

CASE STUDY 7
References
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Janssen, D. J., Curtis, J. R., Au, D. H., Spruit, M. A., Downey, L., Schools, J. M., & Engelberg,
R. A. (2011). Patient-clinician communication about end-of-life care for Dutch and US
patients with COPD. European Respiratory Journal, Vol. 38(2), pp. 268-276.
Lilly, E. J., & Senderovich, H. (2016). Palliative care in chronic obstructive pulmonary disease.
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CASE STUDY 8
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