At stage 4 you may begin to struggle with breathing in your day to day life. In some cases exacerbations become serious enough that they're life threatening. It is likely that your quality of life is significantly reduced. If your COPD reaches this stage you may begin to fear suffocation and pain 3 - 4.
Extreme shortness of breath can be extremely frightening but it can be treated with oxygen. However, during the final stages of COPD the lungs are not able to breathe out carbon dioxide. Rather than the panicked suffocation you may fear, this actually leads to a calming effect/drowsiness and ultimately a coma 3 - 4.
Many people are worried about suffering from extreme pain. While this is rare, your doctor can prescribe effective pain relief that suits the type of pain you’re experiencing, whether that’s constant pain or bursts of isolated pain. You may also wish to discuss with your family where you’d be most comfortable – a hospice or remaining at home 3 - 4.