Dad has stage 3 severe COPD and has refused home oxygen. What can I expect from here on?

[Spitzm]

My 83 year old father (recently widowed) has stage 3 severe COPD and a heart condition. In the last 10 months he has had two hospital admissions with the last one for 4 weeks (includes rehab). At his last appt with his specialist he was told he now qualifies for home oxygen to which he refused. He is on numerous medication for his heart and blood pressure. He is also on anti depressants which has improved his poor temperament. Unfortunately he refuses to come live with me and he has threatened to banish me from visiting him if I ask him again or mention anything about oxygen or his breathing. In other words he wants to live the remainder of his days without acknowledging his condition full knowing the consequences. Much like a cancer patient refusing chemo he refuses oxygen. As his only child I am worried about him everyday. His oxygen sat was 80 at last reading. He has continued to loose alot of weight, become pale/grey, tires easily and eats smaller meals. He wont allow me to ask the doctors any questions at appointments so hence why I am here asking these questions; How long can he continue to live like this without any supplimentary oxygen? When will I know its 'life end stage 4'? How much longer can he continue to live on his own? Will his condition bring physical pain? I'm struggling to watch him deteriorate in front of my eyes..I don't want him to suffer. 2017 was a tough one with the sudden, unexpected death of my mother and I'm finding myself more concerned and wanting to know as much as possible about dad's condition. Any info would be greatly appreciated.

[RibvanRey]

I am sure none of us wants to see or think of a loved one suffering. However when you get to the stage of life that your father has there is another point that enters the question.

Many couples who have lived their lives together, sharing everything good and bad, the will and even the desire to fight often fade.

We cannot replace your doctor in giving advice but you can always consult the doc on your own behalf. In that this is an issue that affects you and your health.

Regards, Rib

[gingermusic]

What a horrible situation for you to be in and I really feel for you. With a result of 80 he should be on oxygen and apart from helping with his breathlessness he needs that extra oxygen to help protect other organs including his heart which will also be short of oxygen. However it is I suppose his body and his decision. Maybe since losing his wife he feels he wants to go and not live without her which is also understandable as a lot of elderly are like this. All you can do is whatever keeps him happy really. But yes do talk to the GP on the quiet and express your concerns.

[sarcoid1234]

Below is a little letter to your dad. I hope he will read it and it may help to persuade him to use oxygen. Some people I have spoken to think that oxygen still has to be obtained from the pharmacist (as was the case several years ago), but it is now delivered to your door. The letter comes from my heart as without oxygen my life would be so much worse.

(I am not sure whether daughter should be replaced with son!)

Dear ………………………. Your daughter is so worried about you and has asked for advice from other people on the British Lung Foundation website. I am 74 and I use oxygen most of the time. It was prescribed by a consultant at the hospital. You will be told what level of oxygen per minute you should use; people with COPD should not use more than prescribed. The local oxygen nurses visit me to make sure I am getting on OK. I find it no trouble at all and without it I would not be able to move around without considerable discomfort. Oxygen use is so easy.

There will be an NHS central oxygen supplier near to you who deliver concentrated oxygen cylinders to your door. I expect you will also be given a static oxygen concentrator machine which works on electricity and delivers oxygen to you whenever it is turned on. It filters oxygen out of the air. It can be used 24hours every day. It has a 30 foot oxygen tube so you can move around easily. I think your oxygen supplier can fix the tubing to the wall so that you don’t fall over it. Alternatively the oxygen supplier might lend you long-term a portable concentrator which you wheel around when you move so that you don’t need the long hose which is a bit of a fall hazard.

I need oxygen when I sleep as well as during the day, but nighttime oxygen is no trouble; I do not notice the cannula in my nose when I am sleeping as I fix it behind my head to make it more secure.

You will also be given smaller concentrated oxygen cylinders. (I am given paediatric cylinders which are smaller than some others.) You may be given two or four such cylinders (you only of course use one at a time!). I have seen people with a wheelable trolley that they put the cylinder in so that they don’t have to carry it; I use a shopping trolley. When your last cylinder is nearly empty you (or your daughter) just telephone the oxygen supplier and they will deliver new filled cylinders the next day to your door.

It is so easy and the oxygen delivery person is so kind. Please do consider having oxygen. I feel sure it will make your life so much more comfortable. We are so lucky to have the facility and the people to help us. I find when I am out with my oxygen on people are very kind.

I have been told I should not let my oxygen level go below 90% as apart from helping with breathlessness the extra oxygen will help protect other organs including your heart. I use a finger oximeter to test my oxygen level; it also tests my heart beat rate. A finger oximeter can easily be bought by your daughter on the internet for about £25.

With very kind thoughts from Christine