Author Archives: Jackie Aim

About sputum

When we talk about clearing your chest we are talking about removing excess sputum.

Sputum chart

Sputum classification
Sputum may be clear or white and frothy (mucoid).

Sputum which is slightly thicker and cloudy or opaque (mucopurulent).

If you have an infection you may see the colour of your sputum getting darker with either a yellow or green tinge. (purulent) This can be a sign to get early advice and medication from your GP or practice nurse.

If the sputum is darker green (severe purulent) it may also start to become thicker and more difficult to cough up in order to clear your airways. This can be caused by a virus or bacteria.

Mucous plugs which can block the small airways can occur at any stage where mucous is becoming thicker and stickier.

What would happen if there is no power of attorney?

A female patient in a hospital bed holding hands with the hospital chaplain

If sometime later you become unwell and no longer able to make or remember decisions – you no longer have capacity.

If you are too unwell to make or communicate your decisions the medical and respiratory team will try to make the best decisions about your care at that time. Healthcare professionals have a duty of care to make the best decisions on your behalf, including asking your family and loved ones about your care. In Scots law the Adults with Incapacity (Scotland) Act 2000 protects the rights of the individual.

If you are unable to make your wishes known and you don’t arrange a power of attorney, bank accounts and assets could be frozen. To sort this out someone needs to apply for Guardianship which is a very costly legal process.

For more information please see:

Power of attorney – Why do you need a power of attorney?

Some people continue to make their own decisions right up to the final days. This is known as Capacity. Capacity means that you can act on and make your own decisions. Capacity means that you understand decisions, their implications and retain the memory of the decisions. You should always be asked about your care if you have capacity.

You can choose to name someone as your welfare and/or financial power of attorney. They would follow your wishes if the time comes when, for whatever reason, you are not able to make or communicate your wishes. Setting up a power of attorney when you are well will give you and your family peace of mind if the time ever comes when you can’t do this yourself. Discuss with them what you want. You can nominate up to four people to do this. There is a cost for arranging power of attorney and you will need legal help. You should nominate someone for both welfare and financial power of attorney. Power of attorney is a legal document and has to be signed by you and other witnesses.

A Welfare Attorney can make decisions about treatments or care based on your wishes as discussed with you.

A Financial Attorney can deal with bills, manage your accounts and take care of your financial affairs. They can make decisions on your behalf if you were unable to make your wishes known when you are ill. You can decide on the level of responsibility they will have to deal with any finances.

For more information please see: My Power of Attorney.

Practical things to do

Have you made a will? In Scotland only 35% of people have a will. Who would inherit your money , possessions or property – known as your estate? Many people do not know that inheritance is not automatic if you have not made a will. It is not difficult and need not be expensive. The more complicated your finances, the more difficult it will be for your loved ones to sort out.

Who would know where your personal documents can be found such as your will, insurance, birth certificate, marriage certificate, pension, bank, property details etc. Also any important phone contacts or addresses. Who would you trust to be your “contact person”? Do you have a next of kin?

Do you have a Faith or spiritual beliefs. It is important that your family know who to contact to support your Faith?

For more information see:

Time to think and find out more

Close up photograph showing older couple holding hands

You may just want to start with practical but important things like making a will or thinking about and discussing your wishes with those closest to you.

You do not have to plan everything in one go. You can do it step by step over a period of time.
You can change your mind and wishes, about what you want, at any time.
What would you ideally want to happen if you were seriously ill?

It is important to record your decisions and wishes. Think about who you need to contact in the family and your GP. You can get advice from your healthcare team.

Recording your thoughts and wishes about your future care can be done formally as an Anticipatory Care Plan. This is a document which you discuss with your healthcare team and your family. By having an anticipatory care plan you are making your choices and your preferences about any future treatment known in advance. Your anticipatory care plan can change if you change your mind about any aspect of care you want or do not want.

For more information please see the following:

Starting a difficult conversation

It is difficult to bring up the subject of future care for fear of upsetting your loved ones. Each side wants to protect the other. They won’t feel comfortable about bringing up the conversation for fear of upsetting you. “you will be fine mum, no need to think about that now”. You could try starting the conversation with something like “I’d like to make plans just in case something unexpected happens”.

If you have decided to think about and plan your future care wishes you could show your loved ones the pages in this section of My Lungs My Life to help get the conversation started.

This conversation should be done while you are well. It is much easier for both you and your loved ones. Family and friends may welcome the opportunity for a discussion. They may also be worried about the responsibility of making decisions that affect you and your future care if they are not sure what you would want yourself.

Talking to them might be difficult at first but it can be a relief to them and you when you have had this kind of discussion.

For more information please see: NHS Inform: Palliative Care Zone – Talking about your condition.

Plan care while you are well

Couple reading

You are focussed on health and making the most of every day. Sometimes to stay well and independent you have to have conversations about your wishes, hopes and fears for the future and how you would like to be cared for if you become ill.

Think of this as just another part of your self management of your COPD which is all about informed choices and the knowledge to make those choices.

Good planning lets everyone involved know your wishes.
We all need to start communicating and being more open to discuss our wishes with our family/partners as a first step.

There is no right or wrong way; you know best what matters to you.

Useful links

The following websites can provide you with more information.

Psychological needs

A young adult woman showing signs of distress

Communication with you and your loved ones is crucial.

You may feel a wide range of different emotions such as anger, sadness, worry about what is to come, concern for your family or a feeling of being contented and at peace. We all have different ways of coping in life and at the end of our lives this is no different.

Where do you get support at times of stress? What kinds of support have you found useful in the past?
Do you prefer to have lots of medical information or do you prefer to only know the necessary information? If it helps, your medical team can try to answer any questions you may have. There are medical treatments which can help you to be more comfortable e.g. medicines to help manage symptoms of anxiety and allow you to feel calmer.

Do you need someone to speak with you in confidence?

Can your family or friends help? It can be useful to speak with others such as family, friends, healthcare professionals or spiritual supports about what is happening for you? Or to speak about anything else as a distraction? Let others know how best to support you.

Does your family need support?

Spiritual needs

Spiritual need does not necessarily mean religion or faith.

Nursing staff and carers should be made aware of your religious or personal spiritual needs.

If speaking with someone from your Faith is important to you, it is important that you let staff know. They can arrange this for you.

It could be that you need time to think about your life and memories, have close family with you for comfort.

You may just want to have your family photographs near by or your favorite music playing quietly in your room.