End-of-life care for CHF patients involves ensuring proper nutrition, adequate rest, physical rehabilitation, and caring for physical, mental, and emotional needs
End-of-life care for congestive heart failure (CHF) patients involves ensuring proper nutrition, adequate rest, physical rehabilitation, and caring for physical, mental, and emotional needs.
- Proper nutrition: End-stage CHF patients generally have a poor appetite, and lack of proper nutrition may make their symptoms worse. The palliative care team helps ensure the patient gets the nutrients they need without aspiration (entry of food or liquids into the airways).
- Adequate rest: As symptoms worsen, it may be difficult for the patient to get proper sleep. Palliative care helps reduce symptoms such as anxiety, cough, and shortness of breath, which can make the patient more comfortable and rest more easily.
- Physical rehabilitation: CHF symptoms can make it difficult for the patient to perform even simple tasks such as brushing their teeth or using the bathroom without feeling breathless. Lack of physical activity can also increase the risk of complications such as bed sores and deep vein thrombosis (DVT). The palliative care team supports the patient with appropriate physical rehabilitation without aggravating their symptoms.
- Addressing physical symptoms: Medications and physical therapy are often used in combination with each other to ease symptoms such as shortness of breath, chest pain, and swelling. This helps improve the patient’s quality of life.
- Mental and emotional care: End-stage CHF can make the patient apprehensive, anxious, irritable, or depressed. Proper counseling or psychotherapy can help them deal with the disease more effectively.
- Caregiver support: Caregivers of patients with advanced CHF need to be cared for as well. Seeing a loved one getting closer to death can be extremely difficult, and family members are often at a loss as to how to address their loved one’s needs. The palliative care team eases the burden and ensures that both the care team and the caregiver are on the same page and prepared for what is to come.
What is CHF?
Congestive heart failure (CHF) is a chronic condition in which the heart does not pump enough blood to meet the body’s demand for oxygen and nutrients This causes a buildup of fluid in the lungs and other parts of the body, typically the feet, ankles, and legs. Heart failure does not mean that the heart has stopped working or is about to stop working; it simply means that it is not working efficiently enough to do its job of pumping blood to various body parts.
Heart failure can affect anyone, although it is more common in men than in women. It affects about 870,000 people each year in the United States. Heart failure is more common in older individuals (over 65), those who are obese or overweight, African Americans, and individuals with underlying cardiovascular diseases (such as heart attack or high blood pressure).
What is end-of-life care?
End-of-life care or hospice care refers to the care of a dying patient. These terms are often used interchangeably with palliative care. Palliative care is a broader term that refers to improving the patient’s quality of life and making things easier for their families. It is offered to patients with serious diseases such as congestive heart failure (CHF), cancer, chronic obstructive pulmonary disease (COPD), and chronic renal failure (CRF).
End-of-life care focuses on helping the patient feel as comfortable as possible and helping family members cope with the challenge of looking after their ailing loved one, rather than improving disease prognosis. End-of-life care bridges the gap between the patient’s needs and their caregiver's concerns, bringing everyone on the same page.
The care team includes professionals who specialize in palliative care, such as:
- Treating cardiologist
- Nurse
- Counselor
- Physiotherapist
- Psychologist
- Dietitian
- Volunteers
QUESTION
In the U.S., 1 in every 4 deaths is caused by heart disease.
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How to get palliative care for CHF
Over 6 million patients have heart failure in the United States. About 10% of these patients are in advanced stages of the disease. Despite the enormous need for palliative care, only a few patients take advantage of it.
If you are seeking palliative care for your loved one, talk to a doctor or go to a Palliative Care Provider Directory to find palliative care facilities nearby.
Family members can also join support groups to connect with other patients and families coping with heart failure. One such group is through the American Heart Association (AHA) and can be accessed on supportnetwork.heart.org/heart. Another support group that provides valuable information is called Conquering CHD.
Palliative care helps address both patients’ and caregivers’ concerns, making it possible to cope with CHF with dignity and as much comfort as possible.
