breathing mask nebulizer

Recognizing the Symptoms of End-Stage COPD

End-stage COPD is the final stage of a difficult disease that affects more than 16 million Americans. People with the disease often have difficulty breathing, and symptoms can progress over time. This blog post will discuss the symptoms of end-stage COPD and how you can get help if you or a loved one is diagnosed with this condition.

What is End-Stage COPD?

COPD stands for chronic obstructive pulmonary disease. The condition encompasses multiple diseases including emphysema and chronic bronchitis. Emphysema is a disease characterized by weakened air sacs in the lungs, and chronic bronchitis is a productive cough that recurs regularly for at least two years in a row, with each bout lasting a minimum of three months.

When COPD reaches its final stages, the patient’s lungs have been significantly damaged, and they are not able to get enough oxygen into their bloodstream. In order to survive, they will need to receive supplemental oxygen therapy. End-stage COPD is a serious and life-threatening condition. It’s characterized by breathlessness, increased mucus production, and deteriorating lung function. Severe COPD can create an immense burden of suffering for those affected, impairing many activities of daily living.

Severely impaired patients may require extensive assistance with life tasks such as dressing or bathing. They may also have difficulty feeding themselves or sleeping due to oxygen deprivation or discomfort at night. People with end-stage COPD may fear traveling for fear of exacerbating their symptoms. Medical professionals and supportive care providers can better equip the patient to manage their symptoms and optimize their quality of life.

Risk Factors for COPD

A range of factors can put a person more at risk for developing COPD. While it’s rare, a genetic condition called alpha-1 antitrypsin deficiency can also cause COPD in some people.

  • Smoking: The main cause of COPD is smoking cigarettes, but other forms of tobacco smoke (such as pipe and cigar smoke) can contribute to the development of the disease.
  • Asthma: People with asthma are more likely to receive a COPD diagnosis. Untreated asthma and allergies can make the likelihood of developing COPD higher.
  • Age: If you’re over 40 years old, you have a higher risk of developing COPD. Most people who are diagnosed with the disease are between the ages of 50 and 74.

People who have a family history of COPD may also have a higher risk of developing the disease. Additionally, women are 37% more likely than men to be diagnosed with COPD.

How is COPD Diagnosed?

To diagnose COPD, doctors use a number of tools. You may be asked to take a spirometry test. This test determines how much air your lungs can hold and whether they’re moving air in and out of your body efficiently. Your doctor may also order a chest X-ray, CT scan, or blood test to check for alpha-1-antitrypsin deficiency.

Stages of COPD

Depending on which symptoms are present, the severity of those symptoms, and how they’ve progressed, your doctor may inform you which stage of COPD you’re in. Stage 1 is the earliest form of COPD that can occur even with zero symptoms, while Stage 4 is considered end-stage COPD, or the most severe stage.

  • Stage 1: People with Stage 1 COPD may present no symptoms or have very mild ones. For instance, a person may get out of breath as they’re doing high-level physical activity.
  • Stage 2: People with Stage 2 COPD often get out of breath doing milder forms of exercise, such as walking.
  • Stage 3: Once COPD has reached Stage 3, activities of daily living can be difficult due to breathing problems.
  • Stage 4: Stage 4 is the most severe form of COPD. Breathing is often difficult, even when sitting, and organs like the heart and lungs may begin to fail.

While COPD can’t be cured or reversed, you can take steps to slow the progression. Some things you can do include quitting smoking, avoiding pollutants in the air, and getting adequate amounts of physical activity to strengthen the muscles used in the respiratory process.

Symptoms of End-Stage COPD

People with COPD have a range of symptoms throughout the progression of the disease. However, symptoms can become more extreme toward the end stages. Some of the end-stage COPD symptoms include:

  • Shortness of breath: COPD makes it difficult for people to breathe, even when resting.
  • Confusion: Hypoxia (low levels of oxygen) can contribute to cognitive difficulties.
  • Chronic respiratory failure: COPD can make it impossible to rid the body of carbon dioxide or take in enough oxygen.
  • Respiratory infections: Lung and other respiratory infections are common in people who have COPD.
  • Anxiety and depression: Living with COPD can make people more anxious and depressed.
  • Wheezing and whistling in lungs: Excess phlegm and coughing are among the many respiratory symptoms of COPD.

Many of these symptoms can also present in earlier stages of COPD. Your doctor will be able to help you determine whether your COPD has progressed.

After End-Stage COPD Diagnosis

Once you’ve been diagnosed with end-stage COPD, you may wish to speak with a mental health professional to help you navigate this difficult time. Friends and family can also provide support. Typically, Stage 4 COPD treatment options include palliative care (including hospice).

Hospice is an option for people who are expected to live six months or less. Rather than continuing aggressive treatment, hospice services focus on making a person as comfortable as possible in the last few months of their lives. Hospice may offer massage therapies, nutritional counseling, medications, and oxygen supplementation. If you’re interested in receiving hospice care, your doctor will be able to provide you with local resources.


End-stage COPD is a serious disease that’s irreversible. Early diagnosis is important so that a person can make any possible changes to increase their comfort and make it easier to breathe. If you or your loved one has been diagnosed with end-stage COPD, many resources exist to help you manage your symptoms.


1. “End-Stage COPD: What to Expect at the End of Life,” Samaritan,

2. “COPD & Diagnostic Testing,” University of Utah,

3. “Chronic Obstructive Pulmonary Disease (COPD),” CDC,,Americans%20who%20have%20this%20disease.

4. “Emphysema,” Mayo Clinic,,instead%20of%20many%20small%20ones.

5. “Bronchitis,” Mayo Clinic,,cough%20or%20other%20symptoms%20worsen.

6. “COPD,” Medline Plus,

7. “Association of Chronic Obstructive Pulmonary Disease With Increased Confusion or Memory Loss and Functional Limitations Among Adults in 21 States, 2011 Behavioral Risk Factor Surveillance System,” CDC,

8. “Asthma-COPD Overlap,” American College of Allergy, Asthma, and Immunology,

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