Hospital to Home

Welcome to the guide on transitioning from hospital to home for individuals with COPD. This article provides an overview of managing COPD exacerbations, what to expect during a hospital stay, and tips for a smooth transition back home.

Managing COPD Exacerbations or Flare-ups

COPD flare-ups can require hospital visits. While preventing all flare-ups isn't possible, early recognition and treatment can reduce their severity.

Recognizing Flare-ups

Watch for small changes in symptoms such as:

Increased breathlessness
Night-time breathlessness
Ineffectiveness of rescue medication
Increased use of rescue medication
Changes in mucus (color, smell, thickness, amount)
Increased coughing

If these symptoms last more than a day, contact your healthcare provider or follow your My COPD Action Plan.

If You Need to Go to the Hospital

Essentials to Bring

Updated list of all medications
List of allergies
Contact information for a decision-maker
Living will or medical power of attorney
Insurance information

At the Emergency Department (ER)

The ER is a busy place prioritizing the most critical cases. Patience is essential, as every patient will eventually be treated.

Being Admitted

If ER treatment is insufficient, you may be admitted. Hospitalists, rather than your primary provider, will typically manage your care.

Treatment in the Hospital

COPD treatments in the hospital include:

Breathing treatments (nebulizers or inhalers)
Deep breathing exercises
Chest physiotherapy (CPT)
Airway clearance devices

Medications and Side Effects

Common treatments and potential side effects:

Steroids: Reduce inflammation but may raise blood pressure or blood sugar.
Bronchodilators: Open airways but may cause jitteriness, dry mouth, or urinary problems.
Antibiotics: Treat bacterial infections but may cause stomach issues.

Intensive Care Unit (ICU) and Step-Down Unit

Severe exacerbations may require ICU care with closer monitoring. Once stabilized, you may move to a step-down unit with intermediate care.

Helping You Breathe

Oxygen Therapy: Delivered via nasal cannula or face mask to maintain adequate oxygen levels.
Non-Invasive Ventilation (NIV): A mask connected to a machine aids breathing.
Mechanical Ventilation: A ventilator breathes for you through a tube in your lungs, used only when absolutely necessary.

Longer-Term Ventilation

If recovery is slow, a tracheostomy tube may be used, allowing you to talk and eat.

Ventilator Risks

Ventilators can cause ventilator-associated pneumonia (VAP). Hospitals have programs to minimize this risk.

Making Your Own Decisions

Prepare for situations where you might not be able to make medical decisions:

Discuss your treatment preferences with family.
Choose a trusted person to ensure your wishes are respected.

Discharge from the Hospital

When going home, your healthcare providers will give instructions on:

Medication changes
Oxygen use
Activity and exercise
Diet
Symptoms to watch for
Breathing treatments
Home care services
Pulmonary rehabilitation
Smoking cessation (if applicable)
Follow-up appointments

Follow-Up Care

Attend follow-up appointments with your healthcare provider within a week of discharge. Bring your medication list and any hospital documents.

Questions to Ask Before Discharge

Do I need any special equipment?
How should I use my inhalers?
Are there any local COPD support groups?

If You are Not Discharged to Your Home

If further care is needed, you may be sent to another facility for specialized services like physical or occupational therapy.

The Recovery Process

Recovery after a hospital stay may take time. Follow your treatment plan, use medications as directed, and monitor for flare-up warning signs. Patience and adherence to your healthcare provider’s advice are key to regaining strength and staying healthy.

Resources

For more information and support:

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