Understanding and Supporting Loved Ones with COPD

Early signs of COPD include:

• Persistent cough, often with mucus.
• Shortness of breath, especially during physical activities.
• Frequent respiratory infections like colds or flu.
• Wheezing or a whistling sound when breathing out.
• Chest tightness.
• Increased fatigue and tiredness after light activities.

Recognising these symptoms early and seeking medical advice is vital to help you tackle the condition and get the best care.  Please note these signs can also signify other serious health problems, so seek an expert medical assessment as soon as possible if you or your loved one is experiencing these symptoms.

To help a loved one living with COPD, carents can enable the person to work with their health care team to develop and follow a personalised care plan.  You can also help with relevant lifestyle support such as stopping smoking to slow disease progression, taking part in regular, gentle exercise to enhance lung function, and preparing healthy meals adapted for severe symptoms such as breathlessness, fatigue and dry mouth.  You can also encourage best use of any medications, and help to recognise and tackle flare-ups.

You can also help someone living with COPD by ensuring they avoid lung irritants, stay hydrated to ease mucus clearance, and ensure they get the correct emotional and mental health support.

COPD can make those affected more likely to experience chest infections like bronchitis or pneumonia. Depending on its severity, the condition can also place an extra strain on the right side of the heart.  Mental health problems such as depression or anxiety can also develop and can affect how severe the impact of COPD can be. If your loved one with COPD is experiencing these symptoms, it is important they talk to their GP for support.

The four stages of COPD are measured using a lung function test called spirometry. Depending on the results of those tests, COPD can be categorised as:

• Stage 1 (Mild COPD) 
• Stage 2 (Moderate COPD)
• Stage 3 (Severe COPD)
• Stage 4 (Very Severe COPD)

Experts will also assess how severe breathlessness symptoms are using the MRC dyspnoea scale:

• Not troubled by breathlessness except on strenuous exercise
• Short of breath when hurrying or walking up a slight hill
• Walks slower than contemporaries on level ground because of breathlessness, or has to stop for breath when walking at own pace
• Stops for breath after walking about 100 metres or after a few minutes on level ground
• Too breathless to leave the house, or breathless when dressing or undressing

When diagnosing COPD, a doctor will review symptoms, examine the chest, and inquire about relevant details such as smoking history and family lung problems.

Key tests include:

• Spirometry: Measures lung function after inhaling a bronchodilator. It assesses the amount of air exhaled and how quickly it’s done, helping to detect airway obstruction.
• Chest X-ray: Identifies other lung-related issues that mimic COPD symptoms, like infections or lung cancer.
• Blood Tests: Check for conditions with similar symptoms (like anaemia) and occasionally rare genetic factors linked to COPD.
• BMI measurement: Measuring weight and height can help to guide lifestyle advice.

Depending on the results,  your doctor might also order other tests, such as sputum analysis to test for infections,  heart health investigations such as an ECG and echocardiogram, peak flow tests, and a CT scan.  These tests can be used to confirm COPD, determine its severity, and build a complete picture to guide treatment.

Emphysema is one form of COPD.  COPD is a broad term that includes various lung diseases that block airflow and make breathing difficult, primarily chronic bronchitis and emphysema. In emphysema, the air sacs (alveoli) in the lungs are damaged, making it difficult to breathe out. Chronic bronchitis, another form of COPD, involves long-term inflammation of the bronchial tubes, which also causes airflow restriction. While some people have COPD with predominantly emphysema or chronic bronchitis characteristics, most have a combination of both.