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Friday, December 13, 2013
I have an 83 year old friend with severe pulmonary fibrosis. I need info on what to expect in the final stages and how to help prepare the family for her death. What can they expect???? I am having difficulty finding info on the final stages/days of the disease and what will happen!!!!!! Thanks!!
The main symptoms of pulmonary fibrosis are shortness of breath and cough. As the disease worsens, these two symptoms get worse. Patients do not usually have pain.
Fortunately, there are things that can help. First, oxygen can be given which can improve the shortness of breath; to determine the proper amount of oxygen necessary, a physician or a respiratory therapist can measure the patient's oxygen level in order to "titrate" the amount of oxygen to give him or her.
When the disease becomes more advanced, and when death is believed to be close, medications such as opiates (for example, morphine, fentanyl, dilaudid, etc.) can be given which will reduce the sensation of breathlessness and reduce the cough. These medications can be given in pill form, liquid form, injected form, inhaled form, or skin patch form so there are a lot of different options for individual patients. Often, involving home hospice can be very helpful to the patient and the family. I try to involve hospice early so that the focus of hospice is on helping the patient to live as comfortably as possible and not just on helping them die as comfortably as possible.
As with all diseases, it is important to be sure that the symptoms are all due to pulmonary fibrosis and that there are no other medical problems that are causing the same symptoms (such as infection, anemia, heart failure, or blood clots).
James N Allen, Jr, MD
Clinical Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University