Attendance Allowance check → Attendance Allowance for COPD and breathlessness

Attendance Allowance for COPD and breathlessness

How COPD, heart failure and other breathing problems show up on the AA1: washing, stairs, oxygen, nebulisers and bad nights, and what to write.

Written and checked by the Attendance Allowance Check team at Virix Ltd. Last reviewed 25 September 2026 against gov.uk.

Breathlessness does not always look like a disability from the outside. Someone with COPD, heart failure or another long-term lung or heart condition may walk into the kitchen unaided. What an onlooker does not see is the ten minutes sitting on the edge of the bed after putting on socks, the shower they now avoid, or the nights spent propped up and frightened. Attendance Allowance can be claimed for exactly this kind of need, but only if the form describes it. This guide looks at how breathing problems affect the questions on the AA1, and at what to write. For the shorter overview, see our conditions page.

How breathing problems fit the rules

Attendance Allowance is for people over State Pension age who need help with personal care, or need someone to keep an eye on them to stay safe, and have needed that for at least six months. It is not paid for the diagnosis, and a spirometry result or an oxygen prescription does not decide the claim by itself. What decides it is the help with everyday bodily functions, such as washing, dressing, getting in and out of bed, using the toilet and moving about indoors, that the person reasonably needs, by day and by night. The eligibility check sets out the full conditions.

The DWP’s guidance for decision makers includes breathing among the bodily functions for which someone may need help. Its example is someone with severe respiratory problems who can only breathe reasonably well when propped up in bed, slides down during the night, cannot pull themselves back up, and so needs propping up repeatedly. That is the kind of detail worth describing.

Where the difficulty usually shows

Washing and dressing

Steam, bending and lifting the arms all make breathing harder. People often describe having to stop halfway through washing, sitting down to dry themselves, being unable to wash their hair or lower legs, or needing someone to help with socks, shoes and tights because bending forward takes their breath. The AA1’s dressing question even gives “you may get breathless” as an example of what to tell them. Say how long washing and dressing take now, how many rests you need, and what you have stopped doing because of it.

Moving about indoors, and the stairs

Question 33 is about moving around indoors, including stairs. If you stop on the stairs, sleep downstairs because of them, or need someone behind you, say so. Questions 24 to 26 ask what kind of home you live in and whether the toilet and bedroom are upstairs, which helps the decision maker picture the day.

Tiredness

Fatigue from a heart or lung condition can be as limiting as breathlessness. If one task leaves you unable to do the next, for example washing in the morning means you cannot dress until later, describe the whole sequence and the time it takes.

Oxygen, inhalers and nebulisers

Question 36 asks about help with medicines and medical treatment, and gives inhalers and oxygen therapy as examples. Help counts if you need someone to set up or clean a nebuliser, manage oxygen tubing and cylinders, remind you which inhaler to use and when, or help you use a spacer because of weak hands. The guidance also says that medical attention you reasonably need, such as from a district nurse, can be added to other help when the decision maker looks at the whole picture.

Nights

Night-time breathlessness, coughing fits, needing to be propped up or moved, needing help to the toilet or commode when breathless, or needing someone to fetch oxygen or a nebuliser, all belong in the night section (questions 42 to 45). The guidance also says that helping someone who cannot sleep because of discomfort or distress can count. Our guide to night-time needs explains how to count times and minutes.

Panic and anxiety

Breathlessness and panic often feed each other. If someone needs to stay with you, talk you through an attack or help you use your inhaler because you cannot manage it while panicking, that is help worth describing, with how often it happens and how long it lasts.

Flare-ups and bad weeks

Chest infections, exacerbations and hospital stays make some weeks much worse than others. Question 38 asks how many days a week you have difficulty. Give a realistic average and describe what a bad spell looks like and how often it comes. Questions 47 to 49 ask about hospital stays, with dates. The notes that come with the form suggest keeping a record over a good day and a bad day.

Falls, dizziness and blackouts

Question 34 asks whether you fall or stumble, and mentions feeling faint, dizzy or blacking out. If breathlessness or low oxygen makes you dizzy and you have fallen, give rough dates, what happened and whether you could get up alone.

What to write at the key questions

Illustrative examples

These are made-up examples to show the level of detail, not real people or wording to copy.

At question 31 (washing): “I cannot stand in the shower because the steam makes me too breathless. I have a strip wash sitting on a stool, and I have to stop two or three times to get my breath back. It takes about 40 minutes. My husband washes my back, legs and feet and helps me dry, because bending forward leaves me gasping. My hair is washed once a week, by him, over the sink.”

At question 42 (nights): “Four or five nights a week I wake up unable to breathe and slide down the pillows. I cannot pull myself back up, so my daughter, who lives with me, props me up and sets up the nebuliser. It takes 20 to 30 minutes before I settle, and it happens once or twice a night.”

More examples are in our guide to example answers, and the daytime questions guide covers questions 28 to 41 in detail.

Aids, and what the decision maker may ask

The DWP’s guidance says the need for help may be reduced by practical solutions, such as an aid or a different arrangement, and gives the example of medication placed by the bed rather than someone getting up to fetch it. It also says the decision maker must consider whether a solution is reasonable and practical for that person, and what its consequences would be. If you already use a shower seat or keep your inhaler by the bed and still need help, explain why.

If someone is very ill

If a doctor or other medical professional has said someone may have 12 months or less to live, the special rules apply: no six-month wait, faster handling, and the higher rate. See GOV.UK’s page on claiming if you’re nearing the end of life.

Getting the form, and free help

You can claim online, or download the AA1 from GOV.UK, fill it in on paper and send it by post; GOV.UK explains how to claim. In Scotland, Pension Age Disability Payment replaces Attendance Allowance. Asthma + Lung UK has information for people living with lung conditions, and Age UK and Citizens Advice help with benefit forms free of charge where they can. The guide to the whole AA1 covers the rest of the form, and common mistakes lists what trips people up.

Nothing on this page is medical advice, and we cannot say whether any claim will succeed; that is decided by the DWP.

If you would like a hand with it

We are a private company, Virix Ltd, not part of any government department. We go through the AA1 with you, or with the person you care for, over the telephone, write the answers up in your own words, then print the form and post it to you to read, sign and send. It costs £149, once. If the claim is refused, we help you ask for the decision to be looked at again at no extra cost, and if the answer is still no, we refund the full £149. Or you can choose to pay £249 only if the claim is awarded. Equally, the claim is free to make yourself, and Age UK and Citizens Advice help at no charge where they have capacity, as do some local services; Asthma + Lung UK also offer free information. How the options compare.