Anyone deal with a family member with COPD who refuses the bipap mask?


My Mother is 96 and refuses the bipap or cpap. We can barely get her to tolerate the meds from the nebulizer and thats if we just hold the thing above her face. We know this is going ot kill her. I guess I'm just trying to brace for it and understand what to expect. I mean I'm an LPN I know what it will do.. but not how long. We brought her home from inpatient hospice and she actually seems to be getting stronger. Is this just false symptomology of someone ready to go? Anyone have an input or experience?



If she does not want to use the CPAP, I'd honor her wishes. I do use CPA, because I have a mild case of Hypopnia (shallow breathing during sleep), but, if I were over 80 years old, I don't think I would continue the therapy. At her age, I'd discuss it with her doctor if you think that she doesn't appreciate the treatment. I'm a big supporter of seniors making their own decisions, if they are competent.
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Reply to Sunnygirl1

Basket hill,
If there's one thing I've learned from being a hospice nurse, it's that you can never tell WHEN someone is going to pass away.

Sometimes a patient may "rally" (be more alert, have a better appetite or even walk when they haven't) but then they will pass a day or two after that. It's impossible to second guess the time. Only God knows.

Since your mom is very old and has a terminal diagnosis, I would say to enjoy whatever time you have left with her.

It might be a good idea now to think about arrangements for when she passes (which funeral home, burial or cremation, a service (where and who would be invited, etc.). That stuff is so hard to get together in your grief.

Im sorry you and mom have to go through this. May the Lord give her a peaceful passing.
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Reply to SueC1957

My father doesn’t have COPD but does have sleep apnea, apparently quite badly from what the docs say. He hated every form of mask and mouthpiece for the CPAP machine and after trying every conceivable way to use it, boxed it up and sent it back. Told the docs he couldn’t stand it and it was ruining his plans to die in his sleep anyway. For some people they simply can’t tolerate the device, no matter how much it may be needed. I say let them live in peace
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Reply to Daughterof1930

One of the reasons short of restraints which are highly contraindicated with CPAP, that inpatient facilities cannot force so that they refuse it is because it is considered assault and battery. Did you post this same question before? If she retains CO2 and becomes unresponsive , then give CPAP a try until she wakes up. Remember if she is unconcious that there is a risk of aspiration.
Her nebs at this point are more for relief of symptoms and not to prolong life. If she is fighting a mask, she may only be getting 5% or less of the drug. You described blowby therapy with a mask. There is a lot of literature out there is not recommended because the drug does not get deep enough. You may have better luck when she sleeps to try to get the mask on her
Just keep her comfortable. Offer but do not push. COPD causes much suffering because her body got used to so much shortness of breath years ago. You and I could not tolerate this like she does
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Reply to MACinCT