Living and dying with severe chronic obstructive pulmonary disease: multi-perspective longitudinal qualitative study
BMJPublished 24 January 2011Open access
Hilary Pinnock, Marilyn Kendall, Scott A Murray, Alison Worth, Pamela Levack, M. Porter
Citations335
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TL;DR
Overall, patients told a “chaos narrative” of their illness that was indistinguishable from their life story, with no clear beginning and an unanticipated end described in terms comparable with attitudes to death in a normal elderly population.
Abstract
Our findings challenge current assumptions underpinning provision of end of life care for people with COPD. The policy focus on identifying a time point for transition to palliative care has little resonance for people with COPD or their clinicians and is counter productive if it distracts from early phased introduction of supportive care. Careful assessment of possible supportive and palliative care needs should be triggered at key disease milestones along a lifetime journey with COPD, in particular after hospital admission for an exacerbation.
Keywords
Medicine
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