When it comes to sex and gender-related differences in COPD, women certainly seem to get the short end of the stick. Studies show that women not only tend to be more prone to getting COPD, but also suffer from worse symptoms, later diagnoses, and other COPD-related health problems more often than men.

This is a relatively new revelation; back in the day, COPD used to be known as a “man's disease,” and very little was known about COPD in women. Before the early to mid 1900's, the vast majority of tobacco smokers were men, and it was rare for women to smoke or develop smoking-related diseases like COPD.

This isn't true anymore, however, and the trend seems to flipping in the opposite direction as more women than ever have been diagnosed with COPD in recent years. This shift has made it possible for researchers to study COPD in women more extensively, and this research has revealed some significant—and surprising—differences in how women are affected by this disease.

Some of these differences between men and women have biological origins, including differences in lung anatomy and how men's and women's bodies are affected by COPD. On the other hand, some differences originate from within the healthcare system, which (often unwittingly) tends to treat men and women differently during diagnosis, evaluation, and treatment for COPD.

Unfortunately, many of these disparities result in extra risks and disadvantages for women, including later COPD diagnoses, quicker lung function decline, and even a higher risk of death. However, many of these risks can be mitigated with simple preventative measures and increased awareness of these risks among doctors, caretakers, and people with COPD.

In this post, we're going to take a closer look at the scope and the nature of the problems that women with COPD face in regard to their symptoms, their healthcare, and the impact of the disease. Most importantly, we also present dozens of practical strategies—and links to other helpful resources—that women with COPD can use to minimize these extra risks.

All women with COPD deserve to know how the disease might affect them differently and what they can do in response. Knowledge is power, and the more you learn, the more empowered you will be to take control of your health and live your best life possible with COPD.

The Major COPD Risks that Affect Women, and What You Can Do About Them

In the following sections, we'll explain eight major challenges that women with COPD encounter and explore some of the biological and structural reasons for why these issues tend to affect women more than men. You'll also find a plethora of helpful tips throughout this guide for how women can overcome these challenges and get better outcomes for their health.

If you are a woman with COPD, or know someone who is, we hope that this guide will serve as a helpful tool for managing the gender-specific risks that come with the disease. For more information on COPD management, including more information about sex differences among people with COPD, check out our huge collection of helpful guides in our Respiratory Resource Center.

A quick note: We understand that sex and gender are not one and the same, and that COPD differences intersect both gender and sex. For the sake of brevity and simplicity, however, we use these terms interchangeably—or use one term to refer to both concepts at once—at times in this guide.

Women's Lungs Are More Sensitive to Damage from Smoking

How heavily someone smokes throughout their lifetime—a factor that's often measured in “pack years—influences how severe their COPD-related lung damage is later in life. For example, a person with COPD who smoked one pack of cigarettes every day for 10 years (which is the equivalent of 10 pack years of smoking) will likely have more severe lung damage than someone who only smoked half a pack a day for 10 years (equivalent to 5 pack years of smoking).

Unfortunately, research suggests that women's lungs are more vulnerable than men's to the damaging effects of tobacco smoke. This not only makes women more vulnerable to developing COPD, but also causes women to develop more severe COPD than men who have an equivalent number of pack years.

One study, for example, found that women who smoke less than men have nearly the same amount of measurable emphysema (i.e. damaged air sacs in the lungs). This was true even though the men had smoked significantly more—four more cigarettes per day, on average—than the women in the study.

It's important to note that, as a whole, men actually tend to have worse emphysema than women. However, research suggests that this is largely due to the fact that men tend to smoke more heavily; on average, male smokers in the US have a whopping 33% more pack-years than women, with women averaging 15 pack years and men averaging 20.

However, women still sustain a disproportionately large amount of lung damage despite smoking less—and even starting smoking later—than men. While researchers aren't exactly sure why this happens, they believe this phenomenon could be the result of certain biological features in women that predispose their lungs to smoking-related damage.

These biological features include female hormones like estrogen and progesterone, which have been shown to play a role in how the lungs respond to cigarette smoke. Women also tend to have smaller airway spaces than men, which some researchers believe could result in the airways getting a higher dose of toxins when they're exposed to cigarette smoke.

This effect might not be limited to smoking, however; some studies suggest that women's lungs might be more sensitive to other kinds of respiratory hazards, like air pollution, chemical fumes, and second-hand smoke. This is bolstered by the fact that even women who have never smoked before in their lives get COPD at significantly higher rates than men who have never smoked; nearly 80% of nonsmokers with COPD are women.

What Women with COPD Can Do About It:

Quit Smoking

If you are a woman who smokes, quitting smoking is one of the best possible things you can do for your health. There's no way to reverse the damage that's already done, but you can prevent additional damage—and reap a ton of other benefits—if you stop smoking now.

Check out the following guides to learn everything you've ever wanted to know about quitting smoking:

• How to Quit Smoking Part 1: Overcoming Doubts & Finding Resources to Help You Quit
• How to Quit Smoking Part 2: Coping with Nicotine Withdrawal & Choosing a Quit-Smoking Medication
• How to Quit Smoking Part 3: Taking the First Steps & Strategies for Staying Smoke Free

Protect Your Lungs from Potential Hazards

Women should also be extra careful about exposing their lungs to other respiratory hazards, since they seem to be extra vulnerable to their damaging effects. For example, women—like all people—should avoid hazardous occupations (e.g. jobs that expose you to exhaust fumes or dust) and take steps to reduce indoor air pollution in their homes (e.g. avoid using wood-burning stoves, noxious chemicals, and other products that release harmful fumes indoors).

Protecting your lungs from these hazards can also help prevent irritation, inflammation, and flare-ups that make COPD symptoms harder to control. It can also reduce your risk for COPD exacerbations, which can cause additional, permanent lung damage and lung function decline.

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We'll discuss more about how to avoid common respiratory hazards (and link you to several in-depth guides on the topic) in the sections below.

Women Have a Higher Risk of Getting COPD than Men

As we discussed in the previous section, women's lungs tend to be more vulnerable to respiratory irritants than men and tend to sustain more lung damage from each cigarette they smoke. Therefore, it should be no surprise that this causes women to have an overall higher risk for developing COPD than men.

Research suggests that this difference is quite significant; one large systematic review found that women who smoke are fifty percent more likely to get COPD than men who smoke. Other studies show that women tend to be more likely to get COPD from lesser amounts of smoking, and also tend to develop COPD earlier in life.

However, because COPD is such a complicated disease that usually develops years after the exposure that causes it, pinning down the exact reason for gender differences in COPD risk difficult. In addition to biological factors, there are likely a variety of social, lifestyle, and demographic factors at play, such as: gender-related differences in healthcare accessibility, healthcare quality, smoking behaviors, geographical location, and more.

What Women with COPD Can Do About It:

Take Good Care of Your Lungs

The only reliable way to reduce your risk for COPD is to protect your lungs from smoke and other respiratory irritants (like air pollution) throughout your lifetime. The more frequently your lungs are exposed to and inflamed by respiratory hazards, the more you put yourself at risk for lung diseases like COPD.

Because women are more susceptible to COPD, women should be extra careful about what they breathe into their lungs. That means not smoking, or quitting if you do, and doing your best to breathe clean, pollutant-free air as much as possible.

Of course, there's only so much you can do about certain respiratory irritants like outdoor air pollution. But even if you live in a place with low air quality, you can still take steps to reduce how much air pollution breathe (e.g. planning outdoor activities for times when your local air pollution is low).

Here is a list of some of the major respiratory irritants that can increase your risk for COPD:

• Second-hand smoke
• Any kind of smoke or combustion fumes (e.g. smoke from fireplaces, wood-burning stoves, car exhaust, cooking fumes, etc.)
• Radon gas (a common radioactive gas found in homes that can only be detected with a proper radon test)
• Common commercial cleaning and pest-control products
• Many crafting, renovation, and construction materials, including paints, treated lumber, adhesives, solvents, new carpets and flooring, etc.
• Occupational hazards like dust, chemical fumes, and diesel exhaust

It's worth mentioning that, even though any kind of respiratory irritant can be dangerous if you're exposed to it long term, smoking is by far the biggest hazard and the most important one to avoid. Smoking is responsible for more cases of COPD than anything else; a full 85 to 90 percent of all COPD cases are caused by smoking.

Check out the following guides for even more tips about what you can do to avoid respiratory irritants and reduce your risk for COPD:

• How Volatile Organic Compounds Harm Your Lungs, and How to Avoid Them
• How to Cope with Poor Outdoor Air Quality
• How to Protect a Child from Lung Diseases Like COPD

Reduce Sources of Pollution in Your Home

Even though we've already stressed the importance of avoiding respiratory irritants, it's important to discuss indoor air pollution specifically, especially since women tend to be exposed to this type of pollution the most. That's because, even in modern times, women tend to spend more time than men at home doing household tasks that could be hazardous to their lungs.

Cooking and cleaning, for example, two major sources of exposure to respiratory irritants at home. In fact, research shows that non-smoking women who cook more often—and have smokier kitchens when they cook—are more likely to develop COPD.

Fumes from cleaning products, especially chemicals like ammonia and bleach, can also damage your lungs and increase your risk for COPD. Luckily, there are many things you can do to reduce the risks from cooking and cleaning, but you need to do them consistently to keep the air in your home clean.

One of the best things you can do is establish a good ventilation system in your kitchen and any rooms you use chemicals to clean. The goal is to create an air flow that funnels the fumes outdoors, and you can do this with a fume hood (e.g. above your kitchen stove), a ventilation fan (which many bathrooms have pre-installed), or simply by opening up some windows to allow the fumes to escape.

You can also reduce your exposure to chemical irritants by being more selective about what kinds of products you use. Many household cleaning products can be hazardous, so it's a good idea to look at the labels of everything you buy and try to find alternative products that are safer for your lungs.

These are just a few of many possible steps you can take to keep your indoor air as clean as possible. For more tips about how to cook and clean more safely and reduce other sources of air pollution in your home, check out the following guides from our Respiratory Resource Center:

• How to Improve Your Indoor Air Quality for COPD
• How Cleaning Products Can Damage Your Lungs, and What You Can Do to Prevent It
• Your Complete Guide to Choosing an Indoor Air Filter to Improve Your COPD Symptoms
• Spring Cleaning Tips for Healthy Lungs & COPD

Women are Less Likely to Receive a Correct COPD Diagnosis

Unfortunately, women with COPD tend to be disadvantaged in the US healthcare system, and the problem begins at the very first step: women with COPD are less likely to get an accurate COPD diagnosis, more likely to get misdiagnosed with asthma, and tend to get diagnosed later (as in after the disease has progressed further) than men.

One of the main reasons for these discrepancies seems to be doctor bias that affects how they evaluate men vs. women with symptoms that could be a sign of COPD. As a result, women with COPD symptoms are less likely to receive a spirometry test than men, which is likely the primary reason that women are under-diagnosed compared to men.

Spirometry tests are the most powerful tool that doctors have to diagnose COPD, and getting one is vital for an accurate COPD diagnosis. In fact, research shows that the gap between COPD diagnosis rates in men versus women is reduced when doctors have spirometry test data to help them make their diagnoses.

This suggests that, if doctors just did spirometry testing in a more consistent manner, they could significantly reduce or eliminate the diagnosis divide between women and men. However, while this might sound simple, it's not such an easy task; this issue is part of a wider problem of gender bias in healthcare that sees women disadvantaged in a wide range of different ways.

Fortunately, these long-standing issues have received a lot more attention in recent years. As doctors and researchers continue to investigate these gender biases in healthcare, they can develop new strategies for addressing them and reducing the negative effects they have on patients.

What Women with COPD Can Do About It:

Be on the Look Out for COPD Symptoms

Women, and especially women who have risk factors for lung disease, need to be on the lookout for signs of COPD as they age. Never ignore any long-term changes in your respiratory symptoms, especially persistent coughing or shortness of breath.

If you do notice any changes, makes sure to bring them up with your doctor as soon as soon as possible after they occur. The earlier you get diagnosed, the earlier you can get treatment that can improve your quality of life and the long-term outlook for your health.

To learn more about how to recognize the early symptoms of COPD, check out the following guides:

• When Should You Get Tested for COPD?
• Everything You Need to Know About Lung Disease Diagnosis

Advocate for Yourself

Ideally, every doctor would always treat men and women equally and would know how to properly diagnose COPD in women just as well as men. However, this is unfortunately not the case, and the responsibility often falls instead on women patients to advocate for themselves.

Unfortunately, this isn't always easy to do, especially if you (like many people) find medical professionals intimidating or simply have trouble speaking up at the right times. Luckily, being a good self-advocate is something you can learn, and you can even enlist others to help you if you need.

One way to become a better self-advocate is to be more pro-active about your health in general. That means educating yourself about your body and common disease symptoms, and being diligent about bringing things up with your doctor if you have any symptoms or concerns.

It could also mean standing up for yourself if a medical professional doesn't take your concerns seriously. If you think that something you're worried about needs to be looked into further, don't rely on your doctor bring up the next step; if you go to your doctor with persistent respiratory symptoms, for example, you might need to ask your doctor specifically to do a diagnostic spirometry test.

If you're unable to advocate for yourself for any reason, or simply need some backup, you can always bring someone else to advocate on your behalf. Sometimes, two voices are more effective than one at getting stubborn healthcare professionals to listen to your needs.

It's also important for women to be aware of doctors potential biases and find a doctor they can trust. Your doctor should be someone who listens, respects your concerns, and never ignores

For many people fighting chronic lung diseases like COPD, the hardest battles are not the physical ones, but the ones that happen inside the mind. Coping with a disease that disrupts your breathing—a basic life function—is far from easy, and it takes a major mental toll on many people with the disease.

Though COPD is usually thought of as a disease that affects the physical body first and foremost, it's known to come with a long list of psychological side-effects and risks. These include clinically-recognized disorders like anxiety and depression as well as other forms of mental and emotional distress that are a bit more difficult to quantify and define.

Many people with COPD find themselves consumed with worry, for instance, or over-focusing on the difficulties and losses in their lives. While this is a common, natural reaction shared by many people with chronic diseases, it's not a healthy, happy, or sustainable way to go through life long term.

Luckily, there are many healthy, effective tools for coping with COPD and the sometimes overwhelming emotional challenges of living with the disease. In this post, we're going to focus on one method in particular: gratitude exercises, which are proven to help improve happiness and emotional well-being.

Though little-known and under-appreciated, gratitude exercises are backed by a great deal of research that supports the idea that gratitude—when practiced correctly and consistently—can improve a variety of different aspects of mental health. In particular, gratitude exercises can make it easier to cope with misfortune and help you find more contentment and appreciation in life in spite of your COPD.

Why Gratitude?

At first glance, gratitude practice might sound like a strange solution for people who struggle to cope with the mental and physical strain of COPD. We understand how it might sound ironic—or even condescending—to suggest that people should feel grateful while dealing with a debilitating, chronic disease.

Certainly, we're not saying the people with COPD should be grateful for their disease, nor that people with COPD should feel any obligation to be grateful at all. However, gratitude is a recognized psychological intervention, and it's something that anyone can practice by doing simple exercises at home.

Practicing gratitude also doesn't mean you're supposed to feel grateful all the time. It's not meant to invalidate your feelings, replace negative emotions, or even drown out unpleasant thoughts. Instead, gratitude practice is meant to help you access more positive emotions in addition to the negative ones, and to help you see the good things even when the bad things are hard to see past.

According to one blogger who writes about their experiences with chronic illness, "It is not easy to feel thankful when we are chronically ill; in fact, sometimes we feel cheated out of life." However, she explains, that's all the more reason to practice gratitude, which, like any skill, can be honed and improved over time.

Practicing gratitude helps you look at the world through a different lens—one that helps you see beyond your struggles and recognize the good things in your life. In this way, gratitude practice helps you build a more positive outlook on life in general, which can help you keep hope and happiness alive no matter how bad things might seem.

What Does Gratitude Have to Do With Mental Health?

Research on gratitude shows that it has a variety of mental health benefits, and many people with COPD report finding comfort and relief in gratitude. Of course, that doesn't mean gratitude practice works for everyone, but it does suggest it's a worthwhile option for people who struggle with mental and emotional health because of their COPD.

Gratitude is an important concept in the field of positive psychology, a sub-set of psychological research that focuses on identifying traits and behaviors that support positive mental well-being. This area of psychology is all about strengthening positive traits (reinforcing the things that make people happy) rather than fixing negative traits (correcting the things that make people unhappy).

In the scope of positive psychology, the purpose of gratitude is not to treat any specific mental problem or disorder, but to help people cultivate habits and perspectives that promote better general mental health. Of course, we're not suggesting that gratitude practice is a substitute for mental health treatment, or that gratitude alone is enough to overcome the (often) enormous burden of COPD-related emotional distress.

While gratitude can be a helpful tool for those struggling with mental problems, it's not enough to treat serious emotional problems or mental illnesses on its own. If you suffer from a mental illness like anxiety or depression, or you are unable to cope with the mental burden of COPD on your own, you should first seek proper treatment from a trained mental health professional.

If you'd like to learn more about mental health treatment for COPD or other coping methods to try, check out the following guides from our respiratory resource center:

• Coping with COPD
• Mental health treatment options for people with COPD
• Mind-body exercises for COPD

What Does it Mean to Practice Gratitude?

We often think of gratitude as something we show to others, but gratitude is also something you can practice all by—and for—yourself. That's what this guide is all about: how gratitude as a personal practice can help you feel better and cope better with the mental difficulties that often come with COPD.

In the simplest sense, gratitude practice is simply the act recognizing positive things in your life. It's about seeing the good things through the bad and taking time to actively look for—and spend some time thinking about—things in your life that you can be thankful for.

Personal gratitude practice is not about expressing thanks to others; it's about using gratitude as a personal tool to improve your mental well-being.

More specifically, however, “gratitude practice” can mean doing structured gratitude exercises that help you “practice” gratitude in a more deliberate, goal-oriented way. These gratitude exercises (also known as “gratitude interventions”) are designed to help you harness the benefits of gratitude to improve your psychological health.

Gratitude exercises come in many shapes and forms, including written activities (such as gratitude journaling) and more abstract thought-based techniques (such as gratitude meditation) We'll show you how to practice these and other effective gratitude exercises a bit later in this guide.

Of course, it's possible to practice gratitude on your own without a strategy; however, studies suggest that you're likely to get more from your gratitude practice if you do it in a structured way. Gratitude exercises provide a framework to help you practice gratitude consistently and put the practice to work in your life.

As the authors of one study put it (PDF link), “relatively simple intentional changes in one’s thoughts and behaviors can precipitate meaningful increases in happiness.” That's what gratitude practice is all about: improving your mental well-being by taking deliberate actions to recognize and reflect on the things you have to feel thankful for.

How to Find Gratitude Under the Shadow of Chronic Disease

So far we've discussed the meaning of personal gratitude and what gratitude exercises are, but we haven't yet discussed what it really means to feel grateful, or what kinds of things you should feel thankful for when yo have COPD. These are personal questions that form the core of gratitude practice, and the answers depend on your depend on your experiences, your circumstances, and what you value in life.

Unfortunately, many people with COPD and other chronic diseases have faced so much misfortune that that they lose touch with what it's like to grateful. When your life is full of health problems and hardship, it can even feel impossible to find anything that you could feel thankful for.

However, times like these are often when you need the gratitude the most. Even if it seems like you don't have much to appreciate, doing gratitude exercises can help you fine-tune your gratitude senses and teach yourself how to recognize the good things, both big and small.

You'll likely be surprised at all the positive things you can find when you're actively looking for them instead of focusing on the problems and hardships in your life. With practice, you can learn to find joy and contentment in even the most mundane and unexpected places, like the pleasure of taking your first sip of morning coffee or the satisfaction of practicing self-care.

This is especially important for people with COPD, many of whom live with constant reminders of their disease and what their body can't do. Gratitude practice can teach you to love and appreciate your body more by helping you acknowledge all of the amazing, helpful things that your body can do.

That's what gratitude practice is all about—getting in the habit of looking out for the good things no matter how grim and hopeless your circumstances might seem. Sometimes it just takes some time to build up your gratitude muscle before you can break outside the box of negative thinking and explore the full positive potential in your life.

Just know that there is no right or wrong way to feel personal gratitude, and there's no right or wrong thing to feel grateful for. What matters most is what you think is worthy of gratitude, and how you can put those feelings of gratitude to work in your life.

The Benefits of Gratitude for People with COPD

The psychological sciences have long recognized the potential of gratitude to improve mental well-being, and it's been the topic of a great deal of studies over the years. In fact, there's a wide body of academic research on gratitude that spans the fields of positive psychology, mental health treatment, and quality-of-life improvements for people with chronic diseases.

Before we go on, however, it's important to clarify that there's an important distinction between looking at the benefits of gratitude (as an existing feeling or trait) versus the benefits of gratitude interventions (exercises that focus on gratitude and appreciation). Both are important for understanding how gratitude effects well-being, but they tell very different stories about what the benefits of gratitude mean.

Studies on the benefits of gratitude itself essentially describe the differences between people with different gratitude tendencies; they compare the well-being of people who have more gratitude to the well-being of people who have less. However, studies on the benefits of gratitude interventions actually measure how people's well-being changes in response to gratitude exercises, and how gratitude can be used to increase people's well-being.

In other words, the benefits of gratitude alone may only apply to those who are already grateful people; they don't tell us much—if anything—about what gratitude exercises can do. The benefits of gratitude exercises, however, can apply to anyone who completes a gratitude intervention, regardless of natural gratitude tendencies or baseline gratitude levels.

It's also important to note that, in general, the size of gratitude benefits tends to be modest; however, that doesn't mean that gratitude can't still have a significant positive effect on people's lives. Gratitude isn't exactly a game-changer, but it is an effective tool for building healthier mental habits and introducing more positive feelings and perspectives into your life.

Improved Emotional and General Well-being

Two things that research consistently finds about gratitude is that it tends to foster positive emotions and that people who feel more gratitude tend to have better mental health. Research also shows that gratitude exercises are associated with a variety of other benefits related to personal well-being.

Numerous studies, for example, have found that people who participate in simple, structured gratitude exercises—such as writing down what they're thankful for every day—tend to experience more positive emotions and fewer negative emotions than people who don't. Studies also show that gratitude interventions can increase people's general happiness and satisfaction with their lives.

One large meta-review that analyzed 38 high-quality gratitude studies offers a great summary of the effects of gratitude interventions, including how well they work and what their benefits are. The study identifies nearly a dozen specific benefits of gratitude practices, including:

• Increased gratitude
• Increased happiness
• More positive feelings
• Fewer negative feelings
• Reduced depression
• Increased well-being
• Increased life satisfaction
• Increased optimism
• Increased relationship quality

The meta-review also confirms that these positive effects aren't just temporary; in fact, they seem to be just as strong when measured at 6 months after the gratitude intervention as when they're measured just two weeks after the exercise is done. One study on older adults, for example, found that a two-week gratitude intervention resulted in improved well-being that persisted for at least 30 days.

This emotional boost is is something that many people with COPD could benefit from, particularly those who tend to feel hopeless or pessimistic about their condition. By helping you learn how to think and feel more positively, gratitude practice can help you break free from the cycle of negativity and despair that so often plagues people living with chronic diseases.

Increased Resilience

Research shows that gratitude is an effective tool for coping with hardship, including the hardship of living with chronic illness. One study, for example, found that feelings of gratitude are associated with a reduced risk of depression in people with chronic disease.

This is likely due to the the fact that gratitude fosters positive feelings, and positive feelings make it easier to cope when things get tough. This is part of the “broaden and build” model in psychology, which suggests that experiencing positive emotions creates a kind of “reserve” of positive feelings that you can use to help yourself feel better in times of need (PDF link).

In other words, doing activities (like gratitude exercises) that generate positive emotions now can make you more resilient to hardships in the future. This is particularly helpful for people with COPD and other chronic diseases whose lives are often filled with struggles big and small, both in the context of daily living (e.g. chronic discomfort and gradual physical decline) and in the context of managing their disease (e.g. hospitalizations and unpleasant treatments like oxygen therapy).

Gratitude exercises can help you build up the mental fortitude you need to cope with these struggles and get the most out of life. The stronger your mental health and skills in positive thinking, the better you'll be able to deal with whatever troubles that life (and COPD) throws your way.

Improved Relationships

Another benefit of gratitude that's worth mentioning is improved relationships. Several studies have shown that gratitude interventions can improve relationship quality and satisfaction, in part helping you appreciate your bonds with other people more.

This is an important benefit for people with COPD, who often feel isolated at a time when they need other people the most. Who knows? Practicing gratitude could help bring you closer to your loved ones or help you discover new sources of love and support that you didn't even know you had before.

Improved Sleep

A number of studies have investigated the impact of gratitude on physical health measures like blood pressure or sleep quality, but results so far are inconclusive at best. Unfortunately, there is very little research in this area, since most studies (understandably) focus on the mental health benefits of gratitude rather than physical health.

However, several studies suggest that gratitude interventions can improve sleep quality. This makes sense, since we know that gratitude can have a variety of psychological benefits, and research shows that sleep quality is closely connected to psychological health.

Other studies suggest that gratitude interventions might be able to improve other physical factors such as blood pressure, asthma control, or eating behaviors. However, based on the evidence found so far, many researchers doubt that these benefits are substantial, if they exist at all.

Improved Quality of Life for People with COPD

Unfortunately, very few studies have looked at the implications of gratitude and gratitude interventions for COPD patients specifically. Those that have, however, have come up with similar results to those found in other gratitude studies.

One study, for example, found that people with COPD who are predisposed to feel gratitude tend to have a better quality of life than those who don't share that trait. Researchers from one study specifically recommended gratitude exercises as a means for COPD patients to "work toward more flexible, positive thinking through the use of concrete tools."

This suggests that gratitude is not only beneficial for people with chronic diseases, but that gratitude exercises can be an effective tool for coping with COPD specifically. This is echoed in the personal testimonies of COPD patients (on sites like copd.net) who have found and hope and healing through gratitude.

To sum it all up, gratitude helps you appreciate what you have and feel more satisfied with your life and relationships, even when things are difficult because of your COPD. Doing activities that foster gratitude and other positive emotions can also also make you more resilient to adversity, making it easier to cope with health-related misfortunes such as hospitalization or COPD-related physical decline.

Potential Drawbacks of Gratitude Practice

While gratitude can be a helpful tool for good, it can sometimes backfire if used in the wrong way. For example, focusing on too much on gratitude—or letting it become a rigid way of thinking—can undermine other valid thoughts and emotions you have.

You might start to think “I shouldn't think these negative thoughts, I should feel grateful!” which can just make you feel guilty for feeling bad. That's why gratitude isn't supposed to be used to replace negative feelings, but rather to add more positive feelings and thoughts into your life.

You shouldn't ever feel pressured to feel grateful; it's okay to feel how you feel, even if you feel bad, and even if you have lots of things to be grateful for. In fact, it's important to let yourself experience unpleasant emotions without judgment or shame, and to make peace with your negative feelings rather than wishing them away.

According to the psychotherapist Katie Willard Virant, "to be thankful for what one possesses does not mean that one cannot simultaneously feel grief for what one has lost.” She explains how her experiences have taught her that gratitude does not necessarily put a stop to mourning, but rather “[places] it into a context that [makes] it more bearable.”

Another thing you should avoid during gratitude practice is comparing yourself to other people, which often leads to unnecessary judgment and guilt. For example, you might end up thinking, “Some people have illnesses that are worse than mine, so I shouldn't feel so depressed about having COPD!”

It's important to remember that your feelings—whatever they are—are valid, no matter whether or not other people have it better or worse than you. In fact, there's no need to pass any judgment at all about what you “should” or “shouldn't” feel grateful for. Whatever you can find to appreciate within yourself and your own circumstances is worthwhile, no matter what other people's circumstances might be.

As you practice gratitude, it's important to check in every once in awhile to make sure it's helping and working for you. Gratitude practice isn't for everyone, and it's only worth doing if it actually helps you feel better, not worse.

How to Practice Gratitude

Now that we've discussed the merits and reasoning behind using gratitude as a coping method for COPD, let's take a closer look at some different techniques for practicing gratitude. In the following sections, we'll introduce you to several simple gratitude exercises along with some helpful tips for how to get started on your own.

Like most types of mental health and coping techniques, everyone's experience is different, and different methods tend to work for different people. So, if you're new to gratitude practice (and even if you're not), you might need to try out more than one method before it sticks.

Gratitude works best when you practice it frequently; ideally, you should try to do a gratitude exercise every day or at least a few times per week. You might find it easier to make it a habit if you integrate the exercises into an existing daily routine, such as your usual self-care regimen or bedtime preparations.

Also keep in mind that none of these practices are set in stone; feel free to tweak, adjust, and combine these exercises—and any others you come up with—however you see fit. What's important is to find a technique that feels meaningful and resonates with you.

Daily Gratitude Reflections

Doing daily gratitude reflections is probably the easiest way to practice gratitude: all you have to do is spend a few minutes at the end of every day to think back on good experiences and the things you have to appreciate. It's a great place to start if you're new to gratitude practice since it's quick, simple, and doesn't take any special skills or supplies.

The goal of these reflections is to put yourself in a mindset of positivity and gratitude long enough to come up with at least a few specific things that you feel thankful for. Those things can be just about anything: something good that happened to you, something that's made you happy recently, or just about anything positive you've might have noticed or experienced throughout the day.

You might find these gratitude reflections more difficult some days than others, such as when you feel sick or things just aren't going your way. However, it gets easier to access feelings of gratitude—even on the bad days—over time as you practice putting yourself in the mindset of actively seeking out the good things in your life.

Gratitude Journaling

Gratitude journaling is one of the most common and well-studied methods for practicing gratitude. It's basically just like gratitude reflection but with one extra step: you have to write down the things you are thankful for, or at least write down your thoughts about good things you've noticed or experienced throughout the day.

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The need for a healthy diet is something that every person shares, young and old, sick and healthy, and everything in between. However, the importance of good nutrition grows as we get older, and it becomes critical for many people living with chronic diseases like COPD.

People with COPD need to be particularly careful to get enough calories and nutrients to support their lungs and other body processes that are affected by the disease. COPD also makes you prone to a variety of diet-related problems, including under-nutrition, weight gain, and weight loss.

However, health and nutrition can get complicated, and sticking to a healthy diet isn't an easy thing to do. If you're like many people, the idea of putting together a healthy, well-balanced meal might feel intimidating, or you might not even quite know where to begin.

That's why we've put together this guide to help people with COPD plan healthy meals and get all the nutrition they need. In this post, we explain not only what a healthy COPD diet looks like, but we also show you how to put together healthy meals on the fly at home.

We also present a variety of practical meal ideas and examples of healthy and versatile dishes you can prepare on your own and modify as you please. These, along with the additional guides and helpful resources linked throughout this guide, should give you everything you need to get started eating a healthier diet that improves—rather than exacerbates—your COPD.

The Cornerstones of Good Nutrition for COPD

Before we start looking at some specific COPD-healthy dishes and meal plans, it's important to have a general grasp of what a healthy diet for someone with COPD looks like. That doesn't mean you have to be a diet guru, but you should know some general principles of nutrition and how to put together a balanced meal.

You should also be aware of the different ways that your diet and eating habits can affect your COPD and worsen symptoms like shortness of breath. We'll address these and a variety of other important dietary considerations in the sections below before we dive into our list of healthy meal examples and some practical diet recommendations for people with COPD.

Balance Your Food Groups (Protein, Fat, & Carbs)

If you look up nutritional guidelines—which you can find online from a variety of government and health organizations—they contain a list of all the vital components that make up a healthy diet. They tell you everything from what categories of food to eat, down to the exact amount of vitamins and minerals you should take in on a daily basis.

Because this information is readily available from lots of great sources, we're not going to go into them in great detail here. However, we do want to highlight some of the most important principles you need to know in order to learn how to create balanced, nutritious meals.

Macronutrient Proportions

First, you should strive for a healthy balance of the three major macronutrients in your diet: proteins, fats, and carbohydrates (also known as carbs). Health experts recommend spreading out your daily calories between these nutrient groups, aiming for the following (approximate) percentages:

• About 20% of your diet should come from protein; high-protein foods include meats, seafood, eggs, beans, peas, nuts, and soy.
• About 30% of your diet should come from fat; this includes fats found naturally in foods like dairy, meat, eggs, and nuts, and also added fats like butter and vegetable oils.
• About 50% of your diet should come from carbs, which are found in a variety of foods including fruits, vegetables, dairy, and grains—however, people with COPD may benefit from a diet with fewer carbs (we discuss this in more detail the next section just below)

Healthy Sources of Nutrients

Second, you should be familiar with which foods from each of these nutrients groups are more or less healthy to eat. Here are a few examples of some healthy vs unhealthy sources of protein, fat, and carbs:

• Whole grain carbohydrates (e.g. whole grain breads and pastas) are healthier than simple, refined grains (e.g. white pastas and breads).
• Lean proteins (e.g. chicken and fish) and unprocessed meats are generally healthier than fatty proteins (e.g. beef and lamb) and processed meats (e.g. sausage, deli meat, and other cured meats).
• Unsaturated fats (e.g. oils and other fats that are liquid at room temperature) are generally healthier for you and your heart than saturated fats (e.g. butter, lard, and other fats that are solid at room temperature).

Major Food Groups and Serving Sizes

Third, you should know what the basic, top-level food groups are and how many portions of each you should eat each day. Keep in mind that what counts as a single portion varies among different types of food within the group.

You can learn more about correct serving sizes on choosemyplate.gov and in the table just below.

Here's an overview of what US guidelines for daily servings say:

As you plan your meals and snacks, make it your goal to choose foods that help you fulfill the daily requirements for each food group. You don't have to be perfect, either; approximating your portions and and getting as close as possible to these targets is a perfectly healthy goal.

Foods and Ingredients to Avoid

Finally, you should know what kinds of foods are unhealthy, or unhealthy in large amounts, and do your best to limit them in your diet. These include things like excess sodium, too many simple carbs, added oils, added sugar, and trans-fats.

Foods and Ingredients to Avoid:

• Fried foods
• Heavily processed foods
• Sugary drinks
• Foods high in salt
• Foods high in sugar and simple carbohydrates
• Foods high in saturated fats
• All sources of trans fats
• Foods with added oils and fats
• Too much caffeine
• Too much alcohol

Limit Carbohydrates for Better Breathing

Most people with COPD don't need to follow a special diet, and should be perfectly healthy following the general nutritional guidelines set by the USDA. However, there is one notable exception: some people with COPD may benefit from a diet with fewer carbohydrates.

Because of the nature of how the body processes carbohydrates, eating carbs causes your body to produce more carbon dioxide than when you eat proteins or fats. Because carbon dioxide is a waste product that has to be processed by the lungs, high-carb foods put extra strain on your respiratory system, forcing your lungs to work harder and use up more energy.

If you have COPD, this translates to increased shortness breath, since your damaged lungs are already struggling to process oxygen and carbon dioxide fast enough to meet your body's needs. In fact, studies show that relatively small changes in carbohydrate consumption can have significant effects on COPD symptoms, with more carbs causing notable increases in breathlessness and reduced exercise tolerance.

Because of this, a low-carbohydrate diet can be beneficial for people with COPD, improving their lungs' efficiency and reducing shortness of breath. That means reducing your intake of high-carbohydrate foods (such as grains, beans, and carb-heavy fruits and veggies), and replacing them with low-carb alternatives and more healthy proteins and fats.

You'll find more tips for reducing carbs later on in this guide, both in our sample meal ideas and in our section on practical diet & cooking tips.

Aim for Variety

Although daily diet recommendations can get very specific, that doesn't mean you need to go overboard tracking every little thing, nor do you need to stress about meeting the exact targets every single day. Unless you have specific instructions from a doctor or dietitian, getting the right balance of nutrients on average is perfectly acceptable, and will prevent the vast majority of nutrient deficiencies.

In fact, most people are able to get a sufficient amount (PDF link) of vitamins and nutrients without tracking their diet too closely. That's because, in general, most people eat a wide enough variety of foods to supply their bodies with everything they need.

Of course, this laissez-faire approach won't work if your diet is too unbalanced. If you're not careful, a diet that's too heavy in one thing or too light in another can lead to nutrient deficiencies, which can be particularly dangerous for people with COPD.

An easy way to prevent this, however, is to always strive for variety in your diet. That means not only eating plenty of nutritious foods, but also eating a lot of different kinds of healthy foods with different types of micronutrients, which include vitamins, minerals, and metals like iron and zinc.

It helps to familiarize yourself with the various food sub-categories, which are simply smaller groups within a food group that have similar nutrient profiles. For example, the USDA divides vegetables into 5 separate categories and recommends that you eat a certain amount from each group every week.

Here is a summary of the weekly vegetable sub-group guidelines for adults:

• Dark green vegetables: 1.5 to 2 cups per week
• Red & orange vegetables: 4 to 6 cups per week
• Starchy vegetables: 5 to 6 cups per week
• Beans and Peas: 1 to 2 cups per week
• Other vegetables: 3.5 to 5 cups per week

Knowing these different subgroups makes it easier to ensure that you pick out foods that come from a variety of different groups, instead of just one or two. Maintaining this kind of diversity in your diet will help you ensure that your body gets all the micronutrients it needs to fuel your lungs and keep your body strong.

Here are a couple links to more information about food groups and subgroups:

• A list of all the major food groups and sub-groups with examples of several foods for each category
• A list of common vegetables that belong to each of the 5 major vegetable subgroups

Choose Whole Foods When Possible

When you peruse all the boxed foods, frozen dinners, and other processed foods that make up the large part of grocery store shelves, it's often hard to tell what's good for you and what isn't. Even bold claims like “all natural” or “reduced fat” don't tell you much about a product's actual health, or what those claims even mean in the context of a well-balanced diet.

That's why it's best to cook your own meals at home using whole ingredients whenever possible. That means starting with basic ingredients that are as close as possible to their raw, natural state, such as whole fruits and vegetables, plain beans, and whole grains.

Your ingredients don't need to be “fresh” as long as they're are minimally processed and don't contain added ingredients like salt, oil, or sugar. Frozen fruits and veggies, for example, are just as good for you as the fresh (and more expensive) versions you'll find in the produce section.

Beware of Nutrient Deficiencies Associated with COPD

In ideal conditions, you could get all the nutrients you need just by eating a healthy diet. However, life is often far from ideal, and it's not always possible to get enough vitamins and minerals from the food you eat alone.

This is especially true for people with COPD, who often struggle to get enough nutrients due to both the symptoms and the biological effects of the disease. According to COPD nutrition research, up to 40% of COPD patients are underweight and undernourished.

Certain types of deficiencies are more common in people with COPD than others, including vitamin D, vitamin B12, and iron deficiency. People with disease are also especially prone to osteoporosis, which can be caused by deficiencies in both calcium and vitamin C.

Some of these nutrient deficiencies are directly related to COPD and the medications (such as steroids) used to treat it. Many of them are also associated with certain characteristics that COPD patients tend to have in common, such as age, tobacco smoking history, and other factors related to lifestyle and health.

Research also shows that undernourishment can have particularly severe consequences for people with COPD, including an increased risk of death and hospitalization, more frequent exacerbations. Poor nutrition is also associated with a variety of other negative COPD symptoms, such as reduced lung function, reduced muscle strength, increases shortness of breath, and declines in physical endurance.

Because of this, a large percentage of people with COPD need to take vitamin and/or mineral supplements to satisfy their body's nutritional needs. However, you shouldn't start using supplements without your doctor's permission; when you have a serious chronic condition like COPD, you should never take any new medicines or supplements without consulting your doctor first.

Seeing to your doctor also gives you the opportunity to undergo testing so you can know exactly what—if any—extra nutrients your body needs. Then your doctor can prescribe you the specific supplements you need in proper amounts to correct any deficiencies you currently have or that your doctor believes you are at risk for.

Know Your Calorie Requirements

Many people with COPD struggle with weight loss and undernourishment because of uncomfortable COPD symptoms that make it difficult to eat. However, another reason for malnutrition is simply not eating enough to make up for the extra calories burned through breathing, since lungs affected by COPD use up much more energy to breathe.

This extra energy has to come from somewhere, which is why people with COPD often need more calories and nutrients than the average healthy person. Because of this, many patients—especially those with advanced COPD—need to eat a high-calorie diet to satisfy their body's needs.

That's why, if you have COPD, it's important to talk to your doctor about your diet and to figure out how many daily calories you need to eat. If your doctor puts you on a high-calorie diet, make sure to take it seriously and do your best to meet your calorie target every day.

This can be difficult to do, especially if you're one of the many people with COPD who struggle with pain and breathlessness when you eat. However, there are a variety of strategies that can help, such as eating more frequent, smaller meals spaced out throughout the day (you can find more tips for adjusting to a high-calorie diet toward the end of this guide in the section on practical diet and cooking tips).

Make sure to consult your doctor if you're having trouble managing your diet on your own, and consider consulting a registered dietitian for more specialized help. Dietitians are trained to help people with special health and dietary considerations, and they can work with you to find solutions and put together a realistic diet plan that's tailored to your needs.

Limit Salt

According to US dietary guidelines, you shouldn't eat more than 2,300 milligrams (mg) of salt per day. However, because salt is ubiquitous in so many types of food, most people get far too much of it in their diet.

Unfortunately, too much salt is bad for your health in a variety of ways, increasing your risk for hypertension and heart disease. It's even more dangerous for older adults, and particularly people with COPD, who have a higher risk for age-related heart problems.

A high-salt diet can also cause water retention and bloating, which can worsen common COPD symptoms like breathlessness and chest discomfort. It can also make mealtimes more difficult if you have trouble eating enough food or struggle with shortness of breath when you eat.

Unfortunately, salt can be very difficult to avoid; many popular foods contain excessive amounts of sodium, especially processed foods and snacks. There are also many seemly-innocuous foods that have lots of

Daily medications are a primary life-line for people with COPD, and a necessary part of life for people with asthma and other respiratory diseases. In fact, most COPD patients have to follow a strict treatment regimen and take several different medications every day just to keep their symptoms under control.

Of these medications, inhalers are perhaps the most important and are certainly the most frequently prescribed medications for people with asthma and COPD. Unfortunately, an alarmingly high number of patients don't use their inhalers as they should.

A major reason for this is the fact that asthma and COPD medication regimens can be complicated and difficult to keep track of. However, there's a new kind of tool available, known as smart inhaler technology, that is designed specifically to address this problem.

Smart inhalers can help you manage your medication by recording when you use your inhaler and reminding you when it's time to take the next dose. This makes it easier to remember to take your medication on time and helps you keep track of how well you adhere to your treatment schedule.

What is a Smart Inhaler?

A smart inhaler is, essentially, an inhaler that is designed to communicate with a mobile phone application. This application helps you keep track of important information like your medication schedule and when you are supposed to take your next dose.

A sensor on the inhaler communicates with the mobile application via bluetooth so you can track your inhaler use data in the app. The app records the date, time, and sometimes even the location of each dose you take, and then uses this information to schedule your next dose reminder.

Some smart inhalers use a built-in sensor that's integrated into the body of the inhaler itself. Others, like the Propeller sensor, are more versatile external sensors that you can attached to a variety of different inhalers, including ones you already have.

Smart inhaler technology is useful for monitoring how well you adhere to your treatment schedule over time and for identifying ways you can improve. It also serves as a useful tool for reminding yourself when you last took a dose and for easily tracking how frequently you use your rescue inhaler.

You also can instruct your smart inhaler app to alert you via a phone alarm or notification whenever it's time to take another dose. These digital reminders make it much easier to keep up with a consistent treatment schedule and keep your respiratory symptoms under control.

Some smart inhalers include other helpful features, such as high pollen and pollution alerts or the ability to sense if your forget to bring your inhaler with you when you leave home. As the technology continues to develop, the range of helpful tools and features available via smart inhaler technology will also continue to grow.

What Kinds of Smart Inhalers are Available?

The variety of smart inhalers on the market today is somewhat limited. However, the technology seems to be catching on, and there's sure to be a wider variety of smart inhaler sensors and applications available in the coming years.

It's important to note that most smart inhaler sensors are only approved for use with specific types of medications and inhaler types. Before choosing a sensor, you should double check the manufacturer's website and the device specifications to make sure that it will work with the types of inhalers you're prescribed as well as the type of mobile phone you use.

Here are the two most popular smart inhaler technologies that are approved for use in the US:

• Propeller Smart Inhaler: An external sensor that you can attach to a wide variety of inhalers. Currently available for free to most people from the Propeller website.
• Adherium Hailie Smart Inhaler: An external sensor that you can attach to the following inhalers: Ventolin, Symbicort, ProAir, and Flovent. Available from the hailie.com store.

These products are not yet available in the United States or are currently in development:

• FindAir: Currently only available to purchase in Europe, this external sensor works with more than ten different types of metered-dose rescue inhalers. You can purchase this sensor (if you live in one of the approved European countries) and check to see if it works with your inhaler by visiting their website.
• Teva ProAir: In development
• 3M Intelligent Control Inhaler: In development

Why Should People With Asthma and COPD Consider Using a Smart Inhaler?

Despite the importance of the medication, too many people with COPD and other respiratory diseases take their inhalers for granted or struggle to keep up with their daily doses. However, experts believe that smart inhaler technology can make it easier for patients to comply with treatment and keep their symptoms under control.

Your Inhaler is Your Lifeline

First of all, every person with COPD should understand how vital their inhalers are for managing their disease. Inhaled medications are quick-acting, versatile, and effective, in large part because they deliver medication directly to your lungs, and they form the cornerstone of just about every COPD treatment plan.

Most people with asthma and COPD use inhalers for both long-term symptom management and for short-term relief from breathlessness and other respiratory symptoms. When you use your inhaler as your doctor instructs you to, it can allow you to breathe better, live better, and—in the case of people with COPD—even live longer than you could without your medication.

However, better breathing and disease control isn't the only reason that medication is important. Keeping up with your treatment schedule is vital for living a healthy and fulfilling life.

When your symptoms are controlled via medication, it makes all sorts of activities easier. This includes basic tasks that are important for daily living, like cooking, cleaning, and walking to get around.

Using your inhaler as directed can also allow you to exercise better and live a more active life. This makes it easier to live a healthy lifestyle and keep your body strong, which is vital for mainting your mobility and your quality of life when you suffer from COPD.

Because of this, it's extremely important to keep up with your medications and use your inhaler exactly as your doctor instructs you to. However, while this seems simple in practice, many patients fail to use their inhalers correctly by using them improperly, inconsistently, and frequently missing doses.

Most People with COPD Do Not Use Their Inhalers As Directed

Unfortunately, an alarmingly large number of COPD patients don't use their inhaler correctly or as often as they should. This is often the result of ignorance, laziness, poor training, or a simple lack of proper diligence in keeping up with treatment.

In fact, studies show that up to 70 percent of people with COPD use improper inhaler techniques, which can significantly affect how well the medication works. Other studies estimate that only about 50 percent of people who are prescribed inhalers use them as frequently as they should.

This is important, since not using your inhaler as directed can severely affect your ability to manage your disease and your symptoms. For example, if you have COPD and don't follow your treatment plan exactly, you risk having worse symptoms, more exacerbations, and even quicker lung function loss.

Here is a list of some of the potential consequences of not adhering to your medication schedule:

• Increased risk of death
• Increased risk of quicker lung function decline (COPD)
• Increased risk for exacerbations (COPD)
• Increased risk of your medication not working
• May make it more difficult to effectively control your symptoms and manage your disease
• Makes it difficult for your doctor to evaluate your current medications and treatments accurately

Unfortunately, lackluster treatment compliance is commonplace in patients with chronic diseases like COPD who need constant, life-long treatment. It can be difficult and tiresome to adhere to a strict medication regimen for so long, which is why many people with COPD and other respiratory conditions become more careless and apathetic about about their treatment over time.

Studies also suggest that COPD patients are less likely to take their medications when they're feeling better and have fewer symptoms. However, it's not okay to skip a scheduled dose just because you feel like you don't need it; it's just as important to use your inhaler when you're feeling good as when you're feeling bad.

Many people with COPD have to manage several different types of medication at once, which is another reason why so many patients find it difficult to stick to a consistent regimen. It can be particularly difficult to manage multiple medications that vary significantly in type; for example, some COPD patients have to use supplemental oxygen, multiple kinds of inhalers, and pills you take by mouth.

Keeping all of these different medications straight can get confusing, and it can quickly get complicated when you have to remember schedules, correct dosages, and proper technique for half a dozen different types of medicine. It can be especially difficult to cope with when you're dealing with anxiety or life gets so busy that you want to avoid anything that heaps on extra stress.

That's why smart inhaler technology has the potential to be so useful for people with asthma and COPD; it can relieve some of the logistical burden that comes with managing your health. It can keep track of your medication schedule for you and remind you to take each dose so you don't have to shoulder the responsibility alone.

In this way, experts believe that smart inhaler technology can help people with respiratory conditions better adhere to their treatment plan. With the assistance of a smart inhaler app, you're less likely to miss a dose and more likely to comply with the medication schedule that your doctor prescribes.

Taking your medication on time and as instructed is vital for preventing exacerbations, keeping your symptoms stable, and living the best life that you can. Because it can help you comply with your treatment better, using a smart inhaler may even improve how effectively your medication works to manage your disease.

Research Suggests that Smart Inhaler Technology Really Works

Experts have advocated for this kind of medication tracking technology for many years as a way to improve treatment compliance. Although the technology is still new, early research on the effectiveness of smart inhalers have come up with optimistic results.

One study from the Cleveland Clinic found that people with COPD who used the Propeller smart inhaler were significantly less likely to be hospitalized, with a 35% reduction in the number of hospital visits compared to the year before. While this study was small, including only 39 patients, the results are promising and suggest that smart inhaler technology can actually improve patients' health in addition to improving medication adherence.

Additional encouraging research comes from studies of asthma patients, including one study that looked at the Adherium Smartinhaler. This study found that patients who used the smart inhaler technology had a variety of positive health outcomes, including better medication adherence, fewer hospitalizations, and fewer doctor's visits needed.

How Smart Inhalers Can Benefit People with Asthma & COPD

Now that we've explained how smart inhaler technology can help people with asthma and COPD in general, let's take a closer look at what a smart inhaler could do for you. In the next sections, we'll discuss in more detail some of the specific benefits that smart inhaler technology has to offer.

Smart Inhalers Provide Convenient, Effortless Reminders

By working in tandem with your mobile phone, smart inhalers can send alerts to you directly through your phone. That way, you can get convenient reminders you to take your medication no mater where you are.

And because the smart inhaler records your medication schedule and the last time you took a dose, you don't even have to set the reminders yourself. The smart inhaler app can schedule your next dose and set up an automatic alert to let you know when the right time comes.

These reminders follow you wherever you go and make keeping up with your medication schedule as simple and effortless as possible. This is much more convenient, and potentially much more reliable, than keeping track of your schedule on paper or having to set manual reminders on your phone.

Smart Inhalers Can Prevent Missed or Repeated Doses

It can be difficult to remember the last time you used your inhaler when you have to use it multiple times a day. When you do something so often and it becomes part of your daily routine, each instance tends to blur into the next it's hard to tell them apart.

This can make it difficult to remember on your own the exact time you took your last inhaler dose. It can put you in the difficult position of wondering, “Did I use my inhaler already today, or am I remembering the time I used it yesterday?”

It's especially easy to lose track when you have to use more than one inhaler, as many people with asthma and COPD have to do. You might find yourself wondering, “Did I already take my maintenance inhaler? Or was it my quick-relief inhaler that I used earlier this morning?”

Human memory just isn't very reliable, and mis-remembering your last dose could lead you to to take an extra dose on accident, or skip a dose because you falsely believe you've taken it already. This can be dangerous when you rely on your medication to help you breathe and manage your respiratory disease.

Fortunately, smart inhalers eliminate this uncertainty by automatically keeping a record of each and every time you use your inhaler. That way, you can always check the app to see when you took your last dose and remind yourself which inhalers you've already used that day.

This can be particularly useful for people with mild cognitive impairment, a condition that affects your memory and makes it difficult to remember small things like what you did this morning. Mild cognitive impairment is extremely common in people with COPD, and especially patients with severe hypoxemia (low blood oxygen levels).

Smart Inhalers Can Help Reduce Treatment-Related Anxiety

It can be extremely stressful to adhere to a strict medication regimen with multiple medications that you have to take at certain times each day. Having to keep multiple medication schedules in your head and remember things like when you last used a certain inhaler can take up a lot of mental space.

What's more, when you have a chronic disease that requires constant management, forgetting to take your medication can have serious consequences. Because of this, the fear or missing a dose or not being able to keep up with your treatment regimen can turn in to a major source of anxiety.

However, smart inhalers can help relieve some of that worry by doing some of that remembering and scheduling for you. By tracking your doses and reminding you when to use your inhaler, it can take some of that extra weight off your mind.

In this way, using a smart inhaler frees you from the need to arrange manual reminders and constantly keep your inhaler schedule in your head. This can free up mental energy for other important things in life and make your daily treatment regimen less stressful to manage.

Smart Inhalers Can Help Make Your Treatment More Effective

A large number of people who use inhalers find it difficult to take their medication consistently on their own. This leads to missed doses, doubled doses, and otherwise using your inhaler differently than your doctor recommends.

This can significantly reduce the success of your treatment and cause your medication to be less effective than it otherwise would be. Most personalized treatment plans are carefully designed to help you manage your symptoms in the best way possible, but they only work if you actually do what your treatment plan says to do.

Luckily, smart inhaler technology can help you keep track of your medications and how well you're sticking to your treatment plan. By helping you follow your medication schedule that your doctor prescribes more diligently, it can help you manage your symptoms better than before.

You and your doctor can also use to your smart inhaler app to review the full record of every single time you've used your medication, which is much more accurate than using your memory alone. This allows you to look back and see exactly where you've gone wrong and what you can do to better follow your treatment plan.

Smart inhaler technology is also a useful tool for monitoring how you use your as-needed rescue inhaler for short-term symptom relief. An accurate record of how frequently you use your rescue inhaler is valuable data you and your doctor can use to track the severity of your symptoms and watch out for when your symptoms get worse.

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Some smart inhaler apps also record your location when you take a dose, which can be especially valuable for tracking your rescue inhaler use. In some cases, you may even be able to use this information to pinpoint a certain place or situation that triggers your respiratory symptoms.

All of this information can give you valuable insight about your health and your inhaler use habits that you can use to learn how to better control your symptoms. It also allows your doctor to evaluate the effectiveness of your medication more accurately and make tailored adjustments to help you better manage your disease.

Conclusion

If you have asthma or COPD, doing everything you can to adhere to the medication schedule your doctor gives you is essential for your health. That means knowing how to use your inhalers, when to use each inhaler, and what he correct dose for each medication is.

While this can be a lot to manage, it can be easier when you have practical tools like smart inhaler technology to give you a hand. Smart inhalers can save you a lot of time and mental energy managing your medication, freeing you up to enjoy your life without the constant worry of missing a dose.

When you take your medication properly, it can improve your symptoms, your quality of life, and your overall well-being in a number of significant ways. It can not only make it easier to breathe, but it can also help you maintain the energy and oxygen levels you need to live an active and healthy life.

Consider this hypothetical scenario: you have a COPD exacerbation and your shortness of breath suddenly gets much worse than usual. You call your doctor to see what you should do, and she tells you to go to the hospital right away.

If this happened, would you be ready? Would you be able to quickly gather the documents, medical equipment, and other supplies that you need?

If your answer is no, or you're not sure, then you might have a serious need for an emergency action plan. Luckily, it doesn't take much time or effort to prepare for medical emergencies, and doing so could save your life in a critical situation.

To help you get started, we've created this guide explaining how to prepare for COPD medical emergencies and unexpected hospital visits. Throughout this post, we'll go though all the different components of a good emergency action plan and walk you through the steps to make one for yourself.

We'll also explain how to recognize a variety of different COPD-related emergencies and how to know what you should do when your symptoms get worse. Then, we'll teach you how to put together a variety of practical tools that can help you respond more quickly and efficiently during a medical emergency, including:

• An emergency contact and medical info card
• An emergency grab bag with essential documents and items
• A personalized hospital care kit for basic comfort away from home

When you or someone you love has COPD, you never know when a medical emergency will strike. Whether it's because of an illness, exacerbation, or another complication, just about every person with COPD will—at some point or another—need to make a sudden visit to the hospital or emergency room.

That's why it's vital to be ready to spring into action whenever that time may come. Having a plan and a stash of supplies can make all the difference in the middle of a medical crisis, helping you to get to the hospital sooner and ensuring that you have everything you need once you are there.

Recognizing the Signs of an Emergency

The first step to handling a COPD-related medical emergency is recognizing that you have an emergency in the first place. In order to do so, you need to pay attention to your body and know how to identify the signs that you need immediate medical help.

COPD exacerbations are the most common reason for hospitalization and emergency room visits among people with COPD. Of course, not all exacerbations get that bad; some are mild enough to treat at home with medication and guidance from your doctor.

However, it's important to be aware that minor exacerbations can quickly get out of hand and become much more severe. If that happens, you might have to go to the emergency room or check into a hospital for more aggressive in-patient treatment.

That's why it's important to keep close tabs on your COPD symptoms from day to day so you can recognize any changes. If you notice your symptoms flare up and don't improve within a a couple days, that means you might need additional treatment to manage the exacerbation.

Major Signs of a COPD Exacerbation:

• Worse than usual shortness of breath
• Shortness of breath at rest
• Coughing more than usual
• Increase in sputum (mucus you cough up)
• Change in the color of your mucus or sputum
• Increased fatigue
• Fever, shaking, or chills
• Needing to use your rescue inhaler more often than usual

You should also have a COPD action plan that tells you exactly what to do whenever your symptoms get worse. It should tell you which medications to take, when you should call your doctor, and when you should call an ambulance or go to the emergency room.

If you cannot get over an exacerbation on your own, spending some time in the hospital is sometimes the only way to recover. If your symptoms get very severe or you experience breathlessness that won't go away, don't wait and seek medical care immediately.

Severe COPD Symptoms that Could Require Emergency Treatment:

• Shortness of breath that is sudden or more severe than usual
• Coughing up blood
• New chest pain
• Difficulty waking up
• Severe restlessness or anxiety
• Confusion
• Extreme weakness or fatigue
• Flu symptoms, including body ache, fever, and sore throat
• Swelling in the legs

Hypoxia is another common COPD complication that should be treated as a medical emergency. It happens when your blood oxygen saturation falls to dangerously low levels, starving your body of oxygen and potentially causing life-threatening complications.

Severe hypoxia can be fatal if you don't get immediate treatment to increase the amount of oxygen in your blood. However, even mild hypoxia can lead to serious problems like high blood pressure and cognitive decline.

Your risk for hypoxia is higher if you if you already suffer from chronic hypoxemia (blood oxygen levels that are lower than what is considered healthy). It can also cause acute respiratory failure, a life-threatening condition that can occur very suddenly, especially during severe COPD exacerbations.

There are two main types of respiratory failure that occur in people with COPD: one is the result of low blood oxygen levels (hypoxemic respiratory failure), while one is the result of too much carbon dioxide building up in your blood (hypercapnic respiratory failure). If not treated quickly, both severe hypoxia and acute respiratory failure can quickly result in severe organ damage and death.

Signs of Severe Hypoxia or Respiratory Failure

• Rapid breathing
• Racing heartbeat
• Shortness of breath at rest
• Slow heartbeat
• Irregular heartbeat
• Inability to breathe or catch your breath
• Dizziness or lightheadedness
• Inability to communicate
• Profuse sweating
• Extreme sleepiness and fatigue
• Confusion
• Blue or gray tinted skin, especially on fingertips, toes, or lips

Despite advances in COPD treatment and hospital care, people still die from treatable causes just because they don't make it to the hospital quickly enough. So if something feels wrong, don't be afraid to seek help, and never ignore the warning signs of a potential medical emergency.

How to Prepare for an Emergency

Planning ahead for a medical emergency is all about making it as simple as possible for you or someone else to respond to and get help fast. That means being able to identify the emergency immediately, promptly call for help, and quickly gather all the essential supplies and documents you need.

In the following sections, we'll show you some practical tools and strategies doing each of these things, and how to put them all together into an effective emergency action plan. That way, when emergency strikes, you will have everything you need to handle it confidently, efficiently, and with the least amount of stress.

Have a COPD Action Plan

A COPD action plan is essentially the instructions for your COPD treatment written down in a way that is easy to follow and simple to understand. If you don't have a written COPD action plan yet, ask your doctor to make one for you; you can even use a handy pre-made template like this one from the American Lung Association (PDF link).

Having a COPD action plan is important because it tells you you exactly how to treat your COPD symptoms and flare-ups in the most effective way. It also tells you how to recognize the signs that you need to seek additional medical help, either by calling your doctor or going to the emergency room.

The instructions and descriptions a COPD action plan serve as a guide to monitoring your symptoms, managing them better, and recognizing when they've gotten out of your control. In this way, a good COPD action plan can both help prevent medical emergencies and help you respond to them appropriately when they occur.

For more information, check out or guide explaining COPD action plans and how to use them from our Respiratory Resource Center.

Have a Trustworthy Mode of Communication

When you're in an emergency, a phone might be your only way to connect to the outside world. In moments like those, it's absolutely vital to have a reliable mobile phone you can use to call for help.

If you have COPD and don't have a mode of communication you can count on, it's time to get one fast. You should also make sure that you know how to use your phone and and that you feel comfortable making calls.

In case you can't use your usual phone for some reason, you should also keep something like a spare, charged cell phone battery or a separate emergency phone on hand. You can also use your car to charge up your phone battery in a pinch as long as you have the right kind of adapter for your car.

Be Prepared for Environmental Disasters

If you live in a disaster-prone area (or even if you don't), it's a good idea to plan ahead for environmental emergencies like extreme weather and natural disasters. These kinds of events, which can leave you stranded without power or a means to get supplies, are particularly dangerous for people with chronic diseases like COPD.

One of the most important things to do is make sure that you have a way to call for help if the power ever goes out. Even just an old phone with a fully charged battery can be a lifesaver in an emergency.

If you rely on an oxygen concentrator for supplemental oxygen therapy, then you should also have a backup oxygen supply that doesn't rely on electricity to work. However, you should inspect any oxygen tanks you keep in storage regularly, since some (especially liquid oxygen cylinders) can lose oxygen over time.

The American Red Cross also suggests keeping a home emergency survival kit, which includes:

• A first aid kit
• A flashlight & extra batteries
• A battery-powered radio & extra batteries
• A multipurpose tool
• An emergency document folder (we'll show you how to make your own in a section just below)
• Sanitation and hygiene products
• A 7-day supply of medication and medical equipment
• A cell phone and charger
• An emergency blanket
• Extra cash
• Maps of your local area
• In the case of a very serious disaster, a 2-week supply of water and non-perishable food.

Here are some more tips for preparing for power outages and other environmental emergencies that could affect your ability to get medical care:

• Keep a backup source of electricity, such as a gas-powered generator or a backup home battery bank.
• Ask your doctor if he can give you an extra supply of medicine to keep in case there is an emergency that leaves you unable to access or refill your prescriptions.
• Work out a plan with neighbors, family,or friends to ensure that someone can check up on you during a power outage or weather emergency. Let them know if there are any specific supplies or help you will need (e.g. assistance setting up your generator safely).
• If you use an oxygen concentrator or any other electricity-powered medical device, let your local power company know. Then, if there is a power outage, they might be able to prioritize your area as they work to get the power back on.
• Make sure your cell phone (and your emergency backup phone) is able to receive Wireless Emergency Alerts from the Federal Emergency Management Agency.
• Don't wait until the last minute if you are told you need to evacuate your home; leave and get to a safe place as early as you can.
• Anxiety and panic can make your breathlessness worse, but having a plan and supply kit ready can do wonders for helping you stay calm and collected during an environmental emergency.

Make an Emergency Contact List

The very first thing that you have to have to respond to a medical emergency is basic information about how to get the medical help you need. You should always call 911 for an immediate, life-threatening emergency, but it's also important to have an emergency contact list on hand.

Your emergency contact list should include:

• The contact information for your local hospital plus directions for how to get there
• The contact information for your primary care doctor and any other medical specialists that treat you (e.g. your pulmonologist or respiratoy therapist)
• The contact information for the person (or people) close to you who should be notified in the case of an emergency
• The contact information for each person or place should include:
• Full name of the person or place (For doctors, include the name of the medical facility they work in.)
• Full address
• Phone number{s) including area code

Having this list on hand will ensure that you can contact the hospital and get there quickly in an urgent situation. It also makes it easier for anyone who helps you in an emergency to take action and transport you to the best place for treatment.

Your emergency contact list can also help emergency and hospital personnel contact anyone they need to—such as your family or your doctor—about your condition and care. It could even help you get better treatment by allowing medical personnel to get medical records and other vital information more quickly.

Prepare an Emergency Info Folder

The purpose of an emergency info folder is to keep important documents like medical records, insurance information, and more together in an easy-to-grab package. That way, when a medical emergency strikes, you'll have everything that you and the hospital staff might need to give you the best possible care.

Essentially, your emergency grab bag should contain everything a doctor would need to get up-to-date on your health condition and treatment. It should also include any documents the hospital needs for insurance, financial, or administrative reasons, including personal ID, health insurance information, and some means of financing or payment.

Here is a list of important records you should keep in your emergency info folder:

• A copy of your emergency contact card
• A copy of your health insurance card (and any other important policy information)
• Personal identification (e.g. driver's license or passport)
• A list of all medications and supplements you take, including:
• The name of each medication and supplement
• Your regular dosage for each medication
• How frequently you take each medication
• The name and contact info for the doctor who prescribed these medications
• Important medical info and documents, including:
• A brief description of all health conditions you have
• A list of any food or medicine allergies you have
• Documentation of major treatments, operations, and noteworthy test results (e.g. x-rays, lab results, surgery reports, etc.)
• If applicable, also include any relevant documentation regarding your legal guardianship, power of attorney, or legal caretaker(s)
• A form of payment, such as: a credit card, check book, HSA card or FSA card

Make a Personalized Emergency Hospital Care Kit

Having to stay in a hospital is stressful and uncomfortable, and it can be even worse when you end up there unexpectedly. In order to keep yourself comfortable and sane, it's important to make sure you have some personal comforts to get you by.

The purpose of a hospital care kit is to act as a “go-bag” containing your emergency info folder plus anything else you might need to get by once you're in your hospital room. It's a quick way for you or a loved to grab all the basic supplies and entertainment you might need without any searching or delay.

Think of your hospital care kit like a mini travel bag that you can fill with the same types of things you might pack for a weekend away from home. In particular, consider items from the following major categories: toiletries & hygiene, clothes, medical equipment, and entertainment, and personal items that bring you comfort.

Start by choosing a bag that's small enough to grab and store easily, but big enough to hold a couple days worth of supplies (a duffel bag or gym bag will do). In order to conserve space, try to pack small, compact items; you could buy travel-sized toiletries, for example, or parse full-sized products into small baggies and containers.

Don't worry about packing for a long hospital stay; after all, you never really know how long it will be before you go home. It's better to keep your bag compact and pack just enough supplies to last until you can send someone out to fetch more.

To help you decide what to prioritize, take a moment to think about what it's like to be stuck in a hospital room, and then try to think of what little things might make it a little bit comfortable and easier to bear. The ideas that come to mind can help you narrow down your options and figure out what's most important to you.

Here are some general items you might consider including in your emergency hospital care kit:

Your emergency info folder:

• Put your emergency info folder in the same bag as your hospital care kit so everything you need for a hospital visit will all be in one place
• Make sure to keep the info up to date with any changes in your health, including changes in medication, dosage, or other treatments you use

A set of basic toiletries and personal hygiene necessities, including:

• Small bottles of shampoo, conditioner, & body wash
• A toothbrush, toothpaste, & mouthwash
• Deodorant
• A couple packages of travel tissues
• A small bottle of lotion
• Face cleansing wipes
• Chapstick
• Hand sanitizer

Comfortable, compact clothing, including:

• A couple of comfortable t-shirts
• A couple of comfortable pajama bottoms
• A few pairs of socks (ideally with non-slip bottoms)
• A few pairs of underwear
• A couple of comfortable bras (if applicable)
• A pair of slip-resistant flip flops
• Slippers

Entertainment and things to keep you busy, including:

• Books & magazines
• A compact game or set of cards
• Music & headphones
• Coloring books
• Paper and something to write or draw with
• Simple hobby supplies (e.g. for knitting, drawing, writing, etc.)
• Some spending cash (for vending machines, newpapers, etc.)
• A prepaid phone card (some hospitals do not allow cell phones)

Supplemental oxygen supplies (if you use oxygen), including:

• Oxygen mask or nasal cannula
• Humidifier bottle
• Any lubricants or lotions you normally use for comfort

Other personal items you might want to include:

• A notebook and pen for jotting down questions and notes
• An eye mask & earplugs for sleeping
• An extra phone charger & wall plug
• A soft blanket or bathrobe
• A refillable water bottle
• Photos, keepsakes, or other comfort items
• Sanitizing wipes
• Dry shampoo (for when bathing is difficult)
• Hair ties
• Tweezers
• A shaving razor
• Nail clippers
• Hair styling products and cosmetics

You should also keep in mind that, even

Being a COPD caregiver is no simple or straightforward task; it requires empathy, endurance, compassion, and creativity to fulfill the many different roles and responsibilities that the job requires. It often demands a great deal of time and self-sacrifice, while also requiring a seemly endless well of energy and patience.

This can be a heavy burden for caregivers to bear day after day, causing frustration, exhaustion, and emotional strain. As a result, many caregivers find themselves in disarray, feeling so drained and overwhelmed that they neglect their own personal needs.

This kind of burnout is detrimental to your health and well-being, and adds unnecessary suffering to an already difficult task. It can also lead to negative psychological changes—like reduced patience and poor concentration—that could affect your caregiving abilities, too.

Because of this, part of being a COPD caregiver is learning how to cope with the physical and emotional burdens of the job without draining yourself in the process. However, that's easier said than done, especially if you have a very dependent loved one or patient who needs full-time care.

It's easy to get so bogged down by worry, stress, or the weight of caregiver responsibilities that your own needs fall by the wayside. But when you put so much of your time and energy into caring for someone else, it's important to remember to care for yourself, too.

That's why we created this guide specifically to help caregivers of people with COPD find better ways to cope, stay healthy, and practice effective self-care. Inside, you'll find a variety of useful strategies for improving your own well-being, including tips for reducing stress, finding sources of support, and finding time for yourself in-between demanding caregiving tasks.

Utilizing these and the other techniques in this guide can help you stay you afloat when you feel overwhelmed and help you keep up the strength to face whatever challenges come your way. When you have the means to keep your head above water, you'll find that the hardships of being a COPD caregiver are much easier to bear.

The Sacrifice that Comes With Giving Care

Some COPD caregivers are professionals who are hired either full-time or part-time to provide care to a COPD patient (usually) in their home; these are known as “formal” caregivers. In most cases, however, people with COPD are taken care of at home by their loved ones, which are known as “informal” caregivers.

In fact, most caregivers are close family members and spouses who make huge sacrifices to be a caregiver out of necessity, compassion, or love. Some caregivers even have to leave their families, jobs, and normal lives behind in order to to be able to move in with their sick loved one and take care of them full time.

That's because taking care of someone with COPD can be a very demanding job, requiring long hours and a great deal of flexibility. A COPD caregiver never knows when they'll need to rush their patient to the hospital or provide extra care during a symptom flare-up.

In many cases, being a caregiver requires you to take on a wide variety of responsibilities that go far beyond basic care. People with advanced COPD, in particular, sometimes need intensive, full-time assistance with all the major aspects of daily life.

Here are some of the common responsibilities that come along with being a COPD caregiver:

• Providing Basic Medical Care:
• Administering COPD medications
• Sanitizing and preparing medical equipment (e.g. oxygen delivery equipment)
• Assisting with COPD treatments like breathing exercises, chest percussion, etc.
• Assisting with exercise, walking, and other physical activities
• Responding to emergencies
• Coordinating and keeping track of all aspects of COPD treatment
• Providing overnight care
• Facilitating Professional Medical Care
• Transportation to and from appointments
• Attending doctor's visits
• Advocating for their patient
• Managing medical bills and hospital visits
• Working on health insurance claims and negotiating with agents
• General Home Care
• Shopping
• Preparing meals
• Bathing and dressing
• General housekeeping responsibilities
• Providing emotional support

To learn more about what it takes to be a caretaker for someone with COPD, you can find more tips and information in this guide: How to be a Helpful Caregiver for Someone with COPD.

Being a Caregiver Can Take a Huge Toll

Being a full-time caregiver, in particular, comes with an unimaginably large weight of responsibility that can be difficult to bear. It requires a great deal of self-sacrifice and the willingness to spend day after day putting the needs of someone else first.

The physical toll of being a COPD caregiver can be huge; the responsibilities are time-consuming, ever-persistent, and sometimes physically demanding. Because of this, many caregivers fall behind on important health-related activities and suffer from poor sleep, poor diet, and lack of exercise.

Being a caregiver for a loved one with COPD can also be a very heavy mental and emotional burden. It often requires you to give empathy and compassion while putting your own worries and feelings aside, which takes a substantial amount of mental effort to keep up over time.

What's more, it can be heartbreaking to see someone you love fighting a chronic disease that causes so much suffering, physical limitation, and pain. It can be almost unbearable to watch a loved one's physical decline from a distance, but it's even harder when you're by their side every day as they struggle more and more to breathe.

Because of all these things and more, it's no wonder that COPD caregivers are vulnerable to burnout, exhaustion, depression, and a variety of other physical and psychological symptoms. In fact, the toll is so significant that it's caught the attention of researchers who have conducted extensive studies on the effects of being a caregiver for someone with COPD.

For example, one large study of 461,884 informal COPD caregivers found that suffered a wide range of problems that were directly related to their caregiver responsibilities:

• 35% had a health-related problem
• 83% had problems with their social lives and leisure time
• 38% of working-age caregivers experienced problem with their jobs or careers

Other studies have identified some more specific physical and mental impacts that caring for someone with COPD can have:

• Physical Health and Lifestyle Impacts:
• Loss of freedom
• Social isolation
• Sleep disturbance
• Fatigue
• Relationship difficulties
• Loss of intimacy

• Mental health Impacts
• Anxiety
• Depression
• Powerlessness
• Resentment
• Guilt
• Uncertainty and confusion
• General psychological distress

These difficulties for caregivers only increase with the severity of their loved one's or patients' COPD, as patients with more advanced symptoms require more care. And because COPD is a degenerative disease, people with COPD inevitably become more dependent over time, adding even more weight to the physical and mental burdens that their caregivers must bear.

Other studies have looked at some of the general needs that caregivers have with regards to their caregiver role and the hardships it brings. These studies reinforce the idea that COPD caregivers face some specific challenges that other types of caregivers do not, due to the prolonged, degenerative and unpredictable nature of COPD.

For example, COPD exacerbations are inevitable for people living with the disease, and the threat of symptom flare-ups—which can be life-threatening in serious cases—constantly looms overhead. This can cause a great deal of worry and stress for caregivers, who must always be prepared for sudden changes in their patient's or loved one's condition.

Of course, being a caregiver is about much more than just sickness and hardship and suffering—it can also be meaningful, rewarding, and a powerful act of love. Caregiving can also be an opportunity for personal development and bonding, and can even bring families closer together.

Even so, getting through the difficult parts of caring for someone with COPD isn't an easy or simple task. That's why you need a variety of personal coping strategies and sources of outside support that you can lean on when things get tough.

Coping Strategies for Caregivers

Taking care of someone with a chronic disease can be both physically exhausting and mentally draining. This is especially true if you are a full-time or primary caregiver for a loved one with COPD.

If you're not careful, you can easily get burned out or overwhelmed, which isn't good for you or the person for whom you are responsible for caring. That's why it's so important to keep sight of your own well-being and find strategies to help you balance your own needs with your care-giving responsibilities.

In the following sections, we offer some practical strategies that can help you keep strong through hardships and avoid falling into the common slump of burnout and fatigue. That way, you can keep yourself healthy and sane while continuing to be the best caregiver you can be.

Know the Signs of Burnout

The best way to avoid getting burned out and fatigued is to recognize the early warning signs. For example, you might be on the road to burnout if you notice you're feeling exhausted, overwhelmed, or struggling more than usual to cope with stress.

Here are some common signs of burnout you should watch out for:

• Feelings of dread or disillusionment regarding your work and responsibilities
• Chronic stress or anxiety
• Isolation
• Poor performance and/or productivity (in work and other responsibilities)
• Poor sleep and/or fatigue
• Intestinal issues or poor appetite
• Excessive cynicism and/or irritability (both on the job or in other aspects of life)
• Changes in appetite
• Body aches and pains
• Increased irritability, impatience, or being quick to anger
• Lack of interest in activities and recreation
• Use of drugs, alcohol, or other unhealthy habits as a coping mechanism

Burnout isn't good for you or the person you are caring for, so you should take these symptoms seriously when they occur. Don't brush them off until they gets so bad you can no longer ignore them; instead, take action to improve your situation before it gets out of hand.

As soon as you begin to feel your emotional fortitude or energy stores waning, it's time to take a step back and figure out what to do. The first step is to identify what the problem is, or what in your life you are missing: Are you doing too much? Are you losing sleep? Are you having trouble managing anxiety or stress?

Once you've defined the problem, solving it is a matter of finding some viable strategies to give yourself what you need. For example, you can improve poor health habits by figuring out how to make a bit more time in your day for self-care. If your trouble is coping with anxiety or stress, you could address it by seeking mental health counseling or participating in a caregiver support group.

You can find many other helpful ideas and solutions in this guide and in the many caregiver resources linked throughout. It may take some time to find a good set of strategies that fits into your daily routine, but the sooner you start searching and trying, the sooner you can find a balance and begin to see results.

Don't Underestimate Self Care

It's easy to get so sucked into your role as a caregiver that you start to neglect other aspects of your life. Because of this, it's important to pay attention to your own needs as well as those of your loved one or patient, and to develop a personal set of strategies for self-care.

Self-care is a broad term that can apply to just about any activity you do in the pursuit of your own health and well-being. In fact, pretty much all of the tips and strategies in this guide can be considered a form of self care.

A good self-care strategy is varied, balanced, and helps you work toward a more fulfilling and well-rounded life. You should aim to find activities that address both your physical and mental needs, in a way that helps you both maintain and improve your quality of life.

To illustrate what self-care looks like, we've provided several examples of common self-care categories below. However, these examples are far from exhaustive; self care can (and should) reach into many other categories and aspects of life that are not mentioned in this list.

Some Basic Examples of Self-Care:

• Physical Self-Care: These are activities that help you improve your physical well-being, such as exercise, healthy sleeping habits, healthy eating habits, etc. For example, setting aside time to exercise and cook healthy meals ,or staying home from work when you are sick, are both forms of physical self care.
• Emotional Self-Care: These include activities that help you manage and cope with emotions, such as relaxation exercises, emotional expression, and practicing psychological coping mechanisms. For example, taking time to journal and express your thoughts every day is a form of emotional self-care.
• Social Self-Care: This includes activities that help you connect with other people, such as keeping in touch with friends, attending social events, and nurturing both new and existing relationships. For example, scheduling some time to call and chat with a friend once a week is an example of social self-care.
• Spiritual Self-Care: This type of self care helps you find meaning and connect with your personal values and beliefs. It can include things like practicing religion, exploring your spirituality, and finding meaning in the natural world. For example, practicing mindfulness meditation or participating in a religious ceremony are examples of spiritual self care.

Don't be afraid to get creative; there is no right or wrong way to do self care as long as it helps you take care of your needs. Once you find some strategies that seem helpful and appealing to you, write them down somewhere you can find them later. That way, you'll always have your own personal self-care toolkit to reference whenever you need.

However, coming up with the strategies is the easy part; often, it's making time to actually do your self-care activities that proves most difficult. Luckily, a little creativity and flexibility can go a long way toward helping you find ways to work some self-care into your daily routine.

You can find more self-care tips and suggestions throughout this guide, and in other posts in our Respiratory Resource Center blog. You can also find a variety of ideas and examples of self-care activities from other online resources, including the ones below:

• Self-Care for the COPD Caregiver
• Taking Care of YOU: Self-Care for Family Caregivers
• Developing a Self Care Plan from ReachOut Schools

Take Advantage of Small Chunks of Time

When you're a full-time caregiver, making time for yourself can be a daunting challenge. The idea of finding time for self care and relaxation might even create more stress if you feel it's too difficult or impossible to do.

However, it's almost always possible to dig up at least a little extra time that you can use to focus on yourself. Even if all you have is a few minutes here and there, teasing them out, seizing them, and using that time wisely can make a difference in your day.

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It might help if you break down self-care activities into smaller chunks that you can slip in to smaller time slots throughout the day You could, for example, take a few minutes of quiet between caregiving tasks to read, meditate, journal, or just sit down and unwind.

For hobbies and self-care activities that take longer, you may need dedicated some larger stretches of time. Finding those hours might require more careful planning and prioritization, but remember: you are worth every bit of time and effort you put into taking care of yourself.

Make Yourself a Priority

Unless you specifically make an effort to practice self care and prioritize your own well-being, chances are that you'll fall behind. When caring for someone else absorbs so much of your time, it's just too easy put off your own needs and neglect self care.

In order to avoid this, it's important to make yourself and your self care a priority. That means truly valuing yourself and your well-being—not just mentally or theoretically, but showing it with your actions and how you plan your days.

It means showing yourself compassion, and recognizing that you deserve take care of yourself. It means believing you deserve the time to focus on your physical and mental needs, and believing you deserve the time to do things that make you feel happy and well.

Looking after yourself shouldn't be optional, and you should treat your own self-care like any other non-negotiable activity in your life. This is the true first step to successfully putting any of the strategies in this guide into practice; without it, you might never get around to using them in the first place.

Take a Break

All caregivers, even (and especially!) full-time caregivers, both need and deserve occasional breaks. In fact, taking some time off to recharge is not only good for you, but, in the long run, it can also help you be a better caregiver overall.

Unfortunately, many caregivers feel such a weight of responsibility that they feel selfish or even neglectful for spending any time away. However, if you don't get a break from that responsibility every so often, at least, you are bound to end up burned out and fatigued.

Of course, taking time off isn't always simple; in many cases, you will need to arrange for someone else to care for your patient's while you're gone. However, with a little planning, creativity, and delegation (which we'll discuss more in a later section), you're bound to be able to find another person to work in your stead.

Even if you can't get a full day off, it can be extremely refreshing just to get an afternoon or evening away. When you do, try to make the best of the time by focusing on you, letting go of any feelings of worry, stress, or responsibility for awhile.

Remember that taking some time for yourself is a necessity for your own health, and it isn't the same as abandoning your loved one or your duties. You deserve the opportunity to take care of yourself, and your loved one deserves a caregiver who isn't too burned out and exhausted to give them the care they need.

Practice Relaxation Techniques

Being a COPD caregiver often comes with a lot of stress and emotional strain. If you don't have strategies you can use to wind down, relax, and relieve that stress, it can take a huge toll on your health and well-being over time.

That's where relaxation techniques come in; they have long been the go-to recommendation from doctors and mental health professionals for coping with anxiety, stress, and other negative emotions. What's more, many relaxation techniques are quick and simple to learn, perfect for working into a busy caregiver routine.

Relaxations activities are designed to help you relax, clear your mind, and separate yourself from worries and stress. Many focus on utilizing the mind-body connection, a scientifically-supported concept regarding the ability of your mind to influence your body, and your body to influence your mind.

For example, when you feel stressed, it can cause physical reactions like muscle tension or altered immune system function. These physical effects, in turn, send signals to your brain that reinforce stress and other negative feelings. This creates a negative cycle of both physical and mental stress, but this cycle can be mitigated and interrupted by relaxation techniques and mind-body exercises.

Taking the time to focus on mental and physical relaxation can interrupt the downward spiral of stress and help you find relief. It can also give you a much-needed break from the worry, sadness, and grief that often comes with caring for someone with serious chronic disease.

Here are some examples of quick relaxation exercises you can do in 10 minutes or less:

• Practice mindfulness meditation (you can follow along with several free guided meditation sessions here)
• Do some deep breathing exercises
• Practice progressive muscle relaxation
• Do a body scan
• Take a few minutes to stretch your body and loosen up your muscles

Here are some examples of relaxation exercises that you can do in 30 minutes or less:

• Mind-body exercises like yoga or Tai Chi
• Do a longer mindfulness meditation session
• Take a 15-30 minute walk

There are many other activities that can help you relax and let go of stress, such as reading, taking a hot bath, or spending time in nature. Take some time to explore what does and doesn't work for you, and don't forget to use them in times of emotional distress!

Seek Help for Mental Health Problems

The stress and strain of being a COPD caregiver can lead to some serious emotional and psychological symptoms that you shouldn't ignore. In fact, it's quite common for caregivers to struggle with anxiety, depression, and other mental illnesses that can take a serious toll.

These mental struggles are natural and understandable, and it's okay if you're not able to able to manage them on your own. That's what counselors and psychiatrists are there for: to provide the help and support you need to regulate your emotions and develop healthy strategies for coping with whatever psychological difficulties that life and caregiving throws your way.

Give Yourself Some Credit

As a caregiver, it's easy to get so focused on the things you need to do or should be doing that you never think about how much you've already achieved. However, you shouldn't forget that you are providing a vital, admirable service that makes a huge difference in your patient or loved one's life.

People with COPD often regard their caregivers as heroes and saviors, people they (sometimes quite literally) could not live without. So give yourself some credit, and pause for a moment every so often to appreciate all the sacrifices and accomplishments you've made.

Whenever you start to feel frustrated, discouraged, or helpless—as many COPD caregivers do at times— take the time to reflect on your efforts and achievements, and remind yourself of all the good you've done so far. Doing this can help you cope better with stress and guilt, and help you keep a positive spirit when the daily strain of work and worry begins to beat you down.

How to Get Support

The burden of being a COPD caregivers is not something that anyone should have to cope with completely on their own. That's why it's important to find sources of support you can reach out to when needed, whether it's a dedicated caregiver support group, counseling, or simply a fun group activity to help you get away from the stress.

Join a COPD Caregiver Support Group

Many caregivers find that their family and friends struggle to understand what they're going through, which makes it difficult for them to provide the kind of support a caregiver needs. As a result, many caregivers end up feeling isolated and misunderstood.

That's why it's important to get support from other caregivers—people who can relate to what you are going through and understand what it's like to care for someone else with a chronic disease. You need people with whom you can share your worries, experiences, and stories, and receive personalized advice and support.

Luckily, there are a variety of different support groups specifically for COPD caregivers that offer all of these things and more. Many of these groups are remote and based online, but some places have local caregiver support groups that meet in person, too.

You might be able to find a caregiver support group in your area if you ask around your local hospitals, rehab centers, faith communities, and other organizations theat deal with healthcare, COPD and age-related diseases. You might also find more information on local groups through area-specific online forums and bulletin boards (e.g. Craigslist or Nextdoor) or via online searching tools.

Online support groups come in a variety of different formats, including:

• Phone-based support
• Online forums and chat rooms that host support sessions at specific dates and times
• Less-structured support communities that operate similarly to other social networks.

Several online support groups are run by COPD and respiratory disease advocacy organizations, such as the American Lung Association. Here are some links to some online support groups and communities for COPD caregivers and caregivers in general:

• COPD 360 Social is a large online community that is open to anyone affected by COPD, including COPD caregivers and people with the disease. You can participate in the group by following the activity feed, asking and answering questions, read the latest posts from the COPD digest, and more.
• COPD-Support offers a range of services for both COPD patients and caregivers, including an online forum (with board dedicated specifically to caregivers) and a community-driven email list.