A COPD care plan provides a list of actions that people can take to manage their condition. These actions depend on whether the person is feeling well or having a flare-up.
A COPD care plan may involve taking certain medications, using oxygen, and engaging in healthy lifestyle practices, such as exercising and eating a nutritious diet.
Care plans also offer instructions on when to call a doctor and seek emergency treatment.
The purpose of the care plan is to provide guidance on what to do during every phase of COPD.
This article discusses COPD care plans, why they are important, and what they include. It also examines how to get the most from a care plan and what to ask a doctor.
A COPD care plan is an action or self-management plan. A typical plan has the below three sections:
The green zone refers to times when a person is feeling well and experiencing only the usual amounts of coughing and mucus production. Actions to take in this zone include:
This refers to times when someone has a flare-up. Symptoms of a flare-up may include:
- more coughing
- thicker mucus
- lower energy levels
- more swelling in the ankles
- reduced sleep or appetite
- more breathlessness
Actions to take may include:
- taking additional medications, such as a corticosteroids to reduce inflammation in the airways or an antibiotic for a bacterial infection, under the guidance of a doctor
- getting plenty of rest
- avoiding secondhand smoke
The red zone denotes times when urgent medical care is necessary. Symptoms may involve:
- severe shortness of breath, even at rest
- chest pains
- fever or shaking chills
- coughing up blood
- confusion or drowsiness
- an inability to do any activity
- an inability to sleep
Actions to take in the red zone include getting immediate medical care. They may also involve things to do while waiting on help.
According to the American Lung Association (ALA), a care or action plan can have the following benefits for people with COPD:
- It can help them know how and when to take medications.
- It can tell them when to call a doctor and when to get emergency treatment.
- It can help them track how they are doing and know what concerns to bring up with a doctor.
Adherence to an action plan of healthy lifestyle practices can make a difference in COPD severity, the number of flare-ups, and disease progression.
A person’s doctor or members of their health care team create the plan.
Although a care plan includes instructions concerning medications and when to call a doctor, another important section involves lifestyle change advisories. These may include the following:
Eating a healthy diet
According to the ALA, the right nutrients in the diet can result in better breathing. When the body metabolizes food, carbohydrates produce the most carbon dioxide for the amount of oxygen used, while fat produces the least. For this reason, some people with COPD may breathe better when they eat more fat and fewer carbohydrates.
Aside from this, following a healthy eating plan is generally beneficial. The ALA recommends the following nutritional guidelines for people with COPD:
- Eat more complex carbohydrates, such as:
- whole grains
- Limit simple carbohydrates, such as:
- sugary sodas
- Select monounsaturated and polyunsaturated fats, such as:
- corn oil
- canola oil
- safflower oil
- Eat 20–50 grams of fiber daily from foods, such as:
- whole grains
- Limit trans and saturated fats, such as:
- fried food
- Eat protein twice daily from a good source, such as:
Regular physical activity is part of a healthy lifestyle, even for people with COPD, states the ALA. However, a person should ask a doctor about specific exercise recommendations before starting a routine.
Moderate exercise can improve:
- sleep quality
- energy levels
- muscle strength
- shortness of breath
Despite the benefits, people with COPD should not exercise when they:
- are out of oxygen
- have chest pain
- feel nauseated
- have a fever
The ALA recommends doing the below two breathing exercises daily to make the lungs work more efficiently. A person should do each exercise for 5–10 minutes. With regular practice, the exercises can:
- raise oxygen levels
- help the lungs expel accumulated stale air
- strengthen the diaphragm, the muscle that lies below the rib cage, which helps breathing
This involves breathing in through the nose and then breathing out twice as long through the mouth with the lips pursed. This allows more air to flow in and out of the lungs.
This entails breathing in through the nose and then breathing out through the mouth for two to three times the inhale duration.
During this exercise, placing the hand lightly on the stomach helps to be aware of the diaphragm’s rise and fall with each breath. Keeping the neck and shoulders relaxed will help retrain the diaphragm.
An occupational therapist can teach people with COPD ways to converse their energy. This may involve measures such as:
- sitting rather than standing to perform a task
- simplifying tasks
- taking frequent rests regularly
A 2020 clinical trial involving 22 people with severe COPD provides an example of how energy conservation can help. The authors asked the participants to climb six flights of stairs, resting at least 5 seconds after every three steps.
They compared the effect of this intervention with those of a control group that climbed the stairs at their own pace. The results indicated that the energy-conservation method of taking regular short rests led to less labored breathing. However, it is important to note that these recommendations are for people with severe COPD.
Lifestyle recommendations in a care plan make the most difference if a person practices them regularly. A person should review the care plan frequently to ensure they are following all the advisories.
The ALA suggests asking a doctor the following questions about COPD:
- Can you refer me to a pulmonary rehabilitation program? This is an invaluable program involving exercise, breathing techniques, and energy conservation.
- What other things can I do to improve my quality of life? As an example, doctors may recommend joining an online support community.
- Am I using my medications correctly? Some nebulizers and inhalers are difficult to use. Demonstrate to the doctor how you are taking your medicine to ensure you are using the proper technique.
A COPD care plan is a guide that a person can follow in every phase of their condition. If they feel well, they can take their regular medications and engage in exercise.
When someone has a flare-up, they may need to rest more and take additional medications, such as a corticosteroid or antibiotic.
Whether a person feels well or is experiencing a flare-up, it is best to follow doctor-recommended advisories, such as abstaining from smoking and eating a nutritious diet.