The Role of OT with COPD: Treating the Whole Patient
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?