Skip to main content
 

Main menu

  • Home
  • Content
    • Current Issue
    • Editor's Commentary
    • Coming Next Month
    • Archives
    • Most-Read Papers of 2021
  • Authors
    • Author Guidelines
    • Submit a Manuscript
  • Reviewers
    • Reviewer Information
    • Create Reviewer Account
    • Reviewer Guidelines: Original Research
    • Reviewer Guidelines: Reviews
    • Appreciation of Reviewers
  • CRCE
    • Through the Journal
    • JournalCasts
    • AARC University
    • PowerPoint Template
  • Open Forum
    • 2022 Call for Abstracts
    • 2021 Abstracts
    • Previous Open Forums
  • Podcast
    • English
    • Español
    • Portugûes
    • 国语
  • Videos
    • Video Abstracts
    • Author Interviews
    • Highlighted Articles
    • The Journal

User menu

  • Subscribe
  • My alerts
  • Log in

Search

  • Advanced search
American Association for Respiratory Care
  • Subscribe
  • My alerts
  • Log in
American Association for Respiratory Care

Advanced Search

  • Home
  • Content
    • Current Issue
    • Editor's Commentary
    • Coming Next Month
    • Archives
    • Most-Read Papers of 2021
  • Authors
    • Author Guidelines
    • Submit a Manuscript
  • Reviewers
    • Reviewer Information
    • Create Reviewer Account
    • Reviewer Guidelines: Original Research
    • Reviewer Guidelines: Reviews
    • Appreciation of Reviewers
  • CRCE
    • Through the Journal
    • JournalCasts
    • AARC University
    • PowerPoint Template
  • Open Forum
    • 2022 Call for Abstracts
    • 2021 Abstracts
    • Previous Open Forums
  • Podcast
    • English
    • Español
    • Portugûes
    • 国语
  • Videos
    • Video Abstracts
    • Author Interviews
    • Highlighted Articles
    • The Journal
  • Twitter
  • Facebook
  • YouTube
Research ArticleConference Proceedings

Chronic Obstructive Pulmonary Disease: The Last Year of Life

John Hansen-Flaschen
Respiratory Care January 2004, 49 (1) 90-98;
John Hansen-Flaschen
Pulmonary, Allergy, and Critical Care Division, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: [email protected]
  • Article
  • References
  • Info & Metrics
  • PDF
Loading

Abstract

Nearly one quarter million Americans die with or of advanced chronic obstructive pulmonary disease (COPD) each year. Many patients die after a prolonged functional decline that is accompanied by much suffering. Though difficult prognostically and emotionally, anticipation of death opens the door to planning and preparing for terminal care. Epidemiologists have begun to identify characteristics of COPD patients who are most likely to die within 6–12 months, including severe, irreversible airflow obstruction, severely impaired and declining exercise capacity and performance status, older age, concomitant cardiovascular or other co-morbid disease, and a history of recent hospitalizations for acute care. Clinicians are encouraged to raise the difficult subject of planning for death when many of these characteristics apply. Patients with far-advanced disease are often receptive to the recommendation of a dual agenda: “Hope for and expect the best, and prepare for the worst.” Medical advance planning is best pursued in an out-patient office during a prescheduled, 3-way conversation between patient, health care proxy, and physician. An advance directive can be written after the meeting to summarize the conversation. Clinicians should consider recommending hospice care when a COPD patient is at high risk of respiratory failure from the next chest infection and in need of frequent or specialized home care. Preparation for death should include a realistic appraisal of the prospects for dying peacefully at home and a contingency plan for terminal hospitalization, should the need arise.

  • palliative care
  • terminal care
  • prognosis
  • advance directive
  • living will
  • hospice
  • mortality
  • chronic obstructive pulmonary disease
  • COPD
  • respiratory
  • life support care
  • withholding treatment
  • decision-making
  • respiratory insufficiency
  • artificial respiration

Footnotes

  • Correspondence: John Hansen-Flaschen MD, 874 Maloney Building, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia PA 19104. E-mail: jflash{at}mail.med.upenn.edu.
  • Copyright © 2004 by Daedalus Enterprises Inc.
PreviousNext
Back to top

In this issue

Respiratory Care: 49 (1)
Respiratory Care
Vol. 49, Issue 1
1 Jan 2004
  • Table of Contents
  • Table of Contents (PDF)
  • Cover (PDF)
  • Index by author

 

Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on American Association for Respiratory Care.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Chronic Obstructive Pulmonary Disease: The Last Year of Life
(Your Name) has sent you a message from American Association for Respiratory Care
(Your Name) thought you would like to see the American Association for Respiratory Care web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Chronic Obstructive Pulmonary Disease: The Last Year of Life
John Hansen-Flaschen
Respiratory Care Jan 2004, 49 (1) 90-98;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

Share
Chronic Obstructive Pulmonary Disease: The Last Year of Life
John Hansen-Flaschen
Respiratory Care Jan 2004, 49 (1) 90-98;
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
  • Info & Metrics
  • References
  • PDF

Related Articles

Cited By...

Keywords

  • palliative care
  • terminal care
  • prognosis
  • advance directive
  • living will
  • hospice
  • mortality
  • chronic obstructive pulmonary disease
  • COPD
  • respiratory
  • life support care
  • withholding treatment
  • decision-making
  • respiratory insufficiency
  • artificial respiration

Info For

  • Subscribers
  • Institutions
  • Advertisers

About Us

  • About the Journal
  • Editorial Board
  • Reprints/Permissions

AARC

  • Membership
  • Meetings
  • Clinical Practice Guidelines

More

  • Contact Us
  • RSS
American Association for Respiratory Care

Print ISSN: 0020-1324        Online ISSN: 1943-3654

© Daedalus Enterprises, Inc.

Powered by HighWire