Are Your Nursing Assistants in the Know About COPD?


Did you know that COPD is predicted to be the third leading cause of death by 2030? Because chronic obstructive pulmonary disease is so prevalent, your nursing assistants are bound to care for clients with this condition. They need to know how to help clients deal with the changes that come with a diagnosis of COPD. Here is some information–and a few practical tips–that you can share with your CNAs:

What Is COPD?

You probably know that the term COPD stands for Chronic Obstructive Pulmonary Disease. And, you may know that the lung damage that results from COPD makes the vital act of breathing extremely difficult, sometimes painful and completely inefficient. But, did you know that COPD develops gradually over a long period of time? For example, it usually takes years of cigarette smoking before symptoms become noticeable. While the progression of COPD is different for everyone, it might develop something like this:

Jim started smoking cigarettes when he was 19. Now, he’s 27. His wife wants him to quit smoking, but Jim hasn’t noticed any symptoms of lung damage, so he keeps on smoking. When he turns 31, Jim starts to develop a chronic cough. Sometimes he coughs up a small amount of mucus.

By age 40, Jim begins to notice some occasional shortness of breath. As the years go by, his shortness of breath gets worse and worse. When he turns 47, Jim finally sees a doctor who diagnoses COPD and starts Jim on some treatments. He notices a little bit of improvement at first-less coughing and fewer episodes of shortness of breath. Jim decides it’s okay to continue smoking-just a few cigarettes a day.

In his early 50’s, Jim starts to slowly get worse. His COPD is progressing-in spite of medical treatments. Jim has repeated coughing attacks and constant shortness of breath. He loses his job and can no longer support his family. Now, each time Jim has a coughing attack, it takes longer and longer for him to feel better. (Unfortunately, his lungs suffered a lot of damage before he finally went to a doctor. This makes it harder to manage the COPD.) By age 55, Jim’s damaged lungs barely work. He has to gasp for every breath of air. Jim dies at the young age of 56-leaving a wife and two teenaged children.

Facts about COPD

COPD is a chronic disease, which means that it continues over a long period of time. And it’s obstructive, because it blocks the passage of air, making it hard to breathe. COPD is a pulmonary disease, which means that it affects the lungs.

COPD is also a progressive and irreversible disease. This means that it gets worse over time and that a person with COPD won’t get better (once there has been damage in the lungs).

Early symptoms of COPD often start out mild and do not cause much concern. Over time, as the symptoms worsen and fail to resolve, lung damage begins to occur. There are four main symptoms of COPD:

  1. Chronic cough that may produce mucus. This is usually the earliest symptom. It can start out mild, then gradually increase in frequency and produce more and more mucus.

  2. Shortness of breath with minimal exertion. This usually develops later on and continues to get worse as COPD progresses.
  3. Chest tightness. As lung damage progresses, breathing becomes more difficult. There may be a feeling of painful tightness in the chest.
  4. Wheezing or a whistling sound that occurs while breathing is common if the airways become swollen or blocked.

Other symptoms of COPD may include:

  • Fatigue, depression and anxiety.
  • Weight loss.
  • Enlarged chest (also called “barrel chest”).
  • Too little oxygen can cause COPD clients to have a bluish color to their skin, lips, and nails.
  • Headache, irritability, and problems thinking and learning.

10 Client Care Tips

There is no cure for COPD. But, there are some things you can do to help. Here are a few tips for improving the quality of life of your clients with COPD.

1. Watch your clients when they use their inhalers. It’s important that they know how to use them properly. Using an inhaler seems simple, but you would be surprised at how may people forget to take off the cap! Let your supervisor know if you think they may be using them wrong.

2. Ask to see your client’s inhaler. If you notice a “powder” around the hole where the medicine comes out, the inhaler needs to be cleaned. Clean the canister by removing the medication canister from the mouthpiece and rinsing the mouthpiece and cap in warm water. It’s best to do this in the evening so the mouthpiece can “air dry” overnight.

3. If your clients have portable oxygen units, make sure they know exactly how much oxygen they have so that they don’t run short during an outing. It’s very important not to smoke near oxygen. Encourage your clients and their family members not to smoke at all.

4. Try not to let your clients with COPD do too much in one day. Help your clients do their most important chores or activities first-when they have the most energy. And, suggest that your clients sit for as many activities as possible. Believe it or not, sitting uses 25% less energy than standing.

5. Remind your clients to avoid air pollution. Encourage them to remain indoors if the air quality is poor. Even low amounts of ozone can worsen respiratory diseases.

6. If your clients experience shortness of breath during mealtimes, you can suggest that they: eat several small meals instead of three big ones; rest before eating; eat slowly and chew foods well; breathe evenly when chewing; take plenty of time to eat; and avoid hard to eat foods.

7. Staying hydrated is important, too. Encourage your clients to drink plenty of fluids. This is a good way to keep the mucus loose so that it can be brought up by coughing.

8. Avoid wearing strong perfumes or using strong-smelling cleaning fluids around clients with COPD.

9. Many people with COPD also have allergies or asthma. If your clients suffer from allergies, try to be aware of the things that bother them-such as house dust, pollen, strong odors, cigarette smoke and pets. Help them avoid these allergy “triggers”.

10. Remember…encourage your clients and their family members not to smoke. Tell them that over one million smokers successfully quit the habit each year. Of course, it isn’t easy to quit. Most smokers make five attempts to stop before they actually do it. But, there are plenty of products on the market to help, such as nicotine patches, nicotine gum, nicotine nasal spray, and nicotine inhalers. Offer praise and support when your clients quit smoking. (And be a good example yourself by not smoking!)