End-Of-Life Care for Patients With End-Stage Heart Failure, Comparisons of International Guidelines

Heart failure (HF) is a chronic, debilitating condition associated with significant morbidity, mortality, and socioeconomic burden. Patients with end-stage HF (ESHF) who are not a candidate for advanced therapies will continue to progress despite standard medical therapy. Thus, the focus of care shi...

Full description

Saved in:

Bibliographic Details
Published in:	American journal of hospice & palliative medicine Vol. 41; no. 1; pp. 87 - 98
Main Authors:	Rivera, Frederick Berro, Choi, Sarang, Carado, Genquen Philip, Adizas, Arcel V., Bantayan, Nathan Ross B., Loyola, Gerard Jude P., Cha, Sung Whoy, Aparece, John Paul, Rocha, Anlene Jane B., Placino, Siena, Ansay, Marie Francesca M., Mangubat, Gerard Francis E., Mahilum, Mer Lorraine P., Al-Abcha, Abdullah, Suleman, Natasha, Shah, Nishant, Suboc, Tisha Marie B., Volgman, Annabelle Santos
Format:	Journal Article
Language:	English
Published:	Los Angeles, CA SAGE Publications 01-01-2024
Subjects:	Death Heart Failure - therapy Humans Palliative Care Quality of Life Terminal Care heart failure palliative care end-of-life care
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Heart failure (HF) is a chronic, debilitating condition associated with significant morbidity, mortality, and socioeconomic burden. Patients with end-stage HF (ESHF) who are not a candidate for advanced therapies will continue to progress despite standard medical therapy. Thus, the focus of care shifts from prolonging life to controlling symptoms and improving quality of life through palliative care (PC). Because the condition and prognosis of HF patients evolve and can rapidly deteriorate, it is imperative to begin the discussion on end-of-life (EOL) issues early during HF management. These include the completion of an advance directive, do-not-resuscitate orders, and policies on device therapy and discontinuation as part of advance care planning (ACP). ESHF patients who do not have indications for advanced therapies or those who wish not to have a left ventricular assist device (LVAD) or heart transplant (HT) often experience high symptom burden despite adequate medical management. The proper identification and assessment of symptoms such as pain, dyspnea, nausea, depression, and anxiety are essential to the management of ESHF and may be underdiagnosed and undertreated. Psychological support and spiritual care are also crucial to improving the quality of life during EOL. Caregivers of ESHF patients must also be provided supportive care to prevent compassion fatigue and improve resilience in patient care. In this narrative review, we compare the international guidelines and provide an overview of end-of-life and palliative care for patients with ESHF.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1
ISSN:	1049-9091 1938-2715
DOI:	10.1177/10499091231154575