Authors
  • Amanda Landers1,
  • Rachel Wiseman2,
  • Suzanne Pitama2,
  • Lutz Beckert2
Organisations
  • Nurse Maude1,
  • University of Otago2
Year

2014

Excerpt
COPD is a slowly disabling illness, with functional limitations and a high burden of symptoms. Palliative care services focus on quality of life for those facing life-limiting illness. It is sometimes a difficult interface as patients see COPD as a 'way of life', not as a life limiting illness, even when severely impaired.

The aim of this study is to explore the experience of patients with advanced COPD after a life threatening event to develop a shared understanding between themselves and their health professionals.

Qualitative methods were used to capture patient experiences. Patients admitted for non-invasive ventilation for COPD were recruited and interviewed in their homes following discharge. Questions examined the participants understanding of their illness, concerns and plans, exploring end-of-life issues and perceptions of palliative care. Fifteen participants were recruited until themes were saturated. Six transition points or milestones emerged:  Loss of recreation, location of care, need for acute care, oxygen treatment, panic attacks and self-care were common threads throughout the narratives.

Milestones accumulate as a series of losses or events in no particular order. They can be easily recognized and allow health professionals to use a shared language. In advancing COPD milestones may trigger the reassessment of goals of care and integration of a palliative approach.