What Is End-Stage Chronic Obstructive Pulmonary Disease (COPD)?
This article was updated on: 09/15/2018
According to the National Institutes of Health (NIH), about 12 million adults in the United States are diagnosed with chronic obstructive pulmonary disease (COPD), and severe COPD can limit a person’s ability to do routine activities. The Centers for Disease Control and Prevention (CDC) illustrates this point in its “Tips from Former Smokers” campaign. Becky, a former smoker, speaks about her continuous need for oxygen now that she has end-stage chronic obstructive pulmonary disease. However, there are a wide range of treatments that may improve the quality and length of life for people who suffer from COPD, according to the NIH.
Here are steps you can take if you or someone you love has severe or end-stage COPD, and possible Medicare coverage of treatment.
What are the symptoms of end-stage chronic obstructive pulmonary disease (COPD)?
According to the National Heart, Lung, and Blood Institute (NHLBI), chronic obstructive pulmonary disease (COPD) is a disease that gets worse over time and makes it harder to breathe. Severe COPD may prevent you from activities like walking or caring for yourself. People with end-stage chronic obstructive pulmonary disease may need continuous oxygen, like Becky does. She says in a campaign for the Centers for Disease Control and Prevention (CDC) that her life is very different now, though she is grateful for her life-giving oxygen tank.
According to the National Heart, Lung, and Blood Institute (NHLBI), severe COPD symptoms can cause swelling in the feet, ankles, or legs and decreased muscle endurance. Severe disease may also cause weight loss because it’s hard to eat and get enough nutrition while undergoing symptoms such as shortness of breath and fatigue.
The NHLBI advises that you seek emergency help at a hospital if you have these severe COPD symptoms:
- Have trouble catching your breath or talking
- See your lips or fingernails turning blue or gray (a sign of low blood oxygen levels)
- Cannot remain mentally alert
- Notice your heart is beating very fast
- Find that your symptoms are getting worse despite the recommended treatment
What are the treatment options for end-stage chronic obstructive pulmonary disease (COPD)?
The NHLBI says there is no cure for chronic obstructive pulmonary disease (COPD), and physicians and researchers do not know how to reverse the damage done to the lungs and airways in end-stage COPD. There are things you can do, though, if you or someone you know is in this situation, to help you feel better and possibly slow the progression of the disease. Quitting smoking, is the number one step to treating COPD.
The NHLBI recommends lifestyle changes and preventive measures for those with end-stage or severe COPD such as:
- Avoiding places with secondhand smoke, dust, fumes, or other lung irritants
- Making sure to meet your nutritional needs; talk with your doctor about ideas like resting before eating.
- Getting the pneumococcal and flu vaccines after talking to your doctor.
Prescription drug treatments and surgery for those with end-stage or severe COPD include (according to the NHLBI):
- Combination bronchodilators plus inhaled glucocorticosteroids (steroids): Bronchodilators can help relax the muscles around your airways, to help open them and make breathing easier. Steroids can help reduce inflammation in your airways, and a combination of the two medications may be prescribed if your COPD is severe.
- Oxygen therapy: You may need oxygen all the time. This can help you do routine tasks, protect your heart and other organs, sleep more during the night, and live longer.
- Surgery: Surgeries for people who have COPD that is mainly related to emphysema include bullectomy and lung volume reduction surgery. If you have very severe or end-stage chronic COPD, you may want to speak to your doctor about a lung transplant. This is when your damaged lung is removed and replaced with a healthy lung from a deceased donor, and it may improve your quality of life. There are many associated risks, however, such as infections, and a transplant can be fatal if the body rejects the new lung—please discuss your situation with your physician.
Does Medicare cover end-stage chronic obstructive pulmonary disease (COPD)?
Original Medicare (Part A and Part B) covers medically-necessary expenses associated with end-stage COPD. Inpatient hospital care is covered by Medicare Part A (hospital insurance), while doctor visits and outpatient treatments are covered under Medicare Part B (medical insurance). Prescription drug treatments for COPD may be covered under a stand-alone Medicare Part D Prescription Drug Plan or a Medicare Advantage Prescription Drug plan; consult your plan formulary for details. A formulary is a list of covered medications, and it may change at any time; you’ll receive a notice from the plan when necessary.
In some cases, people with end-stage chronic obstructive pulmonary disease may be eligible for hospice care under Part A, which includes coverage for services such as:
- Doctor and nursing care
- Certain prescription drugs for symptom control or pain relief
- Medical equipment and supplies such as walkers, wheelchairs, etc.
- Home hospice aide and homemaker services
- Short-term respite care
Many of these services may be available at no cost provided certain requirements are met, including:
- Your doctor must certify that the disease is terminal with a life expectancy of six months or less.
- You agree to palliative care (for comfort) for your illness instead of treatment to cure your disease.
- You sign a hospice care agreement with Medicare.
If you have concerns about Medicare plan options and coverage for a loved one with end-stage chronic obstructive pulmonary disease (COPD), I’m happy to answer your questions. To request a phone call or email with personalized information, click the appropriate link below. You can also click the Compare Plans button to see a list of plan options in your area you may qualify for. Click the “View profile” link to find out more about me.
For more information about living with end-stage chronic obstructive pulmonary disease (COPD), please see:
“Living with COPD,” National Heart, Lung, and Blood Institute (NHLBI), last modified July 31, 2013, http://www.nhlbi.nih.gov/health/health-topics/topics/copd/livingwith
“Becky’s Videos,” Centers for Disease Control and Prevention (CDC), last modified December 18, 2015, http://www.cdc.gov/tobacco/campaign/tips/resources/videos/becky-videos.html