Hospice can help people with end-stage COPD and other chronic lung diseases when breathlessness is severe even at rest and hospital visits are becoming frequent. The focus is on easing breathing, reducing panic and keeping the person at home.
Signs that hospice may be right for COPD
Because COPD often declines slowly with sudden flare-ups, it can be hard to know when to consider hospice. Doctors often look for:
- Severe shortness of breath at rest or with minimal effort, such as talking or eating
- Frequent emergency visits or hospital stays for lung infections or flare-ups
- Low oxygen levels despite treatment, or needing oxygen all the time
- Unplanned weight loss and weakness
- Spending most of the day in bed or a chair
- Heart strain caused by lung disease (sometimes called cor pulmonale)
Not every sign has to be present. The doctor looks at the overall pattern.
How hospice helps with COPD
- Breathlessness: low-dose morphine or other opioids can ease the feeling of breathlessness safely when dosed by the hospice team. Fans, positioning and breathing techniques also help.
- Oxygen and inhalers: hospice provides oxygen equipment and can continue inhalers and nebulizers when they help comfort.
- Anxiety and panic: breathlessness is frightening. Calming medicines, a plan for flare-ups and 24/7 nurse access reduce panic and ER trips.
- Flare-up plan: the nurse helps the family know what to do during a flare-up at home, often using the comfort kit.
- Energy and daily care: aides help with bathing and personal care, so the person saves energy for what matters to them.
Common questions
Will my loved one have to give up oxygen? No. Oxygen is commonly used for comfort in hospice and is covered when it relates to the terminal illness.
What if they go to the hospital? A person can still go to the hospital if they choose, but they should call hospice first. Hospital care related to COPD that the hospice did not arrange may not be covered. If they want aggressive treatment again, they can leave hospice.
What if they live longer than six months? That is allowed. Hospice can continue as long as the doctor recertifies eligibility at each benefit period.
Next steps
- Read who qualifies for hospice.
- Learn about the four levels of hospice care, including crisis care at home.
- Find a hospice in California.
This guide is general information, not medical advice. Talk with your lung doctor and hospice team about your own situation.