Signs of COPD in the elderly

Chronic obstructive pulmonary disease (COPD) is the name given to a group of lung conditions that cause breathing problems, including emphysema and chronic bronchitis. COPD is something that many people are unaware that they have until they start to experience breathing difficulties in middle age or later life. If COPD is not controlled effectively with treatment, it can have a significant negative impact on normal daily life.

In this article, we look at the signs of COPD to look out for in the elderly and more about the conditions involved, what to do if you think an older loved one has COPD and what potential treatment and management options are available.

Jump to:

• What is COPD?
• What causes COPD?
• What are the symptoms of COPD in elderly people?
• When to seek medical advice with COPD
• Are there different COPD stages?
• COPD treatment in the elderly
• Peace of mind if your older loved one has COPD

What is COPD?

COPD is a name that covers several lung conditions which make it difficult for people to breathe normally, usually because their airways have narrowed as a result of their lung issues.

The two most common lung conditions that are usually included under COPD are:

• Emphysema
• Chronic or long-term bronchitis

These conditions often occur together and cause a narrowing of the airways, which makes it more difficult to breathe in and out, meaning that the body struggles to take in the levels of oxygen it needs and to get rid of the carbon dioxide that we breathe out.

COPD tends to worsen over time, if not treated effectively, so someone with COPD may find it affects their daily life and normal activities more and more, as they are unable to catch their breath and their body is working very hard just to breathe in and out.

Those with COPD also carry an increased risk of developing other serious health conditions, such as heart disease and lung cancer.

COPD is often more evident in older people and doesn’t get diagnosed until there is already significant damage done to the lungs. This is one reason why COPD tends to be considered a condition that mainly affects the elderly.

COPD isn’t curable, but can often be managed very effectively with the right treatment alongside lifestyle changes.

What causes COPD?

COPD usually develops gradually as a result of damage to the lungs that is caused over a long period of time. The most common causes include:

• Smoking
• Exposure to high levels of air pollution over many years
• Exposure to damaging chemicals or dust, usually at work
• Genetic factors that make it more likely for someone to develop COPD

What are the symptoms of COPD in elderly people?

There are many potential symptoms of COPD in elderly people, some of which could also be explained by other conditions that the individual may have, such as asthma or allergies, but it’s important to take note of any signs that could indicate COPD, just in case. These may include:

• Shortness of breath, or taking longer for breathing to return to normal after physical activities or exercise
• Feeling a tightness in the chest
• A wheezing sound when breathing
• A cough that doesn’t go away and may produce mucus
• Frequent chest infections
• Lacking energy or feeling unusually fatigued
• Swollen feet, ankles or legs
• Loss of appetite

Many people with COPD find that there are times when their symptoms are noticeably worse for several days, usually known as a flare-up. However, even if symptoms seem to improve for a time afterward, the COPD hasn’t gone away.

When to seek medical advice with COPD

If you’re concerned about a loved one and think they may have COPD, it’s important to visit their GP as soon as possible. If they are diagnosed with COPD, it’s usually more straightforward to treat and manage if it is caught as early as possible.

If you have a loved one who already has a COPD diagnosis and their condition seems to be getting worse, or the treatment no longer seems to be effectively managing things, consulting their doctor is always a good idea.

Consult a doctor if:

• They develop a high temperature that doesn’t respond to treatment
• Their cough gets noticeably worse or the mucus changes
• They get blue lips or fingernail beds
• Their heartbeat is rapid while resting
• They feel foggy, confused or have trouble concentrating if this is abnormal for them

These can all be signs that they should get medical attention as quickly as possible. Call NHS 111 for tailored advice.

Are there different COPD stages?

COPD can be graded in different ways, depending on how severe the symptoms are and how much the lungs are affected. These are often referred to as COPD stages.

The stages range from GOLD 1, which is mild COPD, through to GOLD 4, which is very severe COPD. These four stages are outlined below.

GOLD 1 – Mild COPD

Lung function is mildly affected and there may be slight problems breathing after exercise or vigorous activity. Someone with mild COPD may have a chronic cough, often accompanied by mucus.

GOLD 2 – Moderate COPD

Lung function is moderately affected, so as well as probably experiencing an ongoing cough and mucus, the individual may also experience more difficulties with breathing, especially after being active.

GOLD 3 – Severe COPD

Lung function is severely affected, so serious breathing difficulties and very frequent coughing is expected, even after very slight exertion.

GOLD 4 – Very severe COPD

Lung function is low, meaning that severe shortness of breath is expected during even a sedentary daily life and the individual is likely to require an oxygen supply at home, sometimes 24/7.

COPD treatment in the elderly

Treatment for COPD will depend on individual circumstances and medical needs, with health professionals providing a plan to help manage symptoms and try to stop things from getting worse, when possible.

Some of the options that may be available, depending on the situation, might include:

Medications for COPD

Different medications may be offered to help alleviate some of the symptoms of COPD. While COPD cannot be cured, symptoms can often be improved, and flare-ups prevented, by using one or more medications.

• Bronchodilators are a group of medications that help open the airways to make breathing easier. They are usually provided in inhalers and may contain one or more medications in the same inhaler. Sometimes this kind of medication can be provided in tablet form too.
• Mucolytics are medications (usually tablets, capsules or a powder that is mixed with water) that can make the troubling mucus, that people with COPD often struggle to cough up, up a little thinner and easier to get rid of.
• Steroids may be prescribed in a short course if there is a COPD flare-up, to reduce inflammation of the airways.
• Antibiotics might be prescribed if there are signs of a chest infection.
• For those with more severe COPD, a nebuliser may be provided. This is a machine that turns liquid medicine into a mist that someone with COPD inhales using a mask or mouthpiece.
• Oxygen therapy may be offered, which means having oxygen tanks at home or portable tanks if using oxygen away from home. The oxygen is usually delivered into the body through a mask or nasal tubes for at least 15 hours a day.
• In a very limited range of cases, there may be some surgical options to help with COPD.
  
  

Lifestyle changes to help with COPD

If the individual with COPD is a smoker, stopping smoking is the most effective way to help prevent COPD from worsening.

Improving fitness and muscle strength through a tailored exercise plan (known as pulmonary rehabilitation) can make a big difference to improving physical resilience, along with mental wellbeing.

Staying active and eating a healthy balanced diet can help with general health to support the body as it deals with the COPD.

Regular checkups to ensure COPD is being managed effectively

It’s important that COPD is managed effectively to help prevent it from getting worse, reduce flare-ups and to help maintain quality of life. It can also help minimise the chances of other serious related health conditions developing.

Checkups should be at least annual, and even more often if there are changes made to medications or other treatments, to make sure that the COPD symptoms are being managed as well as possible.

Peace of mind if your older loved one has COPD

If you have an elderly loved one with COPD, it is very natural to worry about them and what might happen if they have a flare-up when you aren’t there with them. One option to provide peace of mind to you and your older relative or friend is a personal alarm system. A simple press of the button on a wearable pendant or alarm watch for the elderly will raise an alert with TakingCare’s Emergency Resolution Team, who monitor our personal alarms 24 hours a day, 365 days a year.

Choosing the alarm with the right features for your loved one’s lifestyle and preferences can help build their confidence and ensure that help is always at hand if there is an issue related to their COPD or any other kind of incident or accident that might occur.