Disabling Effects

The person normally has little or no symptoms. They would normally have wheeziness and breathlessness on a less than daily basis and would usually only suffer from a mild “smoker’s cough”, producing some mucoid sputum. They may become breathless on moderate, prolonged or heavy exertion.

Mobility

A person with mild restriction would normally be able to walk an unlimited distance, at a normal pace and manner on level ground, and manage hills or slopes.

There would be no need for guidance and supervision whilst outdoors.

Care

Daily living would normally be unaffected, with the patient being able to attend to all daily activities of self-care without any difficulty. This includes bathing, dressing, attending to hygiene and toilet needs, and being able to prepare and cook a main meal.

He/ she would normally be able to climb one flight of stairs. They would not normally be at risk of falls.

Occasionally, the person may have an episode of chest infection, which may cause some difficulty with exercise tolerance, but this would only occur for the minority of the time.

Disabling Effects

The person would normally suffer from wheeziness and breathlessness for part of each day.

Because he/ she would normally be breathless on extra activity, he/ she would have to take things more slowly. He/ she could also be incapacitated by exacerbations (chest infections), where cough and breathlessness are increased, but this is for the minority of the time.

Mobility

A person with moderate restriction would normally be unable to keep up with others when walking on the level. However, he/ she may be able to walk up to 100 to 200 metres, as long as he/she walks at a slow pace.

There would be no need for guidance and supervision while out of doors.

Care

A person with moderate restriction would normally have breathlessness as a noticeable and troublesome symptom. However, this would not normally affect such activities as rising from a bed or chair, bathing, dressing, attending to toilet needs, and being able to prepare and cook a main meal to a significant degree. These people are susceptible to chest infections especially following a cold, and for a few days, or weeks, this could cause him/her to be very breathless and he/she may normally need assistance with some of these activities at this time. They would however normally be breathless on climbing one flight of stairs, (that is, on mild or ordinary exertion). During a chest infection, they would normally have difficulty in climbing a flight of stairs but this would not be for most of the time. People with this condition would not normally be susceptible to falls.

Disabling Effects

Cognitive function would not usually be affected therefore the person is mentally able to cope, on the whole. However, in those who are retaining CO2 (carbon dioxide), cognitive function may be impaired. Because of inability to eat normally, there usually is severe weight loss or malnutrition. Patients suffering from very severe disease would have severe breathlessness on minimal exertion and be on oxygen for several hours a day (unless in CO2 retention i.e. when there is a presence of more than the normal amount of carbon dioxide in the blood tissues). Oxygen is not prescribed in these circumstances.

Mobility

A person with severe restriction would normally experience severe breathlessness on walking any distance. He/ she would not normally be able to walk more than 50 metres at the most, at a very slow pace. There may be a risk of falls.

Care

A person with severe restriction would normally require assistance in all aspects of daily self-care, such as getting in or out of a bed, chair, or the bath, washing, dressing, including lower garments and fastenings, attending to toilet needs, and some aspects of preparing and cooking a main meal such as bending to an oven and carrying and lifting hot saucepans because of severe breathlessness on minimal exertion. He/she would normally not be able to get him/herself comfortable in bed without assistance. In addition, the person would not normally be able to manage one flight of stairs. Some of the time, communication may be affected, because of severe breathlessness, and the person may not be able to cope with aspects of their medical treatment, such as the administration of oxygen, without assistance.

The person would normally need assistance in eating and drinking. There may be a risk of falls and the person would not normally be capable of rising independently from a fall.