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Respiratory conditions and impact on function

Lung conditions such as Chronic Obstructive Pulmonary Disease (COPD), Pulmonary Fibrosis, Asthma, COVID-19, Cystic Fibrosis, Pneumonia and respiratory infections may cause fatigue as a result of breathlessness; impacting your ability to carry out daily living activities.

Fatigue is a feeling of physical tiredness and lack of energy. Everything you do from waking up to going to bed is classed as an ‘activity’ and uses some form of energy. A drop in energy can lead to prolonged feelings of fatigue. It can be compared to having a ‘human battery’. How you use the energy left in the battery, impacts the symptoms of breathlessness. Energy conservation helps prevent the battery from flattening.

What is energy conservation?

Energy conservation is a means of changing the way you carry out your daily living activities, by adapting the environment in which you conduct them. The aim is to reduce unnecessary oxygen expenditure in the body (during activities) to improve your quality of life.

Why is energy conservation important?

Developing energy conservation techniques can help reduce the amount of oxygen and energy required to complete day-to-day activities. It can also help reduce feelings of fatigue, pain and breathlessness. Ultimately, increasing your self-confidence, independence and quality of life.

How can your Occupational Therapist help?

Your Occupational Therapist’s (OT) role is to promote an optimal level of occupational performance through obtaining social history and conducting functional assessments. Following this, your OT will set goals; taking into account your daily activities.
This includes making suggestions on planning and organising daily routines and tasks, as well as recommending and issuing equipment to simplify activities.

Energy conversation techniques

• Prioritise activities of the day and set realistic goals
• Plan your days and weeks activities.
• Pace yourself. Break into smaller, easy to do steps. Allow extra time to complete an activity and do not rush.
• Position and posture are important. Sit down and take rest breaks, avoid prolonged movement and tiring postures.
• Use assistive devices when recommended to save energy and reduce breathlessness.

Applying energy conversation techniques to daily activities

Washing and Grooming

• Gather all necessary items beforehand and keep items in easy reach between shoulder and waist height.
• Rest elbows on counter or dressing table.
• Avoid reaching, bending and twisting as this increases your heart rate and oxygen required.
• Sit where possible, following assessment completed by an Occupational Therapist equipment such as perching stool, bath board, shower stool and chair may be recommended / provided.
• Use long handled equipment to avoid bending.
• Keep the bathroom window / door open to reduce steam, alternatively turn on cold water first then slowly add hot water.
• Use liquid soap instead of a bar. Avoid using scented products such as hair products and lotions.
• Try dry shampoo.
• Rest in a dressing gown or large towel rather than drying.
• Use electrical items, such as a toothbrush, razor, etc.
• Consider Is a daily bath or shower necessary and can you have a strip wash at the sink instead.

Dressing

• Collect all your clothes before you start.
• Utilise a perching stool to sit down whilst dressing.
• Dress your lower half first when you have the most energy between activities. Pull up lower garments together.
• Avoid wearing tight clothing and clothing with fastening at the back.
• Minimise bending by lifting leg up or use step stool.
• Use long handled dressing aids to limit bending down e.g., easy reach, shoehorn, sock aid.
• Wear slip on shoes or use elastic shoelaces to avoid bending.

Meal preparation

• Spread the preparation throughout the day.
• Gather all ingredients and utensils before starting.
• Sit whilst preparing or stirring food using perching stool.
• Rest elbows on counter.
• Ensure there is good ventilation whilst cooking.
• Use a kitchen trolley for transporting items.
• Use a plastic jug to fill the kettle rather than lifting the kettle to the taps.
• Use lightweight cookware and dishes to conserve energy.
• Cook large amounts and refrigerate or freeze extra portions.
• Buy pre-prepared vegetables and frozen ready meals.
• If able, could family or a friend prepare some meals? If not, consider meal on wheels / hot meal delivery service.

Household tasks

• Spread heavy activities throughout the week.
• Balance light with heavy tasks.
• Use long handled and light weight equipment where possible.
• Avoid aerosol products and cleaning product which vaporise into the air.
• Position the rubbish bin near the front or back door for ease of access.
• Use smaller rubbish bags to avoid having to lift / carrying heavier bags, empty them more frequently.
• Let dishes soak in soapy water to eliminate the need to scrub cooked on food.
• Can you ask a friend or family member to help you or pay for someone to help with household tasks.

Shopping

• Make a shopping list to reduce stress.
• Your Occupational Therapist may recommend a wheelchair to conserve energy whilst shopping.When shopping, shop at quieter times and if able use a smaller, shallower trolley to reduced bending.
• Pack items together that go in the fridge / freezer or same cupboard, so it is easier to unpack.
• Do not carry all the weight in one hand. Distribute the weight evenly between two bags.
• Ask family or friends to assist with heavy items.
• Shop online and arrange for home delivery.
• Can you shop on a day when you don’t have other heavy tasks to do.

Laundry

• Spread the tasks throughout the day. Load the machine in the morning, empty it in the afternoon.
• Take rests during and afterwards.
• Sit on a stool to load and unload the washing machine.
• Consider Is it necessary to iron all your clothes. If yes, adjust the ironing board to waist height when either sitting or standing.
• Use fabric conditioner to reduce creasing.
• Do several smaller loads each week, rather than one large wash.
• Use a long-handled grabber to load and unload items.
• Use a laundry basket on wheels.

Useful contacts

References

• Royal College of Occupational Therapist (2023) How to manage your energy: practical advice for people recovering from illness or managing long-term health conditions
• National Institute for Health and Clinical Excellence (2011) Quality Standard 10, Chronic Obstructive Pulmonary Disease in adults. London: NICE.
• British Lung Foundation (2022) Asthma + Lung UK. Breathlessness.
• McCowan, A., Gustafsson, L., Bissett, M., & Sriram, B. K (2023). Occupational therapy in adults with chronic respiratory conditions: A scoping review. Australian Occupational Therapy Journal, 70(3), pp. 392–415.
• Alam, MDJ (2016) Occupational therapy in respiratory medicine: Global challenge in the 21st century. International Journal of Respiratory Medicine, 1(1), pp. 2-5.
• https://www.asthmaandlung.org.uk/