Hospice of the Comforter

     It’s an ongoing challenge for hospices throughout the country to educate their communities on how hospice can help those with end-stage heart disease. Although heart disease is still responsible for the most deaths nationwide, only 12% of hospice patients have this admitting diagnosis.

For those who are weakened by a failing heart, hospice offers valuable services that can help them live more comfortably at home , supported by a specially trained health care team.

     Hospice physicians and nurses help with relieving pain and shortness of breath and the sleeplessness, anxiety and depression that commonly develop. The medical team coordinate appropriate medication management and can also determine which medical equipment may be needed. Most cardiac and symptom management medications as well as assistive equipment are covered under the Hospice Medicare Benefit, and the nurse can arrange for home delivery. The hospice nursing assistant can help with personal care when needed and the social worker and chaplain help with the supportive emotional and spiritual care for both the patient and the family.

     Heart disease is usually a long-term chronic illness that has it ups and downs over the years. It’s time to call hospice for an evaluation when some of the following late stage indicators are present:

• Ongoing weakness, fatigue shortness of breath and /or pain
• Symptoms can no longer be managed by heart medications and are becoming more frequent, even at rest
• Increased dependence on others for activities of daily living
• Frequent hospitalizations
• Presence of other conditions such as respiratory illness, diabetes, kidney disease, etc.

     The Heart Failure Society of America provides a free advance care planning booklet that can be downloaded here. It offers information on how someone with heart disease can best discuss questions and concerns with their physicians and families. It also describes the various health care services that may be provided as heart failure progresses, including the hospice option for end of life care.

     A conversation starter for a meaningful discussion may be a simple statement such as “I’d like to talk about what kind of help we may need since my heart failure seems to be worsening.” It can be a great relief to all when the door is finally opened to talking about needed care and then allowing the hospice provider to plan an assessment visit.