I care for an 80 year old woman with COPD & Emphysemia. In Hospice - ?signs/symptoms as progression occurs?

Question

Hospitalized for 8 weeks with recurrent pneumonia and excessive pleural fluid was removed three times. Last time could not be removed. Fluid/gel-like keeps recurring to the point that the left lung is completely colapsed and right lung has about 1/2 functional space left. Some fluid surrounding the heart as well. Physicians advise that further invasive attempts would probably not be successful, would be painful and the odds of recurrence are high. So, no more options. Family moved her to Hospice. What can I watch for in terms of signs and symptoms as disease progresses. I want to be able to comfort her as much as possible AND I want to be able to notify family when she is getting close. If you have experience with this -- knowledge or have gone through it as a patient of caregiver, I would appreciate your thoughts and advice. Thank you.

Answer 1

I will assume she is now still alert? Does she have oxygen at home for her use? Anyhow, probably some of the signs you should watch for is her breathing. She may become very short of breath and need oxygen if she does not have it already. Then maybe become confused. Keep her head of the bed elevated if this happens to help ease her breathing and keep oxygen on her if at all possible. I think its great that you care so much about her to ask this and good luck with her, she seems in good hands with you.

Answer 2

Unfortunatley once a patient is moved to hospice they are already debilitated to the point of near death. People are not usually on hopice for weeks on end, hospice care is provided for comfort to the patient and family, they provide 24 hour support to familys questions. They will be assesing her on a daily basis, and will notify the family when they think she is almost ready to go. Although in order to qualify for hospice she has to "be close" I think its great that you are concerned about the patient and family, but if the family agread to hospice they should be pretty aware that its an any time kind of thing. When a person gets close to death, they start taking shallow breaths, somtimes there extremities become cold, and they start molting, getting gray, With chronis obstructive pulmonary disease, the patient will likely pass from fluid overload. Its basically drowning them. I suggest frequent turning, pain meds, and maybe some lasix (dieuretic). Make her comfortable, give her oxegen, and give an ear to family and their stressors. Since your patient is a hopice cadidate, you probably will only see these last stages of this disease. Also I suggest suctioning at bedside, so you cna clear mouth of phlem and spit. Good Luck to you

Answer 3

Poor thing.If she is going into respiratory failure,you would notice difficulty in breathing,restlessness,agitation,confusion and cyanosis[bluish discoloration of skin and conjunctiva].