There’s often a difficult shift in perspective required at some point in a progressive disease. When someone has COPD, then throughout the illness there’s usually a focus on pulmonary function tests, treatments for infection, and efforts to slow the progression of the disease. As COPD reaches advanced stages, these efforts have less effect on someone’s condition, and focus shifts to patient comfort. There’s less attention to tests, details and numbers, and more attention to how someone looks and feels.

With advanced COPD, oxygen is used mainly to relieve shortness of breath and the level is adjusted gradually. It’s done gradually because some people with COPD only get the signal to breathe if oxygen levels are low. If this person gets too much oxygen, the breathing signal can be dangerously depressed, and breathing stops. Most people don’t have the specialized knowledge to assess how much oxygen someone needs. Trained specialists who know the patient’s history and current condition have the knowledge to determine the correct level. It’s important to talk regularly with the health care team about how to care for someone at home.

Oxygen is just one of the medications used to treat symptoms of advanced COPD. There may be other medications, such as opioids for shortness of breath and medications for anxiety that can ease breathing and provide comfort. It may be helpful to request palliative care resources. In most areas the palliative care team works with the health care providers to ensure the best care for someone at home.