Enhancing Quality of Life Through Palliative Care in Elderly with Severe Chronic Obstructive Airway Disease and Multimorbidity: A Case Study

Muhammad Ilham Dhiya Rakasiwi; Amalia Ghaisani Putri; Windu Prasetya; Permadita Wicaksono

doi:10.36497/respirsci.v6i3.225

Authors

Muhammad Ilham Dhiya Rakasiwi Bisui Primary Hospital, South Halmahera
Amalia Ghaisani Putri Faculty of Medicine Universitas Indonesia, Jakarta
Windu Prasetya Department of Pulmonology, Soehadi Prijonegoro General Hospital, Sragen
Permadita Wicaksono Department of Pulmonology and Respiratory Medicine, Faculty of Medicine Sebelas Maret University, Surakarta

DOI:

https://doi.org/10.36497/respirsci.v6i3.225

Keywords:

COAD, Elderly, Palliative Care, Health-Related Quality of Life

Abstract

Introduction: Chronic obstructive airway disease (COAD) patients undergo significant problems arising from dyspnea, ultimately affecting their quality of life (QOL). Knowledge of palliative care for chronic or terminal diseases has developed, but its application in severe COAD is limited.

Objective: Present case of an elderly with COAD exacerbation and analyse palliative care studies related to QOL in COAD.

Case: A 65-year-old man came to our emergency ward complaining of severe dyspnea for 7 days, followed by coughing up phlegm of greenish-yellow colour. The QOL assessment with the EQ-5D-5L questionnaire shows severe discomfort and problems in daily activities. After pharmacologic interventions for his acute exacerbations, our team provides palliative care consisting of symptom management and multidimensional assessment to address the patient's symptoms and provide spiritual support. After 7 days of treatment, the spirometry test showed FEV1/FVC 39% and 36% for pre- and post-bronchodilator, respectively. Post-hospitalization QOL showed only a slight problem with the discomfort/pain component.

Discussion: We demonstrated the role of palliative care for elderly COAD patients to improve his HRQOL. Based on systematic literature search that we conducted on three databases, five studies discussed role of palliative care in the HRQOL of COAD patients. Although the assessment instruments differed between each study, all studies showed no statistically significant differences between COAD patients receiving palliative care and standard care. The outcomes of our cases differ from previous studies, possibly because our patient has psychosocial needs during his treatment that we can help fulfil, thus improving their HRQOL.