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Living with Chronic Obstructive Pulmonary Disease (COPD)


Patients with chronic obstructive pulmonary disease (COPD) must adjust their lives to their energy level and capabilities. This may lead to an inactive life and, in some cases, anxiety and depression. However, appropriate training can help someone with COPD lead a more functional, fulfilling, and active lifestyle. This training is called energy conservation, which involves learning to save your energy for things you want to do or must do.

As part of energy conservation, you will learn about adaptive techniques and devices that can help you achieve a better quality of life and find a good balance between work, rest, and recreation. Occupational therapists can provide this training in the hospital, an outpatient setting, or the home.

Six Ps

The key principles of energy conservation include the six “Ps”: prioritize, plan, position, pace yourself, positive attitude, and pursed lip breathing.

As part of prioritizing, you should do what is most important first and use this method to structure your daily and weekly routines. For example, a doctor’s appointment would take priority over dusting your bedroom.

Planning involves alternating heavy and light activities or setting up your items to prepare a meal and then taking a rest. Breaking down an activity into steps helps avoid unnecessary tasks like taking the stairs multiple times per day. Planning activities can also help you avoid extra trips to gather your garden tools before planting flowers.

Positioning means sitting as much as possible for tasks. Sitting decreases someone’s energy usage by 25%. By maintaining good posture while sitting and standing, you will get more oxygen into your lungs. Avoid activities that require extended standing, stooping, or squatting as well as excessive reaching, bending, rubbing, scrubbing, twisting, or any awkward positions that can cause fatigue. When carrying a heavy object like a bowl or box, keep your arms straight and carry the item close to your body to spread the weight between both arms. Use the firm surface of the tabletop or sink to peel vegetables, write, or shave.

Always allow yourself sufficient time to complete a task. Take it slow and do not rush. Take a rest break before you become exhausted. Rest after completing one task and before starting the next one. Focus on what you can do, not what you can’t do. Be creative in adapting your activities. Take small, measurable, and achievable steps to reach your long-term goals.

Pursed lip breathing is a technique that improves the airflow in your lungs and relieves shortness of breath. It empties the trapped air (CO2) from the lungs and brings more oxygen (O2) into the lungs. You can practice pursed lip breathing by inhaling through the nose and exhaling through pursed lips. Exhalation should take twice as long (to a count of 4) as opposed to inhalation, which is performed to a count of 2. Exhale like you are blowing out a candle flame and relax while performing this technique.

Here is an example of breathing as it applies to your self-care. Breathe in before you start each movement. Breathe out when you step over the shower stall ledge or over the tub, reach for your legs or feet, stand up, sit down, and lift your legs to put clothes on and take them off.

Adaptive techniques and devices

Below are adaptive techniques and devices that will help you conserve energy in different facets of self-care.

Grooming:

  • Let your hair air dry rather than using a blow dryer. Consider a hairstyle that is easy to maintain.
  • Organize frequently-used items and keep them next to the sink.
  • Sit in a chair and support your elbows on the sink while shaving and putting on makeup.
  • Use an electric shaver and toothbrush to minimize excess movement and time spent.
  • Avoid aerosols and use roll-on or cream deodorants.

Toileting:

  • Ensure toilet paper is within easy reach.
  • To make it easier to push down and pull up clothing, consider loose items or those with elastic waistbands.
  • Use a raised toilet seat, urinal, or bedside commode if you are too weak to use a standard toilet. Or have someone assist you on a standard toilet.

Dressing:

  • Lay out your clothing the night before or take a rest after retrieving the necessary items before dressing.
  • Dress the lower parts of your body first because it uses more energy.
  • Use adaptive devices such as a dressing stick, sock aid, long-handled shoe horn, and elastic laces. You can also opt for slip-on shoes.
  • Use clothing with simple or front-closing fasteners like Velcro. This will be easier than buttons and clasps. Avoid zippers or consider a zipper pull.
  • Use pursed lip breathing throughout this process. For example, exhale when you are pushing your arm through your sleeve or when you are lifting your leg to push it through your pant leg.
  • If you have a weaker arm or leg, dress that one first and undress the stronger limb first.

Bathing:

  • Organize your bathing items in one place nearby.
  • Use a shower seat or spend less time in the shower.
  • Consider a hand-held shower head to clean places more easily without bending and twisting.
  • Wash in a relaxed, gentle fashion. Avoid vigorous scrubbing.
  • Use combined shampoo and conditioner to minimize time spent showering.
  • Turn on the cold water before the hot water to decrease steam. This will eliminate shortness of breath. Use a terry cloth towel to dry off, since this prevents the need for excessive rubbing.

Cooking:

  • Use prepared vegetables like baby carrots and pre-washed lettuce.
  • Keep one to two pots on the stovetop and one place setting on the countertop for easy access.
  • Cook large portions that can be divided and frozen for future use.
  • Soak dirty pots and pans to decrease the need for scrubbing.
  • Keep it simple by cooking one-pot meals.
  • Sit down to prepare and mix ingredients.
  • Use a wheeled cart to transport items.
  • Use paper plates and cups to avoid washing dishes.
  • Use electric appliances such as can openers, food processors, and mixers.

Household tasks:

  • Spread cleaning out throughout the week. Clean a different room each day rather than going back and forth between rooms
  • Make one side of the bed first and sit to change pillowcases.
  • Avoid spray cleaners as they can exacerbate COPD.
  • Let clean dishes air dry.
  • Use long-handled dust pans and cleaning sponges to minimize bending.
  • Consider having two sets of cleaning supplies: one upstairs and one downstairs.
  • Empty trash bins frequently to avoid carrying heavy trash bags.
  • Consider getting help or hiring a cleaning service for vacuuming and other difficult cleaning tasks.

Laundry:

  • Use a long-handled reacher to put in and remove clothing from the washer and dryer.
  • Use fabric softener to avoid wrinkles.
  • Consider using a clothing rack.
  • Avoid hanging clothing on a clothesline outdoors in extreme temperatures.

It is possible to live with COPD if you use the proper breathing and energy conservation techniques. You don’t necessarily have to give up on activities, but you need to adapt how you do things. Seek the services of an occupational therapist if you need help implementing these techniques or have other questions about energy conservation and COPD management.

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