Question

A 60-year-old patient has recently been diagnosed with GOLD 2 class COPD. He is a current smoker and has only had COPD symptoms for the past year. He and his wife, a retired registered nurse, are attending a class on COPD management. Before the class starts, he complains to you that his wife is pressuring him to make some big changes. First she wants him to stop smoking, which he has agreed to do and has started on pharmacologic therapy to assist in this process. She wants to sell their current home (where they have lived for 25 years) and move to a one-story house. She has started mowing the lawn, which has always been his job, and which he wants to continue to do. She also has asked him to stop his hobby of refinishing furniture to avoid the fumes. He says, “I'm not dying yet, and I don't want to give up any of these things.” She says, “I'm just thinking of your best interests and am planning ahead.” She then asks you to support her suggestions (demands).

1. How should you respond to her request to support her suggestions? What do you think her motive(s) is (are)?

2. Is there justification for any or all of these suggested changes? Provide a rationale for your responses.

3. Should you continue this conversation with both of them together or separately? Provide a rationale for your choice.

4. Which members of the interprofessional team for COPD management would be helpful in this situation? Provide a rationale for your choices.

Answer 1

1. The suggestions are good and may improve his health but can be shifting house considered as last resort. Using a simple pollution control mask may help him to do his hobbies without severe adverse effects.

2. There is a justification. Avoiding the allergen will defenitely improve the health condition and by following the above mentioned suggestion may help.

3. Should be done with togother. Both advantage and disadvantage of suggestions have to be analysed and should be selected accordingly

4. respiratory therapist

A respiratory therapist is key member of the COPD treatment team. Respiratory therapists help to teach the patient about COPD. Patients need to know how COPD affects the lungs and the rest of the body. Respiratory therapists also provide support and guidance about many other parts of the COPD treatment plan, including:

• Understanding COPD medications and how to take them correctly
• Giving advice and support about how to quit smoking for good
• How to avoid infections
• How to use oxygen therapy safely
• Advice about how to improve breathing
• How to deal with COPD attacks (also called “exacerbations”)