Patients with heart failure who die in hospice

Zambroski, Cheryl Hoyt; Moser, Debra K.; Roser, Lynn P.; Heo, Seongkum; Chung, Misook L.

doi:10.1016/j.ahj.2004.06.019

Cited by 54 publications

(42 citation statements)

References 15 publications

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“…Physician and patient report of NYHA status do not correlate well (16), and NYHA also differs from a classification based on metabolic equivalents assigned to patient-reported activity (17). Tools to assess symptoms used in HF patients include the Memorial Symptom Assessment Scale (MSAS) (18), modified for HF (19), and the Edmonton Symptom Assessment Scale (ESAS) (20). The MSAS-HF is a 32-item tool that rates frequency over the previous 2 weeks of symptoms, as well as their severity and distress, but its complexity and length may limit clinical use.…”

Section: Comprehensive Hf Carementioning

confidence: 99%

Palliative Care in Congestive Heart Failure

Goodlin¹

2009

Journal of the American College of Cardiology

327

219

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Symptoms and compromised quality of life prevail throughout the course of heart failure (HF) and thus should be specifically addressed with palliative measures. Palliative care for HF should be integrated into comprehensive HF care, just as evidence-based HF care should be included in end-of-life care for HF patients. The neurohormonal and catabolic derangements in HF are at the base of HF symptoms. A complex set of abnormalities can be addressed with a variety of interventions, including evidence-based HF care, specific exercise, opioids, treatment of sleep-disordered breathing, and interventions to address patient and family perceptions of control over their illness. Both potential sudden cardiac death and generally shortened length of life by HF should be acknowledged and planned for. Strategies to negotiate communication about prognosis with HF patients and their families can be integrated into care. Additional evidence is needed to direct care at the end of life, including use of HF medications, and to define management of multiple sources of distress for HF patients and their families.

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Section: Comprehensive Hf Carementioning

confidence: 99%

Palliative Care in Congestive Heart Failure

Goodlin¹

2009

Journal of the American College of Cardiology

327

219

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“…This is a fact that cannot be ignored by clinicians, patients and their families [1][2][3]. An emerging literature underscores the limitations of healthcare systems in dealing with palliative and supportive care in heart failure [4,5,6 ,7 ,8,9].…”

Section: Introductionmentioning

confidence: 99%

Difficult conversations and chronic heart failure: do you talk the talk or walk the walk?

Davidson

2007

Current Opinion in Supportive &Amp; Palliative Care

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When having these difficult conversations, clinicians need to assess the individual's need and wishes for information as well as their social and cultural background. They also need to consider the setting, timing and content of the discussion, as well as strategies to promote coping and adjustment. Most importantly, patients need a treatment plan to address palliative and supportive care needs to be implemented at the time of breaking this bad news, so that they and their families do not feel abandoned. Learning effective communication skills, implementing strategies for debriefing and the fostering of a team approach, may minimize burden on health providers and improve palliative and supportive care for people with heart failure.

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“…If patients meeting these criteria are not candidates for heart transplantation or other advanced therapies, their mortality rates are similar to those of cancer [7,8]. They have also been shown to have the same symptom burden as patients dying of cancer [8,9•,10-13].…”

Section: Introductionmentioning

confidence: 99%

The use of positive inotropes in end-of-life heart failure care

Nauman

2007

Curr Heart Fail Rep

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End-stage heart failure is associated with mortality equivalent to cancer, yet there is little information about palliative therapy for this disease. Chronic outpatient support with inotropes provides symptomatic relief and life extension for those select patients demonstrating dependence on positive inotropic therapy. The purpose of this review is to provide information about process and implementation of chronic outpatient support with inotropes in patients with end-stage heart failure.

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Patients with heart failure who die in hospice

Cited by 54 publications

References 15 publications

Palliative Care in Congestive Heart Failure

Palliative Care in Congestive Heart Failure

Difficult conversations and chronic heart failure: do you talk the talk or walk the walk?

The use of positive inotropes in end-of-life heart failure care

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