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Concerned About a Family Member

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Dear COPD Coach,
My mother was diagnosed with COPD 4 years ago. She is only 63 years old and she still smokes. I know she will not get better from COPD but I believe the smoking is negating all the oxygen and medications she takes for her symptoms. Over the past couple of months she has more fatigued legs and feet cramping and seems depressed. She stays at home in her comfort zone. She does as much as she can, but simple tasks like cooking exhausts her.

She doesn’t share anything on her COPD with me and I am wondering if there are stages of COPD? I fear she may be entering a stage where I may need to become more involved.

Do you have any suggestions?

—Concerned Daughter

Dear Concerned,
Let me begin by telling you how sorry I am that your family and particularly your mother are facing these difficulties. COPD does not only affect the person with the diagnosis, it usually has significant impact on the entire family!

You are very right in your assumption that by continuing to smoke your mother is negating, or certainly significantly lessening, the benefits of the oxygen and medications. By being inactive, she is also not helping her prognosis. I have heard many stories of people recently diagnosed who, whether consciously or not, withdrew into their “comfort zone” and most amazingly continued to smoke despite the evidence that says smoking most probably caused their COPD! Those less educated about COPD will often assume the stance that “if this is going to kill me, I might as well continue what I enjoy!”

Caregiving From your description of the situation at home, I believe that the time to get involved is NOW! Your mother’s continued smoking is not only destroying any benefit from the medications, it is also shortening her life dramatically!

While somewhat obvious, the first thing your mother needs to do is quit smoking. For some advice on helping her quit you may need to enlist the services of her pulmonary doctor. He might be able to provide you with a program that will allow her to quit. People with COPD often feel as if their lives are spinning out of control. Your mother should know that by quitting smoking she is taking control of the course of the progression of her COPD. It’s a known fact that quitting smoking is the number one way to slow the progression of COPD. For some advice on smoking cessation, you can call our C.O.P.D. Information line at 866-316-2673. The Information Line Associates are also individuals living with COPD, and can help you in your role as caregiver.

The second thing you need to talk to her doctor about is getting your mother enrolled in a pulmonary rehabilitation program. Through exercise, she will train her muscles to work on less oxygen, which will in turn cause her to get less out of breath on exertion. If there isn’t a pulmonary rehabilitation program in your area, talk with your doctor about exercises your mother can do at home (and maybe with you)! An increasing level of inactivity along with low oxygen levels may well be contributing to her problems with her legs and feet, and her inability to carry out everyday tasks.

There are indeed stages of COPD. The stages are now listed as A,B,C and D, with “D” being the most severe. Usually, the need for full time oxygen would place the person at stage 3, possibly 4. How long a person remains at each stage depends on a number of factors. If they are beginning to have exacerbations (times when COPD symptoms get worse), especially ones requiring hospitalization, this can hasten the progression of their COPD. Exposure to smoking (including secondhand smoke), dust, pollution, or chemicals can also greatly hasten the progression. Remaining inactive factors in, as does not following a correct diet and medication schedule.

One of the most important aspects of COPD is education. The more you know about COPD, the better you will be equipped in the role of her caregiver. Knowing what signs to look for to ward off an exacerbation is critical, as is knowing about diet and exercise. A good source of information is our "Big Fat Reference Guide".

At some point, your mother is going to have to come to terms with the decision that she can either smoke and continue on a downward spiral, or seize control of her disease and learn to live with the highest quality of life possible and be a part of the lives of her family. I don’t envy the task you or your mother face, but rest assured that we will be here if you need us.

Best regards,

The COPD Coach

Ask the Expert is aimed at providing information for individuals with COPD to take to your doctor, and is not in any way intended to be medical advice. If you would like to submit a question to the Coaches Corner email us at We would love to hear your questions and comments. You can address your emails to any of the following: COPD Coach, Caregiver Coach, COPD Doctor or COPD RT.


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  • right on! the first step to quitting smoking, in my opinion, is to somehow get mom to care more about living than smoking, if she loves her cigs as much as I did this will not be easy, but I can personally testify to your mother that it is well worth it, best intentions and best wishes, sam.
    • TOTALLY agree !! I have a collage of my Daughters their spouses and my 5 Grand Baby's hanging where it is the first thing I see when I get to computer, used that as my incentive to quit! I want to quit to live longer and be a part of their lives, (PLUS felt guilty if I lit a cigarette with all of them watching me) is not an easy habit to kick...but well worth it. Good luck to you and Mom help her to understand, cigarettes are an addiction as bad as alcohol, cocaine, any of the street addictions ...I AM AN ADDICT, one puff will get me 1 pack.
    • An excellent response, thank you coach. The readiness to stop smoking is a personal one, but families and other loved ones have a special way of motivating- voicing their opinions and love . By sharing how important your loved one is to you and your family and how difficult it would be to have them shorten their life, sometimes is the right motivation for their readiness to taking action. It may take several tries, but being there to love and support and cheer them on is so critical.
      I know I share this story a lot, but for my mom she kept pictures of her grand children around the house as she struggled with smoking cessation and doing her activities each day.

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