Home Care Helps Seniors Who Are Living With Heart Failure
February 14–20, 2016, Is National Heart Failure Awareness Week
February is American Heart Month. During the third week of this recognition period, cardiologists will call attention to heart failure, a condition that costs Americans more than $30 billion each year and affects more than 5 million Americans, most of them older adults.
Heart failure (sometimes called congestive heart failure) occurs when the heart is weakened and cannot pump enough blood for the body’s needs. Heart failure can be caused by other exisiting heart conditions, such as coronary heart disease, as well as by diabetes, high blood pressure and certain lifestyle factors.
Although doctors offer a range of treatments for heart failure, many seniors assume the symptoms are "just signs of old age." This assumption can prevent them from receiving a prompt diagnosis and getting the treatment they need.
It's important to be alert for the symptoms of heart failure, which include:
- Shortness of breath.
- Difficulty breathing when lying down.
- Swelling of feet, ankles and abdomen.
- Coughing and raspy breathing.
These symptoms should be evaluated by a doctor. If the diagnosis is heart failure, treatment may include surgery, medications and careful management of underlying health conditions. The doctor also will most likely recommend self-monitoring and lifestyle changes, such as eating a heart-healthy diet, managing sodium and fluid intake, avoiding smoking and alcohol, maintaining a healthy weight, and following an appropriate exercise routine.
Today, many heart failure patients are referred to cardiac rehabilitation, a medically supervised program that includes exercise training, lifestyle education, counseling, and assistance with managing the patient's medical routine. The American Heart Association (AHA) reports that cardiac rehabilitation increases both the length and quality of patients' lives, as well as reduces depression and hospitalizations. Medicare and Medicaid recently began covering cardiac rehabilitation for certain patients with heart failure, and the AHA has recommended that this coverage be expanded.
Heart failure presents health management challenges.
Many patients find it almost overwhelming to manage their heart failure care routine. In a 2015 study published in the Journal of the American Heart Association, Dr. Candace D. McNaughton of Vanderbilt University Medical Center reported, "The treatment for heart failure can be complex and difficult to understand. It’s important for patients to let their healthcare providers know if they don't understand the directions they were given for their medications, salt and fluid intake, and weight monitoring." McNaughton says that even people who are highly literate and educated may find these instructions daunting. She suggests that patients bring along a family member or friend during doctor visits. Take notes and ask for written instructions if possible.
Practical concerns also may stand in the way. A second 2015 study from the AHA reported, "Although supervised aerobic physical activity is a proven therapy for heart failure patients, lack of social support and practical barriers such as lack of transportation keep many patients from benefiting from cardiac rehab programs." Dr. Lauren B. Cooper of Duke University School of Medicine emphasizes, "Patients, family members and healthcare providers should work together to find solutions to the barriers preventing a patient from participating in a structured exercise program because exercise programs can help patients manage their condition."
Family caregivers often step in to support their loved one's care needs. Local senior services agencies and geriatric care managers (now commonly known as aging life care professionals) can help create a support system. Many families also find that in-home care provides the extra help their loved one needs. A professional in-home caregiver can support compliance with the healthcare provider's recommendations, assisting with:
Medications. Heart failure patients may take a number of medications to treat the condition, in addition to drugs for other health conditions they have. In-home caregivers can take clients to the pharmacy or pick up prescriptions, and assist with pill boxes and other medication reminders.
Diet. Most heart failure patients are prescribed a special diet. In-home caregivers can go to the grocery store and prepare nutritious meals following the healthcare provider's recommendations. Switching from salty, processed foods to a diet with fresh, healthy ingredients is easier with the help of a caregiver.
Medical appointments. Doctor visits, cardiac rehabilitation sessions, smoking cessation classes, counseling for depression—almost all these appointments happen during the day, when family members often are at work. In-home caregivers help clients keep track of these appointments, provide transportation and assist with navigating the often-challenging care regimen.
Keeping a heart failure diary. Many patients are advised to keep a daily record of weight, fluid intake, leg swelling and shortness of breath. In-home caregivers can remind them to do this, as well as help them report concerning signs such as a sudden, steady weight gain; increased fatigue or swelling; and difficulty breathing.
Exercise. Most patients will receive a "prescription" for an appropriate exercise routine. Caregivers provide encouragement, assistance and an extra level of confidence by accompanying clients on walks, reminding them to do their prescribed exercises, and setting up exercise equipment and exercise videos.
Housekeeping and laundry. Some household tasks are challenging and may be prohibited for people with heart failure. In-home caregivers keep the home clean and in good order and remove fall hazards. And if bathing, dressing and grooming are difficult, professional caregivers can help. Depression is a common side effect of heart failure … but feeling clean and well-dressed is a great mood boost!
The challenges of heart failure make it harder to maintain a healthy lifestyle, which in turn worsens heart failure. In-home care helps clients stay on track with their health management routine—and provides peace of mind for families, as well.
The National Heart, Lung, and Blood Institute offers an overview of heart failure.
The Heart Failure Society of America offers consumer information on treating and living with heart failure.
For information on topics related to home care and healthcare, visit our Home Care and Healthcare Advocacy group on LinkedIn.
The information in this article is not intended to replace the advice of your healthcare provider. Talk to your doctor if you have questions about heart health or your recommended treatment.