Identifying signs and symptoms of COPD might seem easy (like it's been more or less summed up in the video above), but identifying deficits in a client's daily lives is not that simple.
Basically, a person's daily live activities are affected by their role in life, cultural background, and lived experiences. Therefore, there is no "one size fits all" intervention in occupational therapy, as client's occupations are considered unique to themselves. Despite that, there are always certain problems that are prominent every COPD client's daily life, and these usually are affected by the signs and symptoms of the disease itself. Here are some more general problems most likely to be faced by people with COPD:
Walking
While walking is not an occupation per se, it can affect many other occupations. Walking is categorized under functional mobility in occupational therapy, meaning it is something we do to allow us to perform occupations. Most people with COPD find it hard to walk long distances, with some of them getting as bad as running out of breath after walking a few metres. It might be hard to imagine, but you can try sprinting as fast as you can for a couple of minutes without stopping to get a feel of how people with COPD feel after they exert themselves too much, which might be just walking for 50 metres.
A client's inability to walk far affects the client in many ways - some of them have problems going out to the shops to buy food to eat, some of them have problems going to the bathroom etc, depending on how far the can walk and what activities they want to do. So while it might seem that walking is a very simple problem, but it can actually make clients lose a big part of their life because they will just be limited to their bed/room/house.
Passing motion
This is one of the less mentioned but very frequently occurring ADL problem that people with COPD face. To be honest, it never occurred to me that passing motion was a problem many COPD clients face until after some time of working in the area. While we may assume that problems in toileting can be linked to them getting short of breath while walking to the toilet, clients have claimed that it's hard for them to pass motion even when they are wheeled to the toilet on wheelchairs, or when they get to the toilet without losing their breath.
The reason is actually linked to constipation - harder faeces cause clients to push harder when passing motion, causing them to go out of breath. The solution is usually pretty easy, increasing their water intake or with the use of enema. But if the client has a secondary condition and cannot take too much water under the doctors advice, and/or if the client does not have enemas at hand (or in cases where enemas can't work), it can be quite a problem.
Eating/Having meals
Not to be mistaken with the OT term feeding, although it is related. This activity is usually a problem for clients who are affected really badly by COPD. While OTs usually assess the feeding function of clients, like bringing the food to mouth (using hands/spoon/chopsticks) or cutting meat and opening bottles*, the physiology of eating (chewing, swallowing etc) also has to be looked into. The tendency of COPD clients to get out of breath often causes them to not be able to eat like normal, as they cannot breath while they eat, so wolfing down food is a big no-no for people with COPD.
Chatting
In this modern age, some people might mistake this for chatting on instant messengers, but no, it's real life chatting or verbal interaction. Chatting does not necessarily have to be done face to face. It can also be done over a phone call too. Many clients with COPD find it hard to talk continuously for a certain period of time, as they cannot talk and breath at the same time.
Other possible areas
While it hasn't been reported, I believe sexual activity could possibly be an activity where clients will face a big problem in. So far I haven't had any clients who has problems in this, particularly because I've never seen any COPD client below the age of 70, and they have been sexually inactive for years. But this could potentially be one area to explore if you have younger or sexually active COPD clients.
There are also certain areas like work (yes, I've had a client who was over 70 years of age and still had to work), hobbies, house chores and other more specific activities that are unique to each client, so digging into the client's life and identifying these occupations** is very important. How do you identify what occupations to look into? That'll come in the next post.
*Cutting meat and opening bottles is listed as the criteria to score a 10 in the Modified Barthel Index.
**As mentioned in the last post, the term occupation here is defined in the OT context, meaning an occupation is an activity that is purposeful and meaningful to the client.
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