Caregiver Corner: Caring for Someone with Heart Failure

Are you a caregiver for someone with heart failure? Being well-informed about the disease can help you understand treatment options, and help you and your loved one find the support that you may need.

What is Heart Failure?

Heart failure (HF) is a serious condition that occurs when your heart isn’t pumping as well as it should. It is a progressive condition where the heart gradually loses its ability to pump enough oxygen- rich blood to supply the body’s needs. Symptoms of heart failure can be mild in the early stage and may not be diagnosed, or possibly be misdiagnosed until conditions worsen. Heart failure can be caused by coronary artery disease, a prior heart attack, enlarged heart, high blood pressure, and rapid heartbeat.

It is estimated that 5.1 million people have heart failure in the United States. Symptoms of heart failure vary: some people have mild symptoms and others live with severe symptoms. Symptoms include shortness of breath during exercise and daily activities and difficulty breathing at rest or when lying flat in bed. Other symptoms include swollen ankles, swollen abdomen and weight gain related to fluid and water retention, weakness, dizziness, fatigue, and irregular or rapid heartbeat.

Diagnosing Heart Failure

A doctor makes a diagnosis of heart failure based on a thorough medical history, including signs and symptoms of heart failure and echocardiogram test results (also referred to as an echo). This test identifies the person’s ejection fraction, which is a measurement of how well the heart is pumping. A person with a healthy heart will have an ejection fraction of 60 percent; along with other symptoms, heart failure may be diagnosed when the ejection fraction is 40 percent or less.

Heart Failure Treatment

Treatment goals include reducing symptoms, slowing the progression of the disease, improving exercise tolerance, and preventing and treating complications. Medication therapy is the primary type of treatment for heart failure, and includes medications to treat the underlying cause of the heart failure. Other treatments include life style changes and, for those with advanced disease, medical device placement and surgery.

Help Your Loved One Manage Their Treatment

As a caregiver, you play an important role in helping your loved one manage their medical treatment.

The following are ways you can help:

  • Learn as much as you can about heart failure and recommended treatments.
  • Attend your loved one’s primary care physician and specialist appointments.
  • Prior to an appointment, be sure to keep a record of any questions that you or your loved one may have. Also, be sure to discuss any concerns you may have, especially if your loved one is having more symptoms than usual
  • Educate yourself and your loved one about the warning signs of worsening heart disease. This will help you and your loved one know when to seek medical help. 
  • If your loved one has not been given written instructions, be sure to ask their health care provider for an action plan that details what to do in case of worsening symptoms.

Remember, if you find that your loved one has new symptoms or sudden worsening of current symptoms, you should notify the healthcare provider immediately.

The following are some symptoms to be concerned about:

  • Rapid weight gain from fluid
  • Shortness of breath
  • Swelling (edema) 
  • Fatigue

Speak to your loved one and his/her health care provider about starting an exercise program and/or participating in a cardiac rehabilitation program. Regular exercise may help them feel less short of breath as regular exercise improves the heart and muscles. A cardiac rehabilitation program is a structured, medically supervised program designed to help patients learn more about their disease and increase their physical fitness. This program also helps to increase physical fitness and reduce heart symptoms.

Help your loved one follow a heart-healthy diet.

They may also need to follow a low-sodium (salt) diet to prevent the body from storing extra water. Following a low-sodium diet can help control heart failure. It is important to cook without salt and to avoid foods with salt.

Assist your loved one in keeping track of daily weights, if prescribed by the health care provider. 

Help your loved one manage their medications

It is important that you keep track of the medications and make sure your loved one is taking them as directed by the doctor. Worsening heart failure can be related to not taking medications as prescribed, or taking a drug that interacts with heart failure medications. Some pain medications such as nonsteroidal anti-inflammatory drugs (ibuprofen, naproxen) can cause interactions with heart medications. You should speak with a health care provider prior to using over-the- counter medications, herbs, and supplements.

Additional tips:

  • Speak with your health care provider about whether or not the flu (influenza) and pneumonia vaccines are appropriate.
  • Discuss long-term care planning for what your loved ones wishes will be as the disease progresses.  
  • If you're a Tufts Health Plan member, partner and work with a care manager. If you're not a member, learn more about Care Managers here.

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For more information and resources for Heart Failure: American Heart Association 

Heart Failure Society of America