Advanced Heart Disease & Hospice Care

By: Marisol Ramirez, RN

Every stage of life is important. Abode’s hospice care clinicians understand how to care for late-stage heart failure patients. Every minute of life is valued and deeply treasured. That is why it is our utmost commitment to provide the best expert care and comfort in the last moments of life that matter most. It is a great honor to be a part of your most vulnerable moments, provide expert care, and provide emotional support and guidance when deciding what options are best for your loved one. Have you or someone you love been diagnosed with advanced heart disease?  Perhaps you vaguely remember your physician using the words “hospice care.” But because of fear or feelings of overwhelm, you’re just not sure where to even begin searching for answers? In this guide, we will bring you clear answers that will allow you to make the best-informed decisions for you or your loved one.

What is hospice?

Hospice care is specifically designed with the patient and family in mind. Ensuring that the patients are safe in their homes, comfortable, and pain-free are essential. Comprehensive hospice services serve the patients and their families most pressing needs:

  1. Physical
  2. Spiritual
  3. Social
  4. Emotional needs
  5. Specific patient or family preferences

You may find yourself needing expert clinicians and skilled nurses to help you manage your heart failure, help with pain control, and help maintain the best possible comfort during the last months of life. Or you may need help with obtaining medical equipment. Knowing that your hospice team is available to you 24/7 brings peace and comfort. 

When is the right time to ask about hospice?

Although only your physician can make the diagnosis, referral, and explain your disease’s prognosis, generally, patients on hospice services have less than six months of life. This may be the most difficult decision you will ever need to make. But you don’t have to go through the process alone. Invite your family and the special people in your life to provide support and be present when discussing options with your physician. 

Also, educate yourself and your family on the signs and symptoms to look for in heart disease. Knowing this can help recognize that it may be that time to start inquiring about hospice care. Your hospice team can support you in educating your loved ones on the disease process and can provide support during this time. 

Signs of end-stage heart failure

Recognizing the signs and symptoms of end-stage heart failure is critical. Recognizing signs can help you:

  1. Seek available treatment options available
  2. Make a plan, along with your doctor that will alleviate discomfort 

According to American Heart Association, end-stage heart failure is when most treatments may no longer work, and symptoms will be more frequent. Below are some of the most common signs of advanced heart failure. 

No further medical intervention is possible

There are many medical interventions available for heart failure. At this point, however, you and your doctor may have decided that medical interventions are not in your best interest. However, if you choose, make sure to explore all of the medical interventions available with your doctor, such as:

  • Implantable cardioverter defibrillators
  • The “pump” or left ventricular assist device
  • Pacemaker
  • Major interventions, ex: open-heart surgery
  • Coronary artery bypass graft
  • Temporary therapies, ex: dialysis
  • Heart transplant

Frequent and recurring chest pain

Frequent and recurring angina, or chest pain, is common at end-stage heart failure. It may become more difficult to breathe. Perhaps feeling short of breath with minimal exertion or even while at rest. Your doctor may recommend:

  1. Oxygen help with comfort measures
  2. Medications to relieve chest pain or heart palpitations, when present

Significant symptoms of fatigue and functional decline

According to this study, medical records of patients with end-stage heart failure tend to have symptoms very similar to patients with cancer:

  • Nausea
  • Cachexia (weight loss, including loss of muscle)
  • Constipation

Other common symptoms to note that may affect patients daily functions:

  • Ankle swelling
  • Persistent cough
  • Nocturia or frequent nighttime urination
  • Physical activity or work restrictions

In addition to the cardiac insufficiency, these symptoms may cause patients to feel overly fatigued and with less energy to complete their normal functions of daily living. Patients may require more hands-on care at this time from their caregivers or family to perform tasks such as bathing, dressing, and grooming care.

The patient doesn’t consent to further medical interventions by personal choice

There may come a point even before the “last six months of life” prognosis that patients may come to terms with their end-stage heart failure diagnosis. They may have already decided that they will not consent to further medical interventions if it causes them more pain or poor quality of life. The patient’s loved ones must be present with love, support, and respect for the patient’s decisions. The patient’s decision to refuse further medical treatment can often bring discord from family members. 

The benefits of hospice for a patient with advanced heart disease

The nature of end-stage heart failure is complex. It involves providing support both for the patient and their families during their most vulnerable moments. According to the American Heart Association, there are benefits to receiving skilled nursing interventions in the home. Skilled interventions reduce the risk of getting admitted to the hospital and reduces the risk of mortality for up to six months after discharge from a hospital setting. 

Hospice services provide an array of benefits for patients with advanced heart disease:

  • Your hospice team is actively involved 24/7 in your care,
  • Preventing heart failure exacerbation complications
  • Providing emotional support

If you think you may benefit from the following services below, then hospice care may be for you: 

Personal attention

Every patient is unique and will present with different needs towards their end-of-life care. Your case manager will craft your hospice plan of care to suit your needs, preferences, and health goals.

Medical support.

Competent healthcare professionals and physicians are on staff to specifically address your concerns, signs and symptoms, physical discomforts, or other medical questions you may have. They are on-call around the clock to support you to ensure you receive the best possible medical care in the comfort of your home. 

Comfort 

Our hospice care team is committed to providing patients and families with the emotional and spiritual support needed. 

What does hospice care do for heart disease patients?

Our hospice team’s goal is to relieve the patient’s pain and suffering, prevent complications, ensure safety in the patient’s surroundings, and provide education in regards to end-of-life best practices. Abode’s hospice services ensure that you or your loved one receives the following services. 

Continuous care

Your team may offer continuous care for up to 24 hours if the patient requires very close monitoring or interventions due to a severe problem or health crisis.  

Routine home care

A team of expert and compassionate professionals conduct regular home care visits. The goal is to help in alleviating symptoms, pain control, and educating patients and their families.  

Medical equipment and supplies

Providing the best possible experience at this stage of life is important. Therefore, Abode Healthcare understands that patients obtaining the proper medical equipment and medical supplies can signify that you have more:

  • Mobility options
  • Outings with loved ones
  • Safety
  • A sense of independence and dignity

Inpatient care

Inpatient care is critical during those moments when extra help is needed to control pain or other symptoms. A short-term inpatient stay will be available in such cases.  

What can hospice do for family members?

The absence of proper end-of-life planning for families can cause them to feel that their loved one parted “suddenly,” according to a study conducted in Australia. Ultimately, having a hospice team for family members means:

  • Getting guidance for the family member’s role in end of life care
  • Getting family prepared for the death of a loved one
  • Getting care and support during and after the death of the patient

Bereavement services

Abode Hospice understands that death is a life-changing moment for the survivors. That is why we provide bereavement services for the family to provide care and support for up to 13 months after a loved one’s death. 

Respite care

Caring for a loved one with end-stage disease can be very difficult. Care at home requires a team effort and collaboration from the various parties involved. However, everyone knows that the patient’s family at the bedside is generally the one most involved physically and emotionally in the care of their ill loved one. Therefore, Abode Hospice provides families with respite services. Our services provide up to five days of inpatient respite services. The family can take a much-needed break to walk away for a while and relax. 

Who pays for hospice services?

 Abode Healthcare accepts Medicaid, Medicare, private insurance, and other forms of reimbursement. You may contact your local branch to find out more about hospice services and insurance questions. 

Our mission at Abode Healthcare

Our mission is to provide the best care for our patients as they near the dying experience. Our goals are to provide competent, skilled care, alleviate symptoms, prevent a crisis, provide guidance, comfort, and support for patients and families. We are here with you every step of the way. Contact Abode Hospice Care for more information

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