Table 4. Needs and actions resulting from the HELP-COPD assessment.
| Domain | Symptoms or concerns discussed | Actions planned |
|---|---|---|
| Physical | Troublesome symptoms: breathlessness (n=14), fatigue or weakness (n=8), pain (n=6), recurrent chest infections (n=4), coughing/sputum production (n=3), weight loss (n=3). | Referrals to GP to discuss the use of morphine for breathlessness (n=1), pulmonary rehabilitation (n=1), home oxygen services (n=1) |
| Concerns about medication | Self-management plan arranged (n=2) rescue medication supplied (n=1). | |
| Check the progress of pulmonary rehabilitation referral | ||
| Psychological | Struggling with anxiety (n=7): Discussion of coping strategies (n=6) | No actions were generated, as no one requested or accepted help for anxiety and/or depression |
| Frustration at their limitations (n=7) | ||
| No one described themselves as ‘depressed’ | ||
| Social | Topics covered included loneliness, bereavement, activities of daily living (ADL), shopping, bathing, housework, housing, going out, going on holiday. | Referral for help with personal care (n=1), carer support services (n=1), assessment for a shower unit (n=1) |
| Coping strategies discussed: pacing, accepting family help: a few had formal carers | Provision of the HELP-COPD leaflet of local services and voluntary agencies that could provide a range of support (n=12). | |
| Provision of information about specific issues (such as going on holiday, arranging insurance, volunteer drivers) was also provided. | ||
| Problems with housing (e.g., inaccessible steps, n=3) | ||
| Spiritual | Discussion of the importance of family life and family support (n=15) | No actions |
| Most of them had no worries (n=15) |
Abbreviations: GP, general practitioner; HELP-COPD, HELPing older people with very severe chronic obstructive pulmonary disease.