My husband has COPD with emphysema, bullous, lung fibrosis and had a heart attack and 3 stints in last 6 months. The Dr has not told us what stage he is in. He tires easily. He still smokes and drinks beer everyday. He cries a lot and tells me he knows he is dying. What can I do to help him?
This is why hospice likely may not be an option for many years yet, if ever, but you don't need hospice to ask the doc for Rx for an anti anxiety medication that will help hubs to not have as strong of cravings, and also relieve some anxiety. He may live for many years. (((hugs)))
If there are any people of faith around you, perhaps someone to comfort him about Life and Death process would be helpful. Perhaps calling in a local pastor (one who is very kind and understanding) may help to calm his fears.
This is a tough time for you, too. Maybe you could both use some help from your local churches or other local outreach organizations. Is hospice an option? Ask the doctor. Maybe a mild sedative or painkiller would help... but I don't know how it interacts with COPD. As a former smoker, I know that the benzodiazepines (Valium, Xanax, Klonopin, et al) help to alleviate cravings for smoking...
Ask the doctor about some anti anxiety medication for hubs to make this time easier on both of you. (((hugs)))
As a young adult smoke was all around us, it was the social norm and no one knew it was going to kill them. Smoke filled rooms were impossible to escape and lighting up in a restaurant or other public place was not frowned on. You could even smoke in your hospital bed as long as you did not set it on fire.
That was in the past so don't try and punish people who are suffering now. Smoking and alcoholism are addictions and you can't cure those just by spanking people or taking away the cigarettes. For one thing the person has to want to overcome this and if it brings comfort at the end of life they are not going to stop and at this point it probably won't improve their prognosis.
As a side note many people with ADHD find that smoking helps calm them. They probably don't know they have ADHD and maybe wouldn't seek treatment and if they did may not be able to afford the inflated prices for the medications. Drug companies have become the evil controllers of peoples' health.
This poor man is suffering at he end of life whether he is responsible for his own misery or not it was probably caused by ignorance and all the good advise and prohibition in the world won't change anything now. He needs compassion not lectures. A good place to start is addressing his depression and supporting him in any way possible and that does not include taking away his props.
That is really the only way his wife can help him, he is beyond changing his ways.
Now if I suggested hospice and morphine to ease his breathing symptoms I know all the anti hospice people would come out of the woodwork and I am just so tired of that. I know people have had bad experiences and I don't doubt the truth of their stories but we all get bad experiences one way or another and healthcare is no exception.
You asked a straight question and you're getting a straight answer. When you play with fire, you get burned, so don't play with fire if you don't want to get burned. This is exactly what smoking and drinking does to people in the end, they get burned when they pay for it with their lives after their health has been jeopardized. Of all the people I knew who died from this kind of thing, if they were alive today I would tell each and everyone of them to their face is that it serves them right because all but one of them continued smoking after diagnosis, and that one person had the brains enough to quit when the others didn't. Oh yes, if I were ever in the position of guardianship in one of such of these types of cases, those wards would definitely not have their cake and eat it too, it's pick one or the other but you're not having both
She asked how she could help him. For him, it's a little late in the day for tough love.
Oh yes, by the way, It looks like the Trump world is actually going to be a better one than people realize. I'm all for his efforts to protect America and its citizens and I strongly agree on where he stands because I follow the news on what's going on. Hopefully he will initiate cracking down really hard on stuff that needs cracking down on
I also knew someone else who smoked for 50 years but I don't know when his lungs went bad. He long since quit but I don't know when. He also had COPD and was on rescue inhalers and a nebulizer. I think he could've lived so much longer and better had he only taken better care of himself.
I actually think they could've both live much longer. However, that didn't happen. If your husband still smokes and you really want to help him, take the smokes and crush them, toss them into the trash and take out the trash. Don't buy any more smokes and don't give him any more money because you know he'll just smoke it away anyway. Also dump the booze down the drain and again, drop empty bottles into the trash and take out the trash and don't give him any more money because you know he'll just drink it away.
If he insists on smoking and drinking, then breathing treatments of any kind are just not going to help him and you should tell him that. I thought the doctor took this one guy I used to know off of the breathing treatments but come to find out it was actually his girlfriend who did but I don't know how she did it, she just did.
What you need to do is give your husband the ultimatum: Either quit smoking or no more breathing treatments. I would become his guardian if I were you, you can make medical decisions as a guardian, and you can make him quit. He's going to have to quit one way or another. Either he quits and resumes breathing treatment, or he continues smoking and no more breathing treatments, this is the ultimatum I personally would give because he's only defeating the purpose of the breathing treatment by continuing to smoke, and that's the truth and that's where I firmly stand. I saw what happens to chain-smokers who won't quit and it's not fair to other patients needing those breathing treatments if someone who won't quit smoking is taking up that medicine. I think this man's girlfriend saw things exactly as I see them, because it's really not fair to other patients who actually need the medicine and some chain smoker comes along and wastes that medicine and defeats it's purpose by continuing to smoke knowing what it's doing to their lungs.
In fact, many years ago I also knew someone else who was on oxygen and still smoked. Several times I watched her shut off her oxygen just to light up. Not fair to other patients who could've easily used that oxygen she was wasting by continuing to smoke. Needless to say, she died of emphysema. If you're going to smoke, don't waste resources other patients need, it's not fair to them or the medical professionals distributing it if you're just going to keep on smoking, it's not right, it's also very wrong if you're not going to do nothing to help yourself. Those resources are only for patients willing to take steps toward helping themselves and not making an already bad problem worse by continuing to do what's hurting them.
Multiple times I saw what smoking does to people, and I for one must speak up and take a firm stand and tell it how it is. I must speak up and say what I saw
And while we are talking about your Husband...you may want to talk to someone as well, depression in caregivers is a very important subject that is often ignored, overlooked or just not addressed as many think it is not "important"
I now wish I had spent less time trying to fix things for my mom, and more time just telling her how incredibly much I loved her and how much it meant to me to have her here on this planet. Maybe being impressed upon with her value to others would have at least given her the motivation to take an antidepressant, which might have made the other things easier. If your husband could be moved to try an antidepressant, you might have more luck with some of the other excellent suggestions here. Warm wishes to you both.
Everyone is different even with the same diagnosis.
The best you can do is accept that this is a life limiting disease and make the best of what you have.
Adjust to what your husband can now do and enjoy that. As his condition becomes worse he will be able to do less and less so relish what you have now.
Help him accept what is going on.
Trying to get him to stop smoking will only frustrate the heck out of you and probably make him dig in his heels even more. And in reality what will stopping now do? Is another week going to make a difference? a month?
He knows he should stop, I am sure you have told him, his doctor has told him so this is nothing new. The only person that can get him to stop is him. And he has to want to do it for himself. (Just make sure he is not smoking when he is on oxygen)
As to the "stages" I went through looking up stages when my Husband was diagnosed with Alzheimer's. I have come to the conclusion there are no real defined areas of "stages" as I said at the start everyone is different and your husband may have signs in all stages but no signs in some of them. So do you pick the sign or symptom he has in the final stage and say that is where he is or do you say ..well he is not having the 2 symptoms in the first stage does that mean he is still in stage 1?
I gave up on "stages" and accepted the decline my Husband had and was grateful that he did things longer than many but was sad by the fact that he stopped some things far sooner than I would have hoped.
The best thing you can do is help your husband through the difficult times and allow both of you to accept help when it is needed.
Call Hospice before you think either of you need it as I am sure he would qualify before you would think he would. Accept the help and support that they will provide. If he is a Veteran contact the VA and find out if there are any programs that might help, and if his condition may be related to any Service injury. (this would be a great help for you both)
Oh, and the fact that he tells you he knows he is dying...we all are...no one gets out alive, we begin dying the day we are born.
He may actually be dying, so getting some real information out of his Drs will help you both even though it may not be what you want to hear. getting the truth out of a Dr can often be like pulling teeth but don't give up.
Stopping smoking is always a good thing to do and always improves health. However if he is actually in the last stage of his life and smoking brings comfort leave him alone he knows the risks. Same applies to the beer as long as he does not over indulge and become unmanageable let him be, again he already knows the risks of alcoholism so leave him alone. Of course continue to provide healthy meals and encourage him in a healthy life style but otherwise offer comfort in any way you can without becoming a victim yourself.
Accepting one's approaching death is something that most people don't do well. Paramount is the fear of the unknown but some are able to rise above this and put their lives in the hands of the Lord.
Fear of the actual dying process is also in the forefront of the minds of many and this can bring huge depression. In your husband's case he almost certainly knows that his COPD will get worse and breathing will become even more difficult, his heart will also probably begin to fail and fluid will build up in his body. His kidneys and liver may also fail which will have unpleasant side effects.
What can you actually do to help?
First of all recognize the realities and make preparations for his inevitable passing whenever it occurs. See an attorney and get all the legal paper work in order. Make sure his will is current and you have the proper authority to handle finances and medical decisions. Would he for instance want to go to the hospital and be put on life support? Does he want to be a DNR? How about IVs and forms of artificial feeding. Choose your funeral home and make those arrangements. Check any life insurance policies and make sure premiums are up to date. This may be a good time to consult with hospice. If there is a choice in your area interview several. Consult his Dr about the continual crying that is distressing both to him and you. There are plenty of antidepressants around that can make a difference. Also think about asking for morphine if he has trouble breathing. Many people are against it's use and I do respect that point of view but the reality is that it does relieve the feelings of breathlessness and very small doses do not put people in a coma. Remember you and he always have the final say about any treatment.
This is not going to be an easy time for either of you and if he does not have the will to continue living, and he may have very good reasons, it is certain that he will not. This is not something you can "fix" however many helpful suggestions you recieve. Only your husband can improve his situation
Believe me, the consequences of emphysema can get a heck of a lot worse than bullae and still not kill him.
But if he cuts back hard on the booze, stops smoking completely, starts taking exercise, follows his doctor's prescriptions to the letter, loses weight and so on and so on, he can still hugely improve his chances of survival.
Are you sure that is what he wants?
SIL has COPD and uses oxygen sometimes....still smokes, is physically very inactive and lives with her 86 yr old mother. Stopping smoking is the most important thing you can do. When I stopped smoking 21 years ago after a 21 yr. habit at a pack a day, sometimes more...I did it cold turkey and kept telling myself "I am not a smoker...why would I want a cigarette?" I took my mind back to when I didn't smoke, and concentrated on things I liked back then...foods, books, colors, etc. This mind set helped me to overcome my cravings and I never touched another cigarette also telling myself that I had my ration of cigarettes to last a lifetime so I could not have any more. This mental tactic worked for me. If he cannot entirely quit...at least try to get him to cut down.