I often like to reprint useful articles I have found and the National Care Planning Institute authorizes reprints, so please feel free to pass on this article about COPD and related depression to anyone you know who may be affected by COPD. And as always, if you need referrals to caring practitioners who can help you sort out the promises from the reality, please contact me.
Helping Your Elderly Parent with COPD Related Depression
Experts say that over a million people in the United States have
chronic obstructive pulmonary disease (COPD). It is a chronic lung
condition that includes bronchitis, emphysema or both.
COPD affects the airways and air sacs within the lungs, which
makes breathing difficult and can result in a person becoming less
active over time. An elderly person who has COPD will easily become
depressed, when dealing not only with breathing difficulties but other
age related problems.
One example of COPD related depression is Martin, age 72. Martin
had lived a busy lifestyle, playing golf, volunteering at the community
center and working in his garden. Diagnosed with COPD six months
previous, and uncertain how to mange his breathing difficulty and new
medications, Martin stopped all his activities. Giving up the things he
loved to do and sitting more at home along with improper diet, he became
a victim to depression.
Martin’s son Anthony realized that his father could not handle
his new situation and depression alone. A trip together to Martin's
physician began the steps to dissipating the depression and enabling
Martin to return to his social life.
Anthony received instructions about his father’s medications from
the doctor and how they were to be used and consequently could help his
father with medication reminders.
The most common types of daily COPD medicines are:
- Inhaler for daily maintenance – Bronchodilators help relax the
muscles around the lungs’ breathing tubes. This reduces shortness of
breath and makes breathing easier.
- Steroids – Corticosteroids, taken in pill form or inhaler
reduce swelling in breathing tubes to quickly make breathing easier. Not
commonly for prolong use.
- Oxygen Treatment – Severe COPD will reduce your lungs’ ability
to put oxygen into your blood to be carried throughout your body.
Martin’s oxygen level was measured to determine if he would need
prescribed oxygen therapy. Oxygen is usually prescribed if the oxygen in
the blood is low during sleep, exercise, or while not active. A
respiratory therapist from an oxygen supply company or home health
service can help with learning how to use oxygen.
An important factor in Martin’s depression and COPD management was his diet.
“A healthy diet can play an important role in the management and treatment of COPD.
Finding the right diet can be tricky for people with
chronic obstructive pulmonary disease (COPD), since they need to eat a
healthy diet and maintain their optimal weight to keep COPD symptoms in
check.” )Krisha McCoy, MS, Lindsey Marcellin, MD, MPH)
Maintaining the right nutrition and
taking vitamins not only keeps the body healthy but heals the mind,
providing emotional well being. Fad diets or extreme dieting are not
appropriate for COPD patients. Extreme weight loss can be as much a
hazard as being overweight. A home care nutritionist can help establish a
healthy menu and diet plan.
With medication and diet under control the final steps to
overcoming Martin’s depression were to return to his daily activities.
With COPD, an elderly person is more hesitant to leave home, especially
if that person's breathing capacity is not as it used to be. There is a
lot of available mobility support for the elderly with small portable
oxygen units, walkers, electric scooters and other supportive equipment
to help these disabled people move about in the community.
With the help of mobile services and his son at his side to start
with, Martin returned to the golf course and community activities. His
new diet and return to previous activity helped Martin overcome his
symptoms of depression.
Studies show that the intervention of family and friends in
helping and supporting elderly people with COPD results in a decrease of
depression and a healthier outcome for the patient.
The Oxford Journals Medicine and Ageing states
“It is also worth exploring how family and friends may be
involved in supporting the patient and to encourage social interaction.
Educating the spouse, family members and friends about depression may
help them to understand the consequences of the disease and to develop
coping strategies and in turn may reduce the likelihood of isolation. A
very recent study that investigated the benefits of emotional support by
family and friends and of spiritual beliefs in patients with major
depression showed that those with higher perceived emotional support had
better outcomes.” (Oxford Journals Medicine Age and Ageing Volume 35,
If you are helping an elder parent with COPD
related depression there are community and professional services to help
you. Start with your parent’s physician. You can also find resources
for oxygen therapy, homecare respiratory treatment, home nursing, home
medical equipment and mobile services.
The National Care Planning Council promotes eldercare resources and lists eldercare services throughout the United States.
My clients come to me to protect assets and preserve the wealth they have worked hard to accumulate. But the problems that create the risk of losing that wealth are not usually related to the world of finance or investing; we are trying to protect assets against the tragic costs of long term care that can result from a fall or sudden medical crisis. Seniors, especially, need to be savvy about staying safe in their homes. The Home Safety Council devotes significant space on their website to tips geared towards making your home safer for seniors.
In addition to modifying your home, another way to maintain yourself at home safely is to work to increase your physical strength. A home care assessment followed by strengthening exercises under the supervision of a physical therapist and personalized nutrition can mean the difference between additional years in your favorite place or a one-way ticket to nursing home level care. One of our local home care agencies, HCR, spearheaded the Lifelongevity program, the first program of its kind in the Rochester area specifically tailored to keeping seniors in their homes. Depending on the individual's medical needs the initial assessment may even be covered in full by Medicare.
We are here to provide planning assistance and referrals, but remember that you need to take advantage of the services available in the community before crisis hits to have the most choices available.
Let’s face it. You think about dying. We all do. We all at some point wonder what friends and family members will say about us when we are gone. Have you ever thought that they might fight over how your remains are treated? Yes, families can actually go to court over how your remains will be disposed of and whether there will be a funeral or memorial for you.
If you already know that your children and your spouse disagree over what should happen to you, you may wish to consider signing a document known as Appointment of an Agent for the Disposition of Remains. New York law provides for it in Public Health Law section 4201. There is a form provided that should be executed in triplicate – one for your attorney, one for the agent named and one for the funeral director. (See my page link for the form.) You should also consider drafting a lovingly worded letter to your family members explaining what you wish to happen.
I have happily not had to confront this with any clients, but we have started preparing the designations more often when clients voice this concern. Now that you know you can address this concern with a simple document, do not keep silent and hope for the best. Make your wishes known.