Stages of COPD

Helpful Highlights

• Heart Failure Stage 1: Mild

• Stage 2: Moderate

• Stage 3: Severe

• Stage 4: Very Severe

As your loved one's COPD evolves and progresses, here is how you can best advocate for them and their treatment.

Be vigilant and keep their primary care provider and pulmonologist informed, especially if there are changes in their condition, such as greater difficulty breathing or worsening of other symptoms, especially if it appears to be an exacerbation.

Ask the primary care provider or pulmonologist about treatment options. Therapies may combine different types of medications, as well as incorporate breathing and physical activities, that can help manage moderate to severe COPD symptoms and may even reduce or prevent COPD exacerbations.

Stay positive and encourage your loved one to stay on their treatment plan. Tips on how to stick with the treatment plan:

• Make it a habit

• Synchronize and schedule activities, meals, medications, and daily routines

• Be prepared if symptoms flare by creating a plan of action with the primary care provider or pulmonologist. For cases of sudden and severe symptoms, such as with an exacerbation, make sure to have the emergency plan instructions from the primary care provider or pulmonologist, the name and number of an emergency contact person who can serve as a backup for assistance, a current list of medications, and all healthcare insurance information (the cards themselves or copies of the front and back).

Stages of COPD

Stage 1: Mild. Symptoms are subtle and often unnoticed with some shortness of breath and nagging dry cough.

Stage 2: Moderate. Symptoms worsen with more frequent or severe shortness of breath, and persistent cough with phlegm/mucus (that may change color), exacerbations may happen but are infrequent and mostly manageable at home.

Stage 3: Severe. Symptoms are severe, especially shortness of breath in the morning, exacerbations are more frequent and intense, requiring medical attention; swelling of feet, ankles, or legs may begin, and there may be occasional wheezing.

Stage 4: Very Severe. Symptoms are very severe where breathing takes great effort, the heartbeat may be fast and/or irregular, crackling breath sounds might be heard or no breath sounds at all in some lung fields, weight loss occurs*, pulmonary hypertension is possible, and there may be episodes of delirium. Exacerbations require hospitalization.

*Weight loss occurs because of a lack of intake of calories and calories being burned. Eating becomes more difficult with Stage 4 COPD because it increases shortness of breath, as breathing stops with swallowing, so people eat less or not at all. Hence, a lack of intake calories. On the flip side, people with COPD may burn 750 calories a day on breathing effort alone (compared to just 50 calories a day for someone without COPD).