Life ending from emphysema?

Dear Ask The Doctor: My Mother In-law is 69 with emphysema. Been on oxygen 24 7 for almost 3 years. She has continued smoking throughout and even smokes while oxygen is being received through the nostril because she can not take it off AT ALL! Recently she has lost 30 lbs. down to 95 lbs. at 5'4". She was just hospitalized with pneumonia in both lungs; the Dr. said it was due to high levels of carbon dioxide build in lungs. She now has to have oxygen deliver through a mask. Her oxygen levels are ok but carbon dioxide is still over 80 and if she takes mask off and takes oxygen through nostrils is shoots up to over 110. What is the prognosis? The Dr. is telling us little to nothing. Father in-law in denial and seems to have no idea of any information about her condition-what her FEV1 is ect.. We have small children and want to start to prepare them if the "end is near". I know there is no clear cut time frame with death from COPD but when someone is in this stage what can we expect?

Dear Vicki:

I understand your concern about COPD; this is a leading cause of death and illness worldwide. Most COPD is caused by long-term smoking and can be prevented by not smoking or quitting soon after you start. Damage to your lungs can't be reversed, so treatment focuses on controlling symptoms and minimizing further damage.

This condition favors the development of frequent colds, the flu or pneumonia. Plus, any respiratory infection can make it much more difficult to breathe and produce further irreversible damage to the lung tissue. I am sorry but there's no cure for COPD, and your mother in law can’t undo the damage to her lungs. But COPD treatments can control symptoms, reduce her risk of complications and exacerbations, and improve her ability to lead an active life. Since she is using oxygen during the whole day, it seems that her COPD is advanced, I can’t advice you on her prognosis without having her pulmonary function tests and a more detailed evaluation but I would suggest her to comply with her medications and avoid lung irritants which would exacerbate her condition.