COPD and Respiratory Care at Home

Care by condition

Breathlessness reorganizes a home. The bedroom moves downstairs, the shower becomes the hardest part of the day, and people quietly stop doing things rather than admitting they cannot do them any more.

Support for COPD is largely about making the essential things cost less breath, catching a flare-up in its first day rather than its fourth, and keeping someone confident enough to keep moving.

What actually changes at home

• Washing and dressing are the hardest tasks of the day, because both involve raising the arms and holding the breath without meaning to.
• Flare-ups start small — a change in the colour or amount of sputum, more breathlessness than usual, a fever — and treating them on day one changes the outcome.
• Inhaler technique is often wrong, and a badly taken inhaler delivers very little of the medication.
• Oxygen at home changes the household: tubing across floors, cylinders to plan around, and firm rules about smoking and open flame.
• Anxiety and breathlessness feed each other, and the panic is as disabling as the breathing.

How we help

• Energy conservation done properly: sitting to shower and dress, pacing tasks, resting before the breathlessness rather than after
• Watching for the early signs of a flare-up and prompting the action plan the respirologist or family doctor has already written
• Prompting inhalers and spacers on schedule, and flagging technique that has drifted
• Safe management of the household around home oxygen — tubing, trip hazards, and the rules about flame
• Meals in smaller, more frequent portions, because a full stomach makes breathing harder
• Calm company through breathless episodes, using the breathing techniques the person has been taught
• Keeping the home clean of the dust and irritants that make things worse
• Support to keep attending pulmonary rehabilitation, which people abandon because of the travel

Who provides the care

Personal support workers deliver this care. Nursing is placed where a plan calls for it. We do not adjust oxygen settings or change medication — that is for the prescriber, and our job is to make sure they hear about a change quickly.

Common questions

My father is on home oxygen. Is that a problem for your carers?

No. Home oxygen is common and the carers we place are used to it — managing the tubing safely, keeping the route clear, and observing the rules about smoking and open flame in the house.

He has an action plan from the clinic with antibiotics at home. Will your carer use it?

Your carer will recognize the signs the plan describes and prompt you and your father to act on it, and will tell you immediately. Starting the medication is a decision for your father or the prescriber, not for us.

Showering leaves him exhausted for hours. What can be done?

Quite a lot. A shower chair, a different order of doing things, taking the reliever inhaler beforehand, and someone doing the parts that involve reaching up. It usually turns a whole morning back into twenty minutes.

Can you help with the panic?

Yes. Breathlessness panic is a real symptom, not weakness, and having a calm person who does not become alarmed is much of the treatment. We work with whatever breathing technique the person has been taught.

Is COPD care covered?

It may be. Ontario Health atHome arranges publicly funded care for people who qualify, home oxygen is funded through the Ontario Home Oxygen Program for those who meet the criteria, and pulmonary rehabilitation is publicly available in many areas. Ask about all three.

Where we provide this care

We provide this support across communities across Ontario, from the Greater Toronto Area to Thunder Bay. If your town is not listed, call us — we will tell you honestly whether we can staff it properly rather than promising and then failing to turn up.

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