What is palliative care for heart failure?

Katie Ortlip
Hospice Nursing

Palliative care is comfort care, so when someone has palliative care for heart failure, there are no longer curative options, such as surgery, and other aggressive treatments that require hospitalization. Often times people have been in and out of the hospital one too many times, and say "no more!" They then make the decision to focus on comfort. I recently had a patient who had been in the hospital several times over the few months before he came on hospice, with chest pain and shortness of breath. He had end-stage heart disease, and knew he was not going to get better. He wanted to focus on comfort, and stay at home. Palliative care for heart failure includes a variety of medications, from morphine drops and Ativan for shortness of breath, to diuretics to remove excess fluid from the body. Equipment, such as oxygen and a hospital bed are often times helpful. The nurse sees the person regularly, so symptoms can be minimized. When comfort and quality-of-life is the goal, palliative or hospice care are great options.

Diseases of the heart and circulatory system are the leading cause of death in the United States. Congestive heart failure (CHF) is a progressively debilitating illness that eventually will lead to death. In this disease the heart gradually loses its ability to pump blood effectively. Without a good blood supply, muscles and organs don't get enough oxygen, causing problems. Because blood doesn't circulate as it should, fluid backs up in the lungs and lower parts of the body. That's why people with this disease often have swelling in the feet and legs. The body is "congested" with fluid, which is why this disease is called congestive
heart failure.

Palliative care relieves the symptoms of heart failure, such as pain, shortness of breath, fatigue, constipation, nausea, loss of appetite and difficulty sleeping. It helps you gain the strength to carry on with daily life. It improves your ability to tolerate medical treatments. And it helps you have more control over your care by better understanding your choices for treatment options.

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