Future care planning: a first step to palliative care for all patients with advanced heart disease

Abstract

Palliative care is recommended for patients with end-stage heart failure with several recent, randomised trials showing improvements in symptoms and quality of life and more studies underway. Future care planning provides a framework for discussing a range of palliative care problems with patients and their families. This approach can be introduced at any time during the patient's journey of care and ideally well in advance of end-of-life care. Future care planning is applicable to a wide range of patients with advanced heart disease and could be delivered systematically by cardiology teams at the time of an unplanned hospital admission, akin to cardiac rehabilitation for myocardial infarction. Integrating cardiology care and palliative care can benefit many patients with advanced heart disease at increased risk of death or hospitalisation. Larger, randomised trials are needed to assess the impact on patient outcomes and experiences.

To explore the prevalence and outcomes of advance care planning for patients with left ventricular assist devices: A review

“…Nonetheless, the literature suggests that as illness progresses hope might be reshaped and maintained when patients are assured that their future care will be consistent with their values (Davison & Simpson, ). While cardiologists are focused on improving patients' QOL by maximising cardiac functions, palliative care (PC) services integrated into the care of patients with advanced HF will address their holistic needs (Denvir et al, ).…”

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

“…A decision to alter the focus of care from modifying disease progression to optimising quality of life should be made in discussion with the patient, cardiologist, nurse and general practitioner. The patient's family should be involved in such discussions if requested by the patient ( Table ).…”

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

“…Również rodzina pacjenta powinna być włączona w dyskusję na ten temat, o ile takie jest życzenie chorego (tab. 14.4) [652,653]. W tabeli 14.5 zawarto podstawowe zalecenia dotyczące podstawowych elementów opieki paliatywnej.…”

“…W większości przypadków cała rodzina powinna otrzymać wsparcie socjalne [652]. Odpowiedni plan postępowania należy opracować podczas dyskusji z pacjentem i jego rodziną.…”