There are more than one million people living with chronic obstructive pulmonary disease (COPD) in the UK. COPD does not follow a predictable course and differs from person to person. It is often difficult to determine the stage that a person has reached in the condition: while some patients will present with a gradual decline, others may remain stable for years, and some will require hospital admission for respiratory support. The uncertainties around the nature and progression of COPD make decisions about end-of-life (EOL) and starting EOL care challenging. This article explores some of the indicators of decline in a person with COPD, including exacerbations, cognitive dysfunction, sarcopenia, depression and anxiety. It also discusses the importance of starting appropriate EOL discussion with patients, as well as the many benefits of multidisciplinary team working when it comes to recognising care needs and enhancing patients’ quality of life.
Dr. Philip Burnard examines the notions of spirituality and sexuality within the nursing domain.
Ellie Lindsay discusses the need for community nurses to address the research-practice gap and incorporate evidence based findings into their daily work.
Ellie Lindsay BSc (Hons), RN, DN, CPT, Dip HE is a Independent Specialist Practitioner and Associate Lecturer CRICP, Thames Valley University, London; Ellie also is a Visiting Fellow, Queensland University of Technology, Australia. Article accepted for publication: June 2005
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Natalie McGeorge reviews a case study which discusses the complexities of holistic and family centred care in paediatric nursing
Natalie McGeorge is a student nurse at Huddersfield University currently studying for a BSc (Hons) Child Nursing.
