Stage 4 COPD: End-Stage COPD And You

As you know, there are four total stages of chronic obstructive pulmonary disease (COPD), ranging from mild to very severe. 

Stage 1 COPD is also known as mild COPD, and stage 2 COPD is the moderate stage at which recognizable symptoms often first appear.

As COPD progresses, your COPD stage will also change to reflect the severity of your symptoms.

Severe stage COPD, or stage 3 COPD, causes significant changes in symptoms, lung health and overall health.

The final stage of COPD is also known as stage 4, or very severe. Here’s everything you need to know about stage 4 COPD or end-stage COPD.

Determining Stage 4 COPD

As in previous stages of COPD, your doctor will likely use the GOLD System and the BODE Index to identify stage 4 COPD.

By this stage, you’ve likely had multiple lung function tests and exercise tolerance tests, such as pulmonary function tests and 6-minute walk tests.

Seeing your doctor regularly is important during any stage of COPD, but it’s especially important during stage 4.

In the GOLD System, stage 4 COPD is categorized as end-stage COPD with a lower forced expiratory volume in one second (FEV1) than stage 3, or those with a stage 3 FEV1 and low blood oxygen levels.

Stage 4 COPD

During stage 4 COPD, many people have significant airflow limitations, which often drastically affect their lives.

In fact, simple tasks, such as taking a shower, making the bed, or cooking a small meal, leave them feeling exhausted and completely out of breath.

While lung function can vary, typically during stage 4, lung function drops to 30 percent or less.

Your doctor will closely monitor your pulmonary health and overall health. 

Because COPD flare-ups worsen symptoms and can be life-threatening, your doctor will work with you to manage and prevent them.

If you experience low blood oxygen levels, your organs, cells, and tissues are unable to receive enough oxygen. 

Oxygen is essential to a properly functioning body, but many people with COPD have difficulty getting adequate oxygen. Your doctor may prescribe oxygen therapy to help you receive more oxygen.

For some people, other conditions that can occur along with COPD may worsen as well, such a heart failure.

If you notice a change in your symptoms or feel ill, your doctor will likely want to ensure you’re not having a COPD flare-up.


COPD is a progressive disease, and there’s no cure. 

However, you and your doctor will work together to develop or modify your treatment plan to best fit your needs. There are many different treatment options, such as medications, lifestyle changes and alternative therapies.

For the management of stable stage 4 COPD, your doctor may prescribe inhalers, and corticosteroids to help you breathe better. 

For example, your doctor may prescribe inhalers called bronchodilators, which help relax and open your airways. 

Your doctor may also prescribe steroids to reduce inflammation and prevent flare-ups.

Sometimes you may need a type of inhaler called a combination inhaler. Combination medications combine two types of medicine in the same drug, such as a bronchodilator and a steroid in the same inhaler.

In the event of a COPD flare-up, your doctor could prescribe antibiotics, oral steroids or even hospitalization.

Remember to report any changes in your symptoms or overall health to your doctor. 

It’s also important to stay up-to-date on flu and pneumonia vaccinations to reduce and prevent flare-ups.

Lifestyle Changes

Your doctor may also recommend certain lifestyle changes. 

One of the most important lifestyle changes you can make is to quit smoking. Smoke is a lung irritant and trigger for COPD symptoms.

While quitting smoking and remaining smoke-free is challenging, there are smoking cessation tips, treatments, and groups to help you succeed.

Eating a healthy diet and getting plenty of exercises have been proven to help people with COPD enjoy a better quality of life.

Too much salt can worsen COPD and heart problems, so try seasoning your food with herbs instead.

Gentle exercises like yoga, walking, and Tai Chi are excellent options for people with limited mobility in any stage of COPD.

Combining lifestyle changes, medications, and alternative therapies can help you live a more active life. 

COPD prognosis and life expectancy vary; however, from stage 1 COPD to stage 4 COPD, these treatment options are available.