Functioning of patients with advanced chronic obstructive pulmonary disease at the end-of-life: A multicenter questionnaire study

Background: Patients with advanced chronic obstructive pulmonary disease (COPD) suffer from symptoms that significantly limit their functioning in society. Some of them fail to receive adequate support from their loved ones or relevant institutions. Moreover, since COPD is a disease of the elderly, numerous patients affected by the disease provide support to their disabled spouses. Help to such patients could be provided through home hospice care which offers psycho-physical-spiritual support, reduces the frequency of hospitalizations at the end-of-life, and takes into account the patient’s preference regarding the place of their dying. The study aimed to collect the opinions of COPD patients regarding their ability to cope with everyday challenges, the support provided to them and their loved ones, their preferences regarding the future use of palliative care, and their possible choice of the place of dying. Patients and methods: A group of 474 advanced COPD patients from three pneumonology centers in Poland (Toruń, Gdańsk, Katowice) were surveyed using a questionnaire consisting of 25 questions which the patients were asked to answer independently and anonymously. This paper presents the conclusions of the part of the survey relating to the daily functioning of the patients and their relatives. Results: One-half of the respondents declared the need for support in their daily functioning. Those having such support most frequently received it from a close family member, usually also supported by other relatives. More than 52% of respondents would be willing to benefit from palliative care if offered in the future. Given a choice of the place to die, most respondents (67.2%) would choose their own homes. Conclusions: The obtained data and patients’ statements indicate the need for institutional care for COPD patients, a better understanding of the needs of these patients and their caregivers in daily functioning, and attention to the preferences regarding the place of dying.