The idea of palliative care can seem overwhelming, but these support systems can make life easier for those with heart failure and their loved ones.

Heart failure is a condition in which your heart can’t pump the amount of blood and oxygen your body needs to function. According to the Centers for Disease Control and Prevention (CDC), roughly 6.2 million adults in the United States live with heart failure.

While there’s currently no cure for heart failure, some treatment options can slow or stop the disease’s progression. But when treatment is no longer effective, such as in the case of advanced heart failure, sometimes the focus may shift to supportive or palliative care instead.

This article discusses what to expect when someone chooses palliative care for heart failure and how to get end-of-life support for a loved one with end stage heart failure.

When someone has advanced heart failure, it means that treatment is no longer effective at slowing down the disease’s progression. Symptoms are often severe at this stage and can significantly affect someone’s overall quality of life.

Palliative care, sometimes called supportive care, describes medical care that can help improve the well-being of people living with serious, chronic health conditions. Palliative care can help improve the following areas and more:

  • mental health
  • quality of life
  • symptom management
  • caregiver support

While there are currently no specific criteria for receiving palliative care, one 2020 research review found that some of the most common reasons for referring someone to palliative care for heart failure include:

  • advanced or late stage heart failure
  • physical and emotional symptoms that worsen
  • multiple hospitalizations in a 6- to 12-month period
  • advanced treatments or no treatments at all
  • a less favorable disease outlook or life expectancy

The decision to pursue palliative care is a personal one that involves various factors ― and the ultimate goal is to come to the decision that’s right for the person with the condition.

According to the World Health Organization (WHO), the overarching goal of palliative care is to reduce the challenges that people with serious conditions can have, including:

  • physical
  • emotional
  • social
  • spiritual

By addressing the above challenges and needs, palliative care can significantly improve the overall quality of life for people with serious conditions.

Palliative care is highly individualized, depending on the person’s condition and needs, but here’s what this care might look like for someone with heart failure:

  • Symptom support: This support incorporates medications that can be effective for addressing symptoms while discontinuing any treatments that may no longer be effective.
  • Decision support: This support offers education on realistic expectations as the disease progresses and can help ensure that all medical decisions align with the person’s preferences.
  • Social support: This support provides feedback, education, and support to family members and caregivers and teaches the skills to process emotions healthily.
  • Mental health support: This support involves getting help from trained mental health professionals and incorporating spiritual support if the person is spiritual or religious.

One of the most common misconceptions about palliative care is that it’s end-of-life care. But palliative care and end-of-life care are different. Although, in some cases, palliative care may include end-of-life care.

For example, palliative care for someone with heart failure nearing the end of their life may include hospice care. Hospice care may include:

  • providing symptom relief
  • honoring end-of-life decisions
  • offering emotional support to the person and their family

Healthcare professionals categorize heart failure into “stages” based on the severity of symptoms. There are two primary stages that the New York Heart Association (NYHA), the American College of Cardiology (ACC), and the American Heart Association (AHA) use to define advanced heart failure:

  • ACC/AHA stage D, which describes advanced heart failure that usually requires hospital, transplant, or palliative support
  • NYHA stage 3 or 4, which describes significant day-to-day symptoms (3) or severe symptoms, even at rest (4)

Many factors can influence how long end stage heart failure lasts, but some studies in a 2018 research review suggested that people living with stage D heart failure may have an average life expectancy of 6–12 months.

If someone you love has received a diagnosis of end stage heart failure, it can be difficult to imagine discussing end-of-life care. But hospice care is one way you can ensure your loved one has the comfort and support they need as they approach the end of their life.

Here are some questions to consider asking when choosing the right hospice care for your loved one:

  • Is the hospice covered under insurance or Medicare?
  • What kind of ongoing services does the hospice offer?
  • What type of care approach does the hospice take?
  • Does the hospice cover extra services, such as after-hours support?
  • How does the hospice integrate your loved one’s current care?
  • Does the hospice provide support for family members?

You can also check out the National Hospice and Palliative Care Organization and the National Association for Home Care & Hospice to find hospice care centers near you.

Supporting yourself or other caregivers

Whether you’ve received a heart failure diagnosis or have a loved one living with the condition, there is support available as you navigate life after diagnosis. Here are a few resources to get you started:

It can be difficult to cope with a diagnosis of heart failure, but neither you nor your loved ones have to go through it alone. Consider checking out the resources above for more support as you take the next steps.

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Heart failure is a serious health condition that affects roughly millions of people across the United States. It can cause various symptoms that can significantly affect someone’s quality of life, especially in the later stages of the disease.

As heart failure progresses to advanced stage heart failure, palliative care can help offer support for the challenges that people with the condition may experience. If you or a loved one lives with heart failure, consider contacting your care team to learn more about the palliative services available to you.