Psych Issues in Patients

On my current placement I was asked to treat an elderly man who was admitted to the ward for respite because his wife was ill and unable to take care of him at home. The man was in his 80’s and I was asked to see him because he was becoming breathless and keeping the other patients awake by coughing all night. On examination he did not appear to have any problems that could be treated by physiotherapy. His SpO2 was normal and didn’t drop when he became breathless, chest sounds were clear and he didn’t have any diagnosed conditions.
During my subjective examination I discovered that he was a Jew and survived the concentration camps of the 2nd world war. He had a very hard life with a fiancé dying 2 weeks before their wedding and several other major life events taking their toll. Currently he was struggling with his wife and didn’t know whether she wanted him to come home when she was better. During our conversation he became anxious and emotional several times and it was during these episodes that he because wheezy and breathless. I had been told by a nurse that the night before he had run away from the hospital and they had to call the police to help find him and at first I wasn’t sure about the best way to help him.
My solution was to give him three exercises to do. The first was to teach him deep breathing exercises to do and I told him that this would help prevent further periods of breathlessness. The second was to teach him how to use controlled breathing when he was getting emotional to help him control the rate and depth of breathing when he was having one of these panic attacks. He final thing I asked him to do was spend the day finding one things that always makes him happy every time he thought about it. It could be a person, place or event but I told him that whenever he felt like he was going to get breathless that he should think about this thing.
I’m not sure how effective this treatment was because the next morning when I was planning to review his progress I found that he’d been discharged. I think that this was a good learning experience for me to discover how psychological issues can have such a profound physiological effect.