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When OTs Wore White Shoes

The Role of OT with COPD: Treating the Whole Patient

Published May 26, 2015 3:48 PM by Debra Karplus

Chronic Obstructive Pulmonary Disease (COPD) is a nasty disease that occupational therapists often work with in their patients. People don't realize the many symptoms that come with this disease until it robs a loved one of any sort of reasonable quality of life, and ultimately leads to a long slow death. One only has to view the numerous television commercials for products to alleviate COPD symptoms to realize that the disease may be more common than one thinks. Though there is no real cure, health care practitioners work to relieve the many unpleasant symptoms of the disease.

There are numerous reputable web sites that describe the different facets of this fatal disease. COPD affects women more than men. Though people often assume that COPD sufferers are smokers or ex-smokers, statistics show that 75% of smokers never get COPD, and 10 to 20% of people who have never smoked do. Poor air quality - indoors, outdoors, at home or at work -may be a factor for those non-smokers who get COPD. 

There also appears to be a genetic component to the disease, which has four distinct stages. Early symptoms of COPD include a cough, wheezing, shortness of breath, and fatigue, as well as some psychological factors such as anxiety and depression. And oxygen PRN is usually part of the medical treatment for the disease.

Fatigue and general weakness are typically the symptoms that cause physicians to order an occupational therapy evaluation and treatment as needed in their patients with COPD. The focus of an OT program usually involves exercise for strengthening upper body function. Training in activities of daily living (ADL) includes energy conservation techniques and work simplification specifically in areas of bathing, dressing, meal preparation and other kitchen tasks. Low-tech adaptive equipment such as bedside commode, bath tub bench, and stool for sitting kitchen tasks are routine OT procedures for patients with COPD.

But OTs need to be aware of the equally debilitating psychological problems that are often part of COPD. Anxiety is not at all uncommon in COPD sufferers. Patients may or may not be prescribed medication to reduce these symptoms. Some of the anxiety may be rooted in the fear of not being able to breathe. Depression and feelings of reduced self-worth are also common to those who have COPD. Crying is common. "This is no life", stated one patient tearfully. At 86, she had been very active until recent months during which she was on oxygen 24/7, and was no longer able to drive. A paid caregiver was brought into her home to help her husband with some of the daily tasks.

Occupational therapy practitioners need to be mindful of the psychological aspects on this unpleasant malady and remember to view the whole patient.

What has been your experience as an OT working with COPD?

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Debbie Karplus June 30, 2015 2:56 PM

Thank you for your article but I wondered if we got the full article.  I was looking for more.  Perhaps because I am currently dealing with my husband who has severe COPD, is on oxygen at highest level and needs  help with his care.  I don't try to be his OT.  I guess I was looking to learn more from OT perspective about levels that you indicated in the article.  But I thought I would share a little of what I am learning.  The fatigue gets worse, the level of ability to do things gets worse as see how out of breath he becomes.  The determination to try to do things that make him even more fatigued is consistent.  He does not give up easily but getting hiim to rest is really difficult much of the time.  He has no CHF but has edema in his legs and feet when does too much or has too much salt.  The salt issue is huge, no salt at all, if can help it.  We avoid pre-prepared foods and cook with only salt free type of seasonings.  I am sure I have more.  I also have questions of how long this can continue, but think it is probably very individual.

Donna Breger Stanton, OT Faculty - Professor, Samuel Merritt University June 10, 2015 4:35 PM
Oakland CA

Thank you for the  article. I work in homecare and frequently work wit patients with COPD also my father is 86yrs. old and has the disease. He has been reduce to sitting in his chair all day struggling to breath and goes no where. My mom takes care of him 24/7 and goes no where. everything you talk about in tis article I have seen with my father and the patients I treat. Many feel their life is useless. We do need to view the whole person. thank you again for this article.                                              P.S. can you recommend some exercises and where I can get handouts?

Joyce Hamilton, Homecare - Occupational Therapist, Catolic Health McAuley Seton June 5, 2015 6:48 PM
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Thank you for serious article I've benefited a lot of this information is comprehensive and I think that each article something useful in the world of health and medicine Thank you very much.

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