COPD Care at Home for Older Adults

Living with COPD means planning the day around breath. Showers, stairs and even getting dressed can leave an older adult winded, and a cold can turn into a hospital stay. This guide covers what COPD looks like day to day, the habits that make breathing easier at home, how to use oxygen safely and the signs that mean it's time to call the doctor or 911.

What is COPD?

COPD (chronic obstructive pulmonary disease) is a group of lung diseases, mainly emphysema and chronic bronchitis, that block airflow and make it hard to breathe. The CDC says nearly 16 million U.S. adults have COPD, with many more undiagnosed. It's one of the top 10 leading causes of death in the country. There's no cure, but it can be managed.

Smoking is the main cause in the U.S. Secondhand smoke, workplace dust and fumes, family history and asthma also play a part. The CDC lists adults 65 and older among the groups at higher risk.

What are the symptoms of COPD?

The National Heart, Lung, and Blood Institute (NHLBI) and the American Lung Association describe these common symptoms:

Shortness of breath, especially with activity
A cough that doesn't go away, often called a "smoker's cough"
Mucus (sputum) that's hard to clear
Wheezing, a whistling or squeaky sound when breathing
Chest tightness that makes deep breaths hard
Fatigue, because the body is working harder to breathe

The NHLBI notes that COPD often starts with mild symptoms that get worse over time. In an older parent this can look like slowing down. They stop taking the stairs, sit down halfway through making the bed or skip outings they used to enjoy.

What does a COPD flare-up look like?

A flare-up (exacerbation) is when symptoms suddenly get worse. The NHLBI says triggers include colds and other infections, cold air, poor air quality, dust and smoke. During a flare-up a person may have:

More trouble breathing than usual
More chest tightness
More coughing, sometimes with yellow or green mucus
A fever

The American Lung Association says flare-ups can mean extra medicine, an emergency room visit or a hospital stay. Ask the doctor what your parent should do when symptoms change, get it in writing and keep a copy on the fridge.

Breathing techniques that help

Doctors and pulmonary rehabilitation teams teach breathing exercises to people with COPD. The American Lung Association describes two of the most common ones.

Pursed-lip breathing

This helps keep the airways open longer so trapped air can get out of the lungs.

Relax the neck and shoulders.
Breathe in slowly through the nose for a count of two.
Pucker the lips as if about to whistle or blow out a candle.
Breathe out slowly through pursed lips for a count of four.

Belly (diaphragmatic) breathing

This slows breathing down so it takes less energy.

Sit upright in a comfortable chair or lie down.
Put hands on the belly.
Breathe in slowly through the nose and let the belly rise like a balloon.
Breathe out slowly through pursed lips.

The American Lung Association recommends practicing for 5 to 10 minutes a day when breathing is normal, so the technique comes naturally during a hard moment. Ask the doctor or a pulmonary rehab therapist to check your parent's technique.

What is pulmonary rehab?

The CDC describes pulmonary rehabilitation as a program that teaches people with COPD how to manage symptoms and save energy. Ask the doctor whether your parent should be referred. If getting there is the obstacle, line up rides before the program starts.

How to save energy with COPD

Every task costs breath. The American Lung Association's tips for daily activities center on pacing, planning, positioning and prioritizing.

Pace it. Rest between activities and keep a slow, steady pace. Spread big chores across the week instead of piling them into one day.
Do the important things first. Save energy for what matters most, during the time of day your parent feels best.
Sit down. Sit while dressing and while chopping or prepping food. Avoid a lot of bending and reaching.
Make bathing easier. A shower chair, handheld showerhead, tub transfer bench and grab bars all help. Use warm water and keep steam down.
Dress the easy way. Loose or stretchy clothes, a long-handled shoehorn, a reacher and a sock aid cut down on bending.
Keep things within reach. Store items used every day on counters at waist height and use a wheeled cart to move things around.

The NHLBI adds a few more. Arrange the home so your parent climbs stairs less. Eat smaller, more frequent meals if breathlessness makes eating hard.

Many of these changes also lower fall risk, since breathlessness and rushing don't mix well on stairs. Our guide to preventing falls at home covers the rest of the house.

Home oxygen safety

The CDC notes that oxygen therapy helps people with COPD who have low blood oxygen. Oxygen and fire don't mix, so the American Lung Association gives these safety rules:

Keep flames and heat at least five feet away from the oxygen unit, whether it's in use or stored.
No smoking anywhere near the oxygen. Post "No Smoking" and "No Open Flames" signs in the home.
Don't use oxygen while cooking on a gas stove.
Skip hair dryers, curling irons, heating pads and electric razors while wearing oxygen.
Avoid petroleum jelly, oil-based lotions and vapor rubs. Use water-based products instead.
Don't use aerosol sprays like hairspray or air freshener.
Don't store oxygen in a closet or car trunk. Keep it a few inches away from walls and curtains.
Plug a concentrator straight into the wall, never into an extension cord.
Don't cut tubing or use more than 50 feet of it. Long tubing is a tripping hazard.
Keep working smoke alarms and a fire extinguisher nearby.

The American Lung Association also suggests telling your power company that someone in the home depends on life-sustaining equipment, and keeping backup oxygen for outages.

Avoiding triggers and infections

Infections can set off a flare-up, so prevention matters.

Vaccines. The CDC recommends that people with COPD get vaccines for COVID-19, flu and pneumococcal disease. The NHLBI adds that adults 60 and older should ask about the RSV vaccine, and that Tdap and shingles shots are recommended for some people. Ask the doctor which ones your parent is due for.

Smoke and fumes. The CDC says quitting is the most important step for anyone with COPD who smokes. The NHLBI recommends avoiding secondhand smoke, chemical fumes, dust and smoke from cooking or heating fuels.

Air quality and weather. The NHLBI suggests checking the daily air quality report, staying indoors on poor air days and avoiding very cold air.

When should you call the doctor or 911?

Call the doctor when symptoms are getting worse or there are signs of infection, like a fever, according to the NHLBI. The American Lung Association also says to call about breathlessness that is increasing during routine activities or frequent respiratory infections.

Call 911 if your parent has any of these warning signs from the NHLBI and the American Lung Association:

Severe trouble breathing or can't speak
Lips or fingernails turning blue or gray, a sign of low oxygen
Confusion or not being as alert as usual
A very fast heartbeat
Their usual treatments aren't working

The NHLBI recommends keeping emergency phone numbers and a current medication list where they're easy to find. Put both on the fridge next to the action plan.

If your parent also has a heart condition, our guide to heart failure care at home covers its warning signs, which can overlap with COPD's.

How in-home care helps with COPD

A lot of COPD care is about getting through the day without running out of breath. An in-home caregiver can take on the tasks that cost the most energy, like bathing with a shower chair, dressing and making meals. They can handle laundry and light housekeeping in the rooms your parent uses. Caregivers give medication reminders on the schedule the doctor set and help with errands and grocery runs. They also drive to appointments, including pulmonary rehab. They keep walkways and oxygen tubing clear and watch for changes in breathing, color or alertness, and they tell the family right away.

Caregivers don't give medication, set oxygen flow or adjust treatment. When care needs a nurse, a licensed one can be arranged.

Tale Circle Care works with families across metro Atlanta, including Roswell, Sandy Springs and Fayetteville. See all our service areas. If you're not sure how much help a parent needs, our list of signs a parent needs help at home can help you sort it out, and our guide to the cost of in-home care in Atlanta covers budgeting. You can also call Taly at (346) 278-3018.

For free help finding other local resources, the Atlanta Regional Commission's Empowerline offers free consultations at (404) 463-3333.

Common questions

Can COPD be cured?

No. The CDC says there's no cure, but treatment, pulmonary rehab and avoiding triggers can help people manage symptoms.

Is it safe to have oxygen in the house?

Yes, when it's used carefully. The main risk is fire. Keep flames and heat at least five feet away, never smoke near it and avoid oil-based products, per the American Lung Association.

How often should someone with COPD practice breathing exercises?

The American Lung Association suggests 5 to 10 minutes a day, practiced when breathing is normal.

What makes COPD worse?

Common triggers named by the NHLBI include colds and other infections, cold air, poor air quality, dust and smoke.

Sources

This guide is general information for families, not medical advice. Ask the person's doctor about their care, and call 911 in an emergency.