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Chronic obstructive pulmonary disease - Management
What are the general principles of managing people with end-stage COPD?
- Optimize medical treatment of chronic obstructive pulmonary disease (COPD) — see Scenario: Stable COPD.
- Establish a clear management plan based on the wishes of the person with COPD (and if appropriate their family or carers).
- Determine whether hospital admission for severe exacerbations is appropriate.
- Start to coordinate care with a respiratory nurse specialist, district nurse, palliative care specialist nurse, and social services.
- Consider admission to a hospice (for example if symptoms are not controlled or if this is the preferred place of death).
- Discuss any advance decisions.
- Consider using a management pathway for the terminal phase, such as the Liverpool Care Pathway (which offers a framework for caring for people at the end of life). For further information, see www.mcpcil.org.uk/liverpool-care-pathway.
- Advise simple measures and offer drug treatments (including oxygen) for breathlessness. See the CKS topic on Palliative cancer care - dyspnoea.
- Manage cough, secretions, pain, fatigue, insomnia, depression, and anxiety — see the CKS topics on:
- For more information, see the CKS topics on Palliative cancer care - general issues.
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