COPD (Chronic Lung Disease) in Older Adults

Plain-language information about COPD (chronic obstructive pulmonary disease) and chronic lung disease in older adults. This page is for older Canadians and their caregivers. It does not replace advice from your own health-care provider.

1. What is COPD / chronic lung disease?

COPD (chronic obstructive pulmonary disease) is a long-term lung condition that makes it harder to breathe. It usually includes:

Chronic bronchitis

Inflamed, narrowed airways with extra mucus

Emphysema

Damage to the air sacs in the lungs

Other chronic lung conditions (such as some types of chronic asthma) can have similar breathing problems.

Common symptoms

Shortness of breath, especially with activity
Chronic cough (often with mucus)
Wheezing
Frequent chest infections or "flare-ups"

Did you know?

COPD is often linked to long-term smoking or exposure to air pollutants, but not always. Some people develop COPD without ever smoking.

2. Why COPD matters more in older adults

COPD is common in older adults and can:

For older adults

Medications for COPD (especially inhalers and some pills) must be used carefully in older adults, especially if there are other heart problems, eye problems, or trouble using inhaler devices.

3. How doctors usually treat COPD

Health-care providers often consider:

Treatment often includes:

Inhalers

Open airways and/or reduce inflammation

Vaccinations

Flu and pneumonia vaccines to reduce infections

Pulmonary rehabilitation

Exercise and education programs

Oxygen therapy

For very low oxygen levels

Quitting smoking

If you smoke, quitting is the single most important thing you can do to slow COPD progression. Your provider can offer support and resources to help.

Important

This website does not tell you which inhaler or treatment plan is right for you. Only your provider can do that.

4. Common types of medicines for COPD in older adults

Bronchodilators (short-acting and long-acting)

Help open the airways to make breathing easier

Inhaled corticosteroids

Reduce inflammation in the airways

Combination inhalers

Contain more than one type of drug for convenience

Oral medications

Some pills to reduce flare-ups, in certain cases

Antibiotics

For bacterial infections, when needed

Oral steroids

Sometimes used short-term during severe flare-ups

Inhaler Technique Matters!

Correct inhaler technique is very important for your medicine to work properly.

Ask your pharmacist or provider to watch you use your inhaler and give feedback.

Many people don't get the full benefit of their inhalers because of incorrect technique. It's worth getting checked!

5. Possible side effects older adults may notice

Side effects depend on the specific medication. Things to watch for and report include:

Shakiness or fast heartbeat after using some inhalers
Hoarse voice or white patches in the mouth (thrush) from inhaled steroids
Swelling in legs or changes in heart rhythm (with certain oral drugs)
Trouble sleeping, mood changes, or increased blood sugar (with steroid courses)
More frequent or severe coughing
Changes in mucus colour, amount, or thickness
New or worse shortness of breath

Tip to prevent thrush

Rinse your mouth with water and spit after using inhaled steroids to help prevent thrush (white patches in mouth).

Do not stop on your own

Do not stop or change your inhalers without talking to your provider, especially if you have been using them for a long time.

6. Habits and lifestyle that may help

Many lung and heart guidelines suggest that certain daily habits may help manage COPD along with medical care. What is safe and realistic is different for each person.

Breathing and activity

Pursed-Lip Breathing

This technique can help when you feel short of breath:

  1. Breathe in slowly through your nose for 2 counts
  2. Purse your lips like you're going to whistle or blow out a candle
  3. Breathe out slowly and gently through pursed lips for 4 counts

Ask your provider or respiratory therapist to show you this technique.

Avoiding triggers

Things to avoid or minimize:

Smoking Second-hand smoke Strong fumes Dust Chemicals Wood smoke

Stay up to date on vaccines

Flu and pneumonia vaccines are especially important for people with COPD to help prevent serious infections.

Nutrition and weight

Always ask first

Ask your health-care provider which activities are safe for you, and whether a pulmonary rehab program is available in your area.

7. When to call your doctor, nurse practitioner, or pharmacist

(Non-urgent)

Contact your health-care provider or pharmacist if:

More short of breath

During your usual activities than before

Using rescue inhaler more

More often than usual

Mucus changes

Colour, amount, or thickness has changed

Inhaler questions

Not sure if you're using it correctly

Side effects

Feeling side effects from your medications

8. When to call 911 or go to the emergency department

Call 911 immediately if:

  • You are very short of breath and your usual medicines do not help
  • You cannot speak in full sentences because of shortness of breath
  • Your lips or face look blue or grey
  • You feel extremely confused, drowsy, or cannot stay awake
  • You have chest pain or pressure that does not go away

If possible, do not drive yourself. Ask someone to call for you or call an ambulance.

Do you have a COPD Action Plan?

An action plan tells you what to do when your symptoms get worse. Ask your provider for a written plan that includes:

  • What "green zone" (doing well) looks like
  • What "yellow zone" (getting worse) looks like and what to do
  • What "red zone" (emergency) looks like and when to call 911

Keep your action plan somewhere easy to find, like on your fridge.

9. Questions to ask your doctor or nurse practitioner

You can print these questions and bring them to your next appointment:

What type and stage of COPD or lung disease do I have?
Which inhalers and medications am I taking, and what does each one do?
Can you or the pharmacist check my inhaler technique?
What should I do if my breathing suddenly gets worse?
Are there exercises or pulmonary rehab programs that would be safe for me?
How do my lung medications interact with my other medicines?