BACKGROUND: I'm 64 yo, I have COPD, as does my 84 yo dad and my 80 yo uncle (Dad's brother), we live in a rural area, no nearby specialists, local docs are so-so with COPD knowledge. My uncle is in End Stage, in bad shape. He can't walk from one end of a room to the other without sitting down to rest, has lost tremendous amt of weight, has no appetite, is on oxygen 24/7. He refused to accept that he had COPD and has done basically nothing over the yrs to slow it down, wouldn't listen to my dad, wouldn't share symptoms with doctors. He WILL NOT go out of town to a specialist, so that's a nonstarter...I don't understand him and why he is the way he is, but, at this point, that doesn't really matter. I don't have to know or agree to want to help him if I can. He just got out of the hospital again last week (pneumonia), the dr. said "end stage" and basically go home and die, I asked some of these questions and got nothing. My uncle is suffering alot, he lives alone (my aunt is in the nursing home with other health issues right now). They have 8 adult children, all living 3 to 4 hrs away, all seem to be complacent about their dad's situation and haven't educated themselves about this disease as far as I can tell. I don't know if he'll accept my help, and it won't be easy to do if he does, being caretaker for my parents and with my own health issues, but I have to try. I cannot sit back and watch him suffer and decline without trying one more time. I plan to go talk to him next week to see if he'll let me come a cpl hrs a day, but where do I start? His activity tolerance is so low, I don't see how he can exercise yet I believe he needs to do SOMETHING. I know it will have to be a slow start, and I need to get the best "bang for the buck" so to speak. So, should I start with seated exercises, like sitting leg raisers, arm windmills, toe touches or would that be of minimal value at this point? Would it be better to start with slow, progressive strengthening in his walking capacity...or some of both? WHat dietary changes for someone with no appetite that would be beneficial for maintaining weight and possibly improve breathing? I guess what I'm seeking are ideas that will us STARTED, beginner efforts that have a chance to provide some relief of symptoms, start to build some strength and improve his life...or has the door already closed? I've search and searched and read but have found nothing that really addresses how or where to start with someone who has deteriorated to this level. And please understand that I know what would best...a specialist, a therapist, PROFESSIONALS, but I ask you to understand that my best hope is that he'll allow ME to help. If I go there and start lecturing and pushing what he refuses to do, I'll have lost before I even begin. I can't give up on him and anything you can share will be very much appreciated. (I apologize for the length of this post!)