Respiratory  |  COPD Pathway - Palliative/End of life Care




Respiratory

COPD Pathway - Palliative/End of life Care

Continue with Stable COPD Management.

Also consider:

1. Medications

Opioids (e.g, morphine 2.5 - 5 mg elixir or tablet prn)

  • Effective for the management of severe dyspnoea.
  • Use small frequent doses. The dose is less than that normally required for pain relief.
  • A long-acting preparation can be useful for some patients.
  • Treat any associated nausea and constipation.

Note: Significant adverse effects may occur, e.g., worsening ventilatory impairment, confusion, delirium. A small initial dose trial is recommended. Advise patients not to drive.

Anxiolytics (e.g, alprazolam 0.25 mg tablet tds prn, clonazepam drops 2 - 4 drops prn)

  • Effective for severe anxiety and panic.
  • Clonazepam is best used less than q6h in order to avoid accumulation (T ½ =18-45h).

Note: Significant adverse effects may occur, e.g., worsening ventilatory impairment, confusion, delirium. A controlled /supervised trial of the initial dose is recommended. Advised patients not to drive.


2. Assessment for home oxygen.  

3. Discussing patient, family, and carer concerns and supports.

4. Discussing home or residential care.

5. Referral to a Hospice or community palliative care service.

6. Palliative Pathway

7. Palliative Social Pathway

8. Palliative Psychological Pathway

9. Hospice referral

10.Websites:


11. Explore end of life funding options.

12.Advance care Planning



Last updated : Friday, October 16, 2015
Next review date : Saturday, October 15,2016


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