Chronic Obstructive Pulmonary Disease Case Study Analysis
This essay will focus on the case study of Harry Johnson, an 84-year-old gentleman, who has a diagnosis of chronic obstructive pulmonary disease (COPD), to identify his key holistic needs around his condition. Before incorporating a critical examination of the nursing care required to enable and assist Harry to manage his condition and at least one of his needs resulting from this; before finally discussing the implications for a nurse’s professional practice in meeting these needs.
Incalzi et al (2014) suggests that COPD is a disease of the elderly, with Fotokian et al (2017) implying that COPD impacts not only the health status, but also the quality of life of an elderly person, by reducing both. Saffel (2012) expands on these thoughts by suggesting that COPD in the elderly is a major cause for them developing chronic morbidity and mortality.
The Kings Fund (2018) state that COPD is a long-term condition, as there is currently no cure and can only be managed by medication and therapies. While both the British Lung Foundation (BLF) and the COPD Foundation (2018) summarise COPD as an umbrella term, used to describe progressive lung conditions such as emphysema and chronic bronchitis, affecting an individual’s alveoli’s and bronchi making breathing difficult. This ties in with how the World Health Organisation (WHO) define COPD, they state it is a progressive life-threatening disease, which causes and individual to become breathless. The National Institute for Health and Care Excellence (NICE) expand on this by stating that one of the main COPD characteristics is airflow obstruction that cannot be fully reserved. Who (2018) imply that current COPD figures show that there are 65 million people worldwide who live with COPD, with NICE (2010) suggest that in the United Kingdom (UK) there are 3 million people living with this condition but expand on this by stating that approx. only 900, 000 people have a COPD diagnosis. There is then the cost of caring for individuals with COPD, with McLean et al (2016) proposing that COPD cost to the National Health Service (NHS) in 2016 was in the region of £1. 8 billion pounds, with this figure set to rise to around £2. 3 billion pounds by 2030; while Lloyd and Garside (2018) suggest that the actual COPD cost to the NHS is around £800 million per year.
When you start to think about and factor in the cost of sick days and loss of business from lung diseases, such as COPD to the UK economy, you find these figures rise sharply, with Trueman, Woodcock and Hancock (2017) suggesting that the current annual cost of COPD in the UK, is approx. £11 billion pounds. With the high prevalence of COPD worldwide shown by these figures, it is also important to note that the Global Initiative for Chronic Lung Disease (GLCOLD) (2017) state that COPD is currently the fourth leading cause of death in the world and is set to become the third by 2020, while WHO (2018b) argue that will not be the case until 2030.
Harry was diagnosed with COPD, 12 years ago and upon receiving his diagnosis, Harry gave up smoking. His smoking along with his days working in a coal mine, could have been the risk factors that lead to him developing COPD. Miles (2017) expands on this by suggesting that COPD prevalence within the mining communities is higher than the national average of 1. 9%, with towns who have a rich mining history, such as likes of South Yorkshire and South Tyneside, who have averages of 2. 3% and 3. 7% concurrently. Harry’s current hospital admission follows an episode of Harry suffering from shortness of breath, coughing and the producing of green phlegm during the night. The BLF (2018) describe common COPD symptoms as being dyspnea on exertion, coughing that lasts for a long period of time, wheezing that becomes more noticeable in the cold weather and the production of more sputum and phlegm. Upon his admission to hospital Harry will have undergone an initial admission assessment, based on the activities of living (ALs) as set out in the nursing model created by Roper, Logan and Tierney (RLT) (2000), thus allowing the nurses caring for Harry to gain a better understanding about how he struggling to manage his ALs.
NICE (2016) suggests that given Harry’s previous hospital admissions and his complex needs arising from his hospital admissions that a comprehensive geriatric assessment (CGA) would be better suited in assessing his needs. Welsh, Gordon and Gladman (2014) describe the CGA as being multidimensional, looking not only at a patient’s medical ailments but also how their functional abilities are affected. Ellis et al (2011) expand on this more by stating that all members of a patients multidisciplinary team will make contributions to their CGA, while also adding that the need for a more specific assessment model for frail/vulnerable elderly patients may be required.
