Caring for Someone with Heart Failure
Heart failure does not mean the heart has stopped — it means the heart is not pumping as well as it should. With the right care, most people with heart failure can live active, meaningful lives. But it requires careful daily management and close attention to warning signs.
Weighing your parent every morning is one of the most important things you can do. A sudden weight gain of 2–3 pounds in a day or 5 pounds in a week means fluid is building up and the doctor needs to know.
Sodium causes the body to hold onto fluid, which puts extra strain on the heart. Most heart failure patients need to limit sodium to 1,500–2,000 mg per day.
Heart failure medications keep fluid off the body and protect the heart. Missing doses leads to fluid buildup and hospital visits.
Some heart failure patients also need to limit how much they drink each day. Ask the doctor if this applies.
Gentle, regular activity is good for the heart. But your parent should stop if they feel short of breath, chest pain, or very tired. Ask the doctor about a cardiac rehabilitation program.
Before eating, after using the bathroom. Write it down or log it in a phone app. Bring the log to every doctor's appointment.
Canned soups, deli meats, and restaurant food are often very high in sodium. Cook at home when possible. Use herbs and spices instead of salt.
A weekly pill organizer with clear compartments helps prevent missed or double doses. Consider a medication dispenser with alarms.
Note shortness of breath, swelling, fatigue levels, and weight daily. This information is invaluable to the doctor and can catch problems before they become emergencies.
If your parent has swelling in their legs and ankles, keeping their feet elevated when sitting helps reduce fluid buildup.
2–3 pounds in one day or 5 pounds in one week — call the doctor today, not next week.
Trouble breathing at rest, waking up at night unable to breathe, or needing more pillows to sleep — call the doctor.
Ankles, feet, or legs that are swelling more than usual.
Any new chest pain — call 911 immediately.
If your parent suddenly feels much more tired than usual or feels faint — call the doctor.
"What is my parent's ejection fraction, and what does it mean for their care?"
"What is the daily weight limit that should trigger a call to you?"
"Are there any sodium or fluid restrictions we should follow?"
"Would cardiac rehabilitation be helpful?"
"Which symptoms mean call you, and which mean go to the emergency room?"
Advanced heart failure is a serious, life-limiting condition. When treatments are no longer keeping symptoms controlled, hospice shifts the focus to comfort and quality of life. It is a courageous and loving choice.
Your loved one is short of breath even at rest, is no longer able to do basic daily activities, is being hospitalized repeatedly for fluid buildup, or has chosen to stop aggressive treatments.
If your parent has been hospitalized two or more times in the past six months for heart failure, it is time to have an honest conversation with the cardiologist about goals of care and hospice.
Medicare covers hospice when a doctor certifies life expectancy is six months or less if the disease follows its expected course. Heart failure qualifies. Many people receive hospice longer than six months.
Nurses, aides, social workers, and chaplains come to your home. They manage fluid, breathlessness, and pain — the most distressing heart failure symptoms — and are available by phone at any hour.
What has helped you? What do you wish you had known? Your words help other caregivers feel less alone.