Enhancing Quality of Life Through Palliative Care in the Elderly with Severe Chronic Obstructive Pulmonary Disease and Multimorbidity: A Case Study

Muhammad Ilham Dhiya Rakasiwi; Amalia Ghaisani Putri; Windu Prasetya; Permadita Wicaksono

doi:10.36497/respirsci.v6i3.225

Authors

Muhammad Ilham Dhiya Rakasiwi Bisui Primary Hospital, South Halmahera - Faculty of Medicine, Universitas Indonesia, Jakarta
Amalia Ghaisani Putri Faculty of Medicine, Universitas Indonesia, Jakarta
Windu Prasetya Department of Pulmonology, Soehadi Prijonegoro General Hospital, Sragen
Permadita Wicaksono Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta

DOI:

https://doi.org/10.36497/respirsci.v6i3.225

Keywords:

COAD, elderly, health-related quality of life, palliative care

Abstract

Background: Chronic obstructive pulmonary disease (COPD) patients experience significant problems arising from dyspnea, ultimately affecting their quality of life (QOL). Knowledge of palliative care for chronic or terminal diseases has developed, but its application in severe COPD is limited. This case presents an elderly patient with a COPD exacerbation and analyzes palliative care studies related to QOL in COPD.

Case: A 65-year-old man presented to the emergency ward with severe dyspnea for 7 days, followed by a productive cough with greenish-yellow sputum. The QOL assessment using the EQ-5D-5L questionnaire showed severe discomfort and problems with daily activities. After pharmacologic interventions for the acute exacerbation, the medical team provided palliative care consisting of symptom management and a multidimensional assessment to address the patient’s symptoms and offer spiritual support. After 7 days of treatment, spirometry showed an FEV₁/FVC of 39% and 36% for pre- and post-bronchodilator, respectively. Post-hospitalization QOL showed only slight problems in the discomfort/pain component.

Discussion: Based on five studies about the role of palliative care in the HRQOL of COPD patients from a systematic literature search, all studies showed no statistically significant differences between COPD patients receiving palliative care and standard care. The outcomes of this case differ from previous studies, possibly because this patient had psychosocial needs during his treatment that the medical team could help fulfil, thus improving his HRQOL.

Conclusion: The literature review on the role of palliative care in hospitalized COPD patients found limited evidence of its benefits. While recommendations from respiratory societies support palliative care, this case highlights improvements in QOL following palliative care during hospitalization.