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Benefits of Advanced Care Planning for COPD Patients

Friday, October 15, 2021

Chronic Obstructive Pulmonary Disease (COPD) is a common progressive disease characterized by airflow limitations and persistent respiratory symptoms, including cough and sputum production. The disease is unpredictable and incurable, and for individuals with advanced forms of COPD, the final years of life are often combined with functional decline, frequent visits to the emergency department, and a general poor quality of life. Among individuals with COPD, common comorbidities range from cardiovascular disease to depression and anxiety. 

Advanced Care Planning (ACP) can be a tricky subject to discuss for individuals when the diagnosis is chronic and not immediately life threatening, as in the case of COPD. In the early stages of COPD, when individuals are still feeling relatively healthy, they don’t feel the need to plan for their future care goals and preferences. Individuals delay making end-of-life decisions due to the idea that there will be time to do so in the future. However, as the disease advances and airflow rates are constricted, ACP often begins to reach the top of mind. Having these conversations early and on can increase the normality of ACP and help individuals not only plan for what is to eventually come but to feel a sense of relief and empowerment in doing so. 

ACP empowers individuals to define their personal goals and preferences for future care, to discuss those with their family, healthcare team, and caregivers and to record and review them as needed. ACP has been associated with improved end-of-life care and an increased sense of relief; however, most formal studies have been observational and performed on terminal or elderly individuals. For those with chronic diseases, the discussion of ACP is uncommon but studies have shown that these interventions may lead to improvements in anxiety and depression, communication between individuals and caregivers and even in COPD symptoms themselves.  

While studies have shown outcome improvements, some practitioners and families find it difficult to discuss ACP with individuals due to a variety of factors, including the possibly long-term prognosis of the disease itself, an individual or family’s inability to see the need for immediate planning, and variability in individual wishes. ACP allows individuals to take an active role in their care and allows families to relax in the knowledge that they are doing not only what is best for the individual but what the individual intends. 

To really experience the full benefits of ACP, discussions should begin at the onset of the COPD diagnosis so that individuals can not only designate their wishes for end-of-life care but for their care throughout the progression of the disease. Having frank discussions regarding these wishes not only improves the quality of care but ensures that individuals are making their own decisions regarding their care at a time when they are stable and engaged enough to do so. Further, making these decisions in the beginning of the disease creates a sense of ease within the individual allowing them to focus more on their health and less on making daily decisions regarding what may or may not happen. Less stress improves the overall sense of wellbeing and therefore a mindset to healing. 

At Iris, our specialized ACP services are designed to support both caregivers and individuals with serious illnesses. We start the planning process early, allowing everyone involved to feel confident about their care choices. Our proprietary, disease-specific AD documentation captures member care goals in straightforward terms, removing complexity for family members during the event of a medical emergency. To learn more about how Iris can improve your health plan’s ACP services for everyone involved, get in touch with our team today.

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