When Should Heart Failure Patients Call Hospice?

January 27, 2022

Elderly couple holding hands

The heart is a muscle in the chest that pumps blood from veins to arteries. Blood delivers oxygen to other vital organs in the body. 

What is Heart Failure?  

Heart Failure is a type of heart disease. It is a result of the heart muscle not pumping blood as effectively as it should. This causes back-ups in the blood and fluid to build in the lungs, heart, abdomen, and other parts of the body. According to the Cleveland Clinic, Heart failure is the leading cause of hospitalization for adults over the age of 65. 

Acute Heart Failure occurs when symptoms develop rapidly. When symptoms develop slowly over weeks or months, it is considered Chronic Heart failure. The CDC reports in 2018, heart failure was mentioned on 31.4% of all death certificates. 

Heart failure progression happens in four stages: A, B, C, and D.  

Stage A Heart Failure 

Stage A is considered pre-heart failure and means you are at high risk for developing heart failure. According to the CDC, your risk of heart failure may increase if you have other medical conditions including but not limited to:  

  • Coronary artery disease (CAD) and heart attacks 
  • Diabetes 
  • High blood pressure 
  • Obesity 
  • Valvular heart disease 

Increased Risks of Heart Failure 

Unhealthy behaviors may also increase your risk of Heart Failure. These can include: 

  • Smoking tobacco 
  • Excessive alcohol intake 
  • Foods that are high in fat, cholesterol, and sodium 
  • Not maintaining regular exercise or physical activity 

At this stage in the diagnosis, your doctor will recommend making positive changes to your lifestyle. Treatment may also include medications to manage cholesterol and blood pressure. 

Stage B Heart Failure 

Stage B is also considered pre-heart failure. In Stage B, patients have been diagnosed with a heart condition but have not yet had symptoms of heart failure. Patients in this stage have an ejection fracture, or percentage of blood pumped out after a heartbeat, of 40% or less. Patients in this stage may be prescribed medicines such as Beta-Blockers or medication to control diabetes. In some cases, surgery may be needed for artery blockage or heart valve replacements. 

Stage C Heart Failure 

During Stage C, patients have been diagnosed with heart failure and are currently experiencing symptoms of the disease. The most common symptoms of heart failure include:  

  • Chest pain 
  • Shortness of breath 
  • Severe fatigue 
  • Dizziness 
  • Fluid retention and swelling  
  • Irregular heartbeat 

At this point, additional medications may be added to your treatment plan already established during stages A and B. Other options may include diet restrictions to lower sodium intake, tracking your weight daily, and possible fluid restrictions. Your treatment plan and the options best suited for your needs will be discussed and monitored by your primary care physician. Some may find it helpful to seek additional support during this time. This may include family members, close friends, or additional guidance from healthcare professionals that specialize in palliative care.  

Palliative Care for Heart Failure 

Palliative Care is specialized care for people living with a life-limiting illness. It offers an extra layer of support to focus on the physical, spiritual, and emotional symptoms you may be experiencing. Palliative care practitioners work directly with your primary care provider by offering additional recommendations for your care. At times you may feel overwhelmed by your treatment plan and new restrictions and medications. Your palliative care practitioner can help offer additional education and answer questions you may have thought of after visiting with your primary care physician.  

EverHeart Hospice offers palliative consultation visits completed by one of their nurse practitioners. They provide these visits wherever you call home, including your own home, nursing facility, or assisted living facility. They also provide education and support through follow-up telephone calls.  

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Stage D Heart Failure 

By the time a patient reaches Stage D, symptoms have advanced and do not get better, even with treatment. Living with Heart Failure is challenging for patients and caregivers. These symptoms are often stressful and can lead to anxiety and repeated Emergency Room and Hospital Visits.  

Patients in Stage D heart failure may need a heart transplant or continuous intravenous medication to survive. At this point in the disease, patients may wish to seek hospice care to manage their condition. 

Unfortunately, only about 50% of people diagnosed with Heart Failure live longer than five years.  

Patients with an estimated life expectancy of 6 months or less are eligible for Hospice. Hospice Care is unique in that it is provided wherever a patient calls home. 

Heart Failure patients may need to consider Hospice when: 

  • They continue showing symptoms despite medication to relieve fluids 
  • Abnormally fast heart rhythm despite treatment 
  • Unexplained fainting 
  • Unexplained or unintentional weight loss 
  • Patient desires to stay out of the hospital if the condition gets worse
  • Ejection fracture 20% or lower 

While Hospice cannot cure a disease, it keeps the patient comfortable and focuses on quality of life. To receive Hospice, your physician must agree that your condition is unlikely to improve and looks at a variety of factors when making this recommendation. Examples include increased hospitalizations, decreased ability to complete activities of daily living such as bathing, feeding, toileting, etc, and unintentional weight loss. 

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How does Hospice Help Heart Failure Patients? 

Symptoms such as feeling out of breath can be uncomfortable and cause stress and anxiety. The expert care team at EverHeart Hospice is available to explain the course of your illness. They can answer your questions and help you understand what you can expect as your heart failure worsens.  

Our team makes recommendations to keep patients comfortable and pain-free as they near the end of life. The goal is to improve quality of life and to treat the patient with dignity no matter their condition. Physicians, nurse practitioners, and nurses all treat patients wherever they call home. There is no need to make office visits under Hospice Care. 

Hospice Aides are available to assist with tasks of daily living such as feeding, bathing, dressing, medical supplies, and toileting. Nutritional supplements, medical equipment, and medications are all provided by EverHeart Hospice. 

With a team that also includes Social Workers, Chaplains, Music Therapists, Bereavement support, and volunteers, you are not alone in your journey. 

How to get Hospice Care: 

Call EverHeart Hospice at 1-800-417-7535 to start Hospice Care for you or a loved one. We are available to answer calls 24 hours a day, 7 days a week.

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