Lung Issues Like COPD and Asthma Can Complicate Care in Older Adults

Lung function declines as you age. Nearly 15% of middle-aged and older U.S. adults suffer from lung disorders. More than 25 million people in the U.S. have asthma, and about 14.8 million adults have COPD. Breathing troubles create health complications for those in long-term care.
Updated: May 1st, 2022
Linda Maxwell

Contributor

Linda Maxwell

Most of us take breathing for granted. Vietnamese Buddhist monk, Thich Nhat Hanh, once said, "Breath is the bridge which connects life to consciousness, which unites your body to your thoughts." You have taken 17,000 breaths in the last twenty-four hours. When we are healthy, our breathing occurs naturally and easily. However, especially as we get older, breathing can become a difficult undertaking.

People suffer from multiple health problems, and breathing difficulties become a much more significant health issue. The Centers for Medicare & Medicaid Services chronic conditions data indicates that 11.7% of all Medicare patients had claims with chronic obstructive pulmonary disease (COPD) diagnosis in 2019. Around 15 percent of older adults have asthma, COPD, or other respiratory disorder.

Symptoms of breathing and lung problems include wheezing, breathlessness, chest tightness, and coughing. The problem is that seniors usually have multiple health problems, which increase with age.

According to the Centers for Disease Control and Prevention, approximately 85% of older adults have at least one chronic health condition, and 60% have at least two chronic illnesses. When you add difficulty breathing, it makes other health issues worse and reduces the quality of life for the individual. 

Lingering COVID-19 Creates On-Going Lung Problems

Older individuals are also at greater risk of COVID-19 infection. Even after a mild case of COVID-19, some people suffer breathing problems that last for months, complicating their overall health picture and adversely impacting their lifestyle.

One research study suggests that one in every six admissions to nursing homes was for patients with a history of emphysema or COPD. Many seniors also have asthma, although it is sometimes difficult to distinguish between the two in older patients. Normal aging-related changes in lung function will exaggerate asthma symptoms and COPD.

Comorbidities Affect Older People in Long-Term Care

The typical individual with COPD admitted to a long-term health care facility will usually have multiple health problems. COPD may not be the patient's primary health problem complicating care services in assisted living and nursing homes. 

Research shows that those with COPD have problems like cardiovascular disease, including coronary artery disease, congestive heart failure, and high blood pressure. Many COPD patients have had a stroke, and 25% also have asthma. 

Pneumonia, another lung issue, is a significant cause of morbidity and mortality in long-term care facilities. These breathing and lung problems are also associated with increased emergency room visits and overnight hospital stays.

Low Oxygen Levels are Dangerous

For many older adults, breathing doesn't come easily due to low oxygen levels. Oxygen therapy is one treatment that helps some patients when they have breathing problems. Normal blood oxygen levels are 95% and above. Home oxygen therapy is recommended when a person’s oxygen level is 88% or less. Those at home receiving in-home care can be treated with oxygen therapy as there is no need to be in a facility just for oxygen treatment. However, those who need more substantial help with daily living activities can receive oxygen therapy and other care services in assisted living and nursing home facilities. 

Treatment for Breathing Problems

COPD is usually progressive. Asthma can range from being mild and associated with outdoor or indoor allergies to chronic requiring medium or high doses of inhaled corticosteroids. Severe asthma does not respond well to standard asthma treatments and can be life-threatening. 

No matter the underlying cause, breathing issues should be treated quickly since the stress on a person's lungs and heart is more significant in older people.

In-home caregivers should ensure that medications for breathing problems are being taken correctly. Increased symptoms like wheezing or severe coughing cannot be ignored. Someone should not smoke if they have asthma, COPD, pneumonia, or another lung disease. Too often, a long-time smokers will attempt to smoke even if they are on oxygen. 

Be sure your loved one is receiving quality care services, whether it is in their home or a long-term care facility. Be proactive with their care. Quality long-term care is costly, and those costs are increasing - but quality caregivers and facilities can make a big difference in overall quality of life. 

Many Families Unprepared for Changes in Health in Loved Ones

Being prepared for these costs and the consequences long-term health care will have on your family and finances should be addressed before you get older and see health declines. 

Since health insurance and Medicare (including supplements) will not pay for most long-term care services, many people turn to Long-Term Care Insurance as a possible solution. But, if you are a former or current smoker or have asthma, can you still obtain coverage?

The answer is yes - depending on the severity of your health problems. Moderate or mild asthma or COPD with infrequent attacks can be insurable, depending on the insurance company. Every insurance company has its own underwriting criteria, so you should get advice from a Long-Term Care Insurance specialist who will review your health history.

Once you obtain coverage, the insurance company cannot cancel the policy as long as you continue to pay the premium. Nor can the insurance company change your premium due to changing health. But keep in mind you must have reasonably good health to obtain coverage, so delaying until your health declines could be you would be unable to get a policy. 

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