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Discussion : COPD
A 60 year-old patient· has recently been diagnosed with Gold 2 class· COPD . He is a current smoker and has only had COPD symptoms for the past· year . He and his wife , a retired registered nurse , are attending a class· on COPD management· . Before the class· starts , he complains to you that his wife is pressuring him to make· some big· changes . First , she wants him to stop· smoking , which he has agreed to do· and has started on pharmacologic therapy to assist· in the process· . She wants to sell· their current home· ( where they have· lived for 25 years) and move· to a one-story house· . She has started mowing the lawn , which has always been his job· , and which he wants to continue· to do· . She also has asked him to stop· his hobby· of refinishing furniture· to avoid· the fumes . "I'm not dying yet , and I don't want· to give· up any of these things" . Shey says , "I'm just thinking of your best interests and am planning ahead" . She then asks you to support· her suggestions (demands) .
1. How should you respond· to her request· to support· her suggestions ? What do· you think· her motive(s) is (are) ?
2. Is there justification for any or all of these suggested changes ? Provide a rationale for your response.
3. Should you continue· this conversation· with both of them together or separately ? Provide a rationale for your response.
4. Which members of the interprofessional team for COPD management· would be· helpful in this situation· ? Provide a rationale for your choices.
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