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Congestive Heart Failure: When It’s Time for Hospice and Palliative Care
Medically reviewed by Dr. Mark Fox
Congestive Heart Failure is the medical description of a heart that is slowly losing its ability to pump blood throughout the body. Thanks to medical advances more and more patients are surviving until they are in “late-stage heart failure” when they may experience pain, anxiety and have trouble breathing. Unlike cancer – where the patient seems to have a steady decline – in Congestive Heart Failure (CHF) a patient’s decline may be marked by a series of incidents, where the heart staggers, then rallies. During this decline, more than 75% of CHF patients report not only pain and difficulty in breathing, but also fatigue, depression and accumulation of liquid in the body (edema).
When a person’s heart failure is getting worse or time may be measured in months or years, Palliative Care can help reduce pain, symptoms and stress.
“There comes a time when further testing is unnecessary,” says Dr. Mark Fox, Medical Director of McLeod Palliative Care and McLeod Hospice. “They just need the proper medications that will allow them to maintain comfort and enjoy time with their family.”
When a patient begins experiencing chest pain at rest, irregular heart rhythms, unexplained fainting or multiple cardiac arrests and resuscitations, it’s time to discuss hospice.
Any patient who is experiencing great difficulties with Congestive Heart Failure can request a Hospice and hospice services. A patient’s physician or a hospital discharge planner can assist with selection of a Hospice and help make arrangements.
Most times a person receives hospice care at home. Occasionally, a person may need an inpatient setting, such as the McLeod Hospice House. Or they may need to be admitted to a hospital. All of these are coordinated by the patient’s Hospice caregivers.
“We can’t fix the disease, so we fix the burden of their symptoms, allowing them to enjoy life as much as possible,” says Dr. Fox. “A heart patient may have too much pain, weight loss or trouble breathing. We support them with medications to help improve their appetite, get stronger and maintain a quality of life as long as possible. We may also talk with the patient, family and heart specialists about turning off an implantable defibrillator to prevent a cardiac shock in the final stages of life.”
Medicare, Medicaid and most private insurance plans cover hospice care.
A hospice patient will still have access to their primary care and heart physicians as well as:
- Availability of Hospice personnel 24/7, if needed.
- Treatment for conditions not related to their CHF
- Pain medications
- Medical supplies and equipment
- Emotional Support
- Physical Therapy
- Psychological and Spiritual support
Look for a Hospice that is:
- Connected with your local hospital.
- Accredited by the Joint Commission, a not-for-profit, independent organization that evaluates health care facilities and programs.
- Medicare-certified to meet, at least, minimum requirements for patient care and management.
- Willing to spell out specifically what services it offers.
Sources include: McLeod Health, American Heart Association, Hospice & Palliative Care Nurses Association, National Institutes of Health, Circulation Journal (AHA)