Breathing Easier at Home With COPD

When breathing is hard, everything is hard: the stairs, the shower, a trip to the doctor. Home health brings the care to you, and teaches you and your family how to manage flare-ups before they turn into emergencies.

If your doctor orders it and you qualify, Original Medicare covers home health at no cost to you.

What COPD and breathing problems can look like at home

Your dad stops halfway down the hallway to the bathroom to catch his breath. Three inhalers sit on the counter, and nobody is sure which one is for every day and which one is for emergencies. Oxygen tubing snakes across the living room floor, and you have already tripped on it twice.

He has good days. Then a cold goes around, and soon he is coughing, wheezing, and scared. You cannot tell whether this is a bad day or the start of something worse.

How home health helps

COPD, including emphysema and chronic bronchitis, is managed in small daily steps. Your doctor sets the plan of care, and your team brings it to the house, where the stairs and the shower are.

Skilled nursing

Your nurse listens to the lungs and checks the oxygen level with a finger clip. Together you sort out which inhaler is for every day and which is for rescue, and practice using each so the medicine reaches the lungs. If he uses oxygen, the nurse checks the setup and goes over safety, especially no smoking or open flames nearby. The nurse also teaches you both what an early flare-up looks like.

Physical therapy

Resting all day can make breathing harder, because the muscles get weaker. The physical therapist starts with short walks in the hallway. He learns pursed-lip breathing, which can slow the breath and ease that panicky feeling. He also learns to pace the front steps: a few steps, breathe, a few more.

Occupational therapy

The occupational therapist looks at where the day runs out of air, then shows ways to shower sitting down, dress without bending over, and cook in short stretches.

Speech therapy

If your dad coughs or chokes at meals, a speech therapist checks his swallow and teaches safer ways to eat and drink. Breathing and swallowing share the same throat, and lung disease can throw off the timing.

Medical social work

Fear of getting breathless can shrink someone's world to one room. The social worker helps with the emotional side and the practical one: finding community programs that offer rides to appointments, trouble with the oxygen supplier, caregiver support, and programs near you.

Home health aide

While your dad is getting skilled nursing or therapy, an aide can help with bathing and dressing on days those tasks take more breath than he has. Aides are part of the skilled care plan, not a separate service.

What the first visit looks like

The first visit usually happens within 24 hours after the doctor or hospital sends the order. You can also call us first, and we will coordinate the order with the doctor. If he is just coming home, our coming home from the hospital checklist helps you get the house ready.

A nurse asks what a good day and a bad day look like. They check his oxygen level and breathing, watch him use each inhaler, and walk the path from bed to bathroom to kitchen with him.

You get one named coordinator. We send the same nurse or therapist whenever we can, and we call before every visit. If someone else must come, we call first. We keep your doctor updated, and your family too, with his okay. Our team speaks English, Spanish, Armenian, Russian, and Tagalog. Speak another language? Call and ask whether we have staff who speak it. If we do not have staff who speak your language, we arrange a free interpreter.

When to call

Call 911 right away for severe trouble breathing, breathing that gets worse fast, lips or fingernails turning blue or gray, chest pain, or confusion or heavy drowsiness. If he cannot speak a full sentence, that is an emergency.

Call your doctor or nurse the same day for more shortness of breath than usual, needing the rescue inhaler more often, more mucus or a change in its color, a fever, new ankle swelling, or an oxygen reading below the number your doctor gave you. When in doubt, call.

What family can do

• Keep the air clean. No smoking in the house or the car. Skip strong sprays and harsh cleaners.
• Tame the tubing. Keep oxygen tubing out of walkways and far from the stove and any open flame.
• Put the plan on the fridge. Ask the nurse to help you write down what a flare-up looks like and who to call.
• Set up the medicines once a week. Inhalers, pills, and nebulizer medicine in one place. See our page on medication management.
• Take care of yourself too. Our guide on caring for a parent or spouse is a good place to start.

Cost and who qualifies: with Original Medicare, covered home health is $0 if you qualify, and your doctor decides. See what Medicare covers, who qualifies, and what is not covered.