Our hospice nurses provide care for several hospice patients with heart disease. And, from experience, there are important questions patients and their loved ones should ask when hospice care services are being considered.
Here are the top questions people with heart disease, or their loved ones, should ask when discussing hospice care. All answers have been provided from VNA's Chief Medical Officer, Dr. Mary Fox.
When is it time to seek out hospice care for a loved one with heart disease?
This question can be hard to answer. As treatments for heart disease are expanding, life expectancy, even for those with severe heart disease, has increased.
However, there comes a time when none of the treatments are working and the heart has weakened so much that hospitalizations are more and more frequent. Most people at this advanced stage of heart disease are miserable and become tired of this pattern.
Hospice care should be considered when patients have had several hospitalizations for heart failure within a short time. Making the decision to seek treatment in hospice allows patients and families to relax a bit, make plans to be together as much as they can, and cultivate the best life possible for whatever time is left.
What are some issues that are unique to working with patients with heart disease?
The most difficult problem in advanced heart disease is fluid overload. This is often very challenging since the kidneys are not usually working well either due to the heart being too weak to pump blood to them. Patients often carry too much fluid, which can be very difficult to relieve.
Image Caption: Dr. Mary Fox takes patient's blood pressure.
What is the hardest part about deciding if hospice care is right for a loved one with heart disease?
I think the hardest part about accepting end-of-life care is that the treatments for heart disease keep changing and improving.
Patients and families are often seeking the next best treatment option that may be just around the corner. But, people eventually tire of constantly going into the hospital and/or being hooked up to IV medications to keep their hearts pumping. Such a way of staying alive can become miserable.
Are there special techniques (VNA) hospice nurses use to help everyday issues?
Our VNA nurses are very experienced in monitoring signs of fluid overload and the anxiety that usually goes along with it, as well as managing the patient's symptoms- with the exclusion of medications given by vein and use of external heart pumps.
How do hospice nurses help heart disease patients manage their symptoms?
Patients and caregivers are instructed in the symptoms of fluid overload, nutritional modifications, and when to take medications to help alleviate the symptoms.
What are some goals or guidelines when it comes to diet and nutrition for patients with heart disease?
With end-stage heart disease, patients have often been on low salt diets for some time before they come under hospice care.
Unfortunately, this diet can be very bland for many people, and seniors will frequently not eat much because of the lack of flavor. And, of course, when a person doesn't eat much, they get weaker.
With VNA hospice care, we're all about making life more enjoyable. Since food often brings pleasure to people, our hospice team is definitely more liberal with a patient's dietary choices.
What kind of mobility or exercise is managed or advised by nurses during patient care?
For people with advanced heart disease, exercise and mobility are simply, as tolerated.
Almost all patients with heart disease are very limited in their activities due to the severity of their illness.