Living With Heart Failure

Heart failure usually can’t be cured, and you will likely have to take medicine for the rest of your life. It’s important that you know that your symptoms may get worse over time. As your symptoms get worse, you may not be able to do many of the things that you did before you had heart failure.

Treatment can relieve your symptoms and make it easier to do some of the things that you like to do. Treatment can also reduce the chance that you’ll have to go to the hospital. For these reasons, it’s very important that you follow your treatment plan. You must:

• Take all of your medicines as your doctor prescribed.
• Make all of the lifestyle changes recommended by your doctor.
• Keep all of your doctor's appointments.

Common causes that worsen symptoms and can lead to a crisis or even a hospital stay are:

• Forgetting to take your medicines
• Not following your diet (such as eating salty foods)
• Drinking excessive amounts of alcohol

If you have trouble following your diet, talk to your doctor. Your doctor can help arrange for a dietitian to work with you on keeping a healthy diet. Alcohol also makes your symptoms worse. If you drink alcohol, don't do so very often, and limit yourself to one drink. If you have severe heart failure, you should not drink alcohol.

People with heart failure often have other serious conditions that require ongoing treatment. If you have other conditions, it’s likely that you are taking medicines for those conditions as well as for heart failure. When taking several medicines, there is always a chance for side effects and interaction between the medicines. Tell your doctor immediately about any problems that you notice with your medicines. Also, talk with your doctor before adding any new medicine. This includes over-the-counter medicines and herbal supplements.

It’s also important that you try to avoid respiratory infections like the flu and pneumonia. Ask your doctor or nurse about getting flu and pneumonia shots.

It’s helpful to have certain information on hand in case you need to go to the hospital or doctor right away. You should plan now to make sure that you have:

• Phone numbers for the doctor, hospital, and people who can take you to the hospital or doctor
• Directions to the hospital and doctor's office
• A list of medicines you are taking

Special Needs for Severe Heart Failure

In the advanced stages, heart failure is a progressive condition that can generally be expected to get worse and eventually lead to death. If you have severe heart failure and symptoms at rest, you can expect your condition to worsen. It’s important that you and your family discuss what you can expect and your final treatment options with your doctor while you are able to do so. The time may come when you are unable to participate in discussions about your care.

Advance directives are documents that tell doctors and hospitals what treatment you want or do not want if you are too ill to speak for yourself. You and your family may decide that you only want treatment to make you comfortable. You, your family, and your doctor may also decide whether you want treatment if your heart or breathing stops.

There are two types of advance directives:

• A living will provides directions and instructions.
• A medical power of attorney names a person you trust to speak for you when you are unable to make decisions.

Advance directives are easy to prepare. You can do it yourself without a lawyer. The only requirement is that you are at least 18 years old. You may prepare your advance directive by:

• Simply writing down your wishes
• Completing a form that your doctor, the hospital, or health department may have
• Using a special computer software program for legal documents
• Going to a lawyer

Depending on the State where you live, the document may also need to be:

• Witnessed by one or two people
• Notarized

As long as you are able to make your own decisions, your advance directives will not be used, and you can accept or refuse any medical treatment. But if you become seriously ill, you may not be able to make decisions about your own treatment.

Give a copy of your living will and power of attorney to a family member, and keep another copy in a safe place. People with severe heart failure are in the hospital often. It’s important that you or a family member bring a copy of your advance directives every time you go to the hospital.

Hospice care

As heart failure worsens, the time may come when treatment is no longer working. If you and your doctor agree that your treatments are not working, hospice care may be an option. Hospice is an organization that can comfort and support you and your family. A team of people provides hospice care. This team includes:

• Doctors
• Nurses
• Social workers
• Nurse's aides
• Chaplains
• Volunteers

The goals of hospice care are to:

• Provide comfort rather than cures
• Give emotional support to you and your family
• Provide care that supports dying with dignity
• Provide spiritual support as requested by you and your family

Hospice supports life and views dying as a natural process. Hospice will work with you and your family to provide the services you need.