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Chronic heart failure: a guide to care

A guide to health care for families and carers.

Heart failure is a common and disabling condition in older people. Good quality health care can ease symptoms and improve outcomes. This guide will help you identify continuing healthcare priorities.

Heart failure is more common amongst older people. Fortunately, with early treatment, most of those affected can still enjoy a good quality of life. There are many causes of heart failure. In older people, it usually relates to problems with the left heart ventricle.

The main symptoms of heart failure include shortness of breath, swollen ankles and feet or lower back, feeling unusually tired or weak. Swelling occurs when fluid builds up in the body. The tiredness and breathlessness relate to a shortage of circulating oxygen.

Both frailty and multimorbidity are common in people living with heart failure.

This checklist is designed to help you plan care, it is not a substitute for medical advice - always seek professional help. It focuses on heart failure related to problems on the left side of the heart. Remember, healthcare professionals will not share information about a patient unless they have been given permission to do so.

How can you help with health and care?

Tips for families and carers who are supporting someone living with heart failure

The type of medicine prescribed depends on many factors, especially the cause and nature of the heart failure.

The NHS has developed an excellent guide to heart failure treatment.

The British Heart Foundation also has a good overview of medication for heart problems.

It is important to appreciate that medicines which treat chronic heart failure can cause significant side effects, including dehydration, low blood pressure, and even kidney problems.

For this reason, if there are any changes to your parent’s heart failure medicines, then they should be reviewed by a health care professional within 2 weeks.

People with heart failure are usually reviewed at least every 6 months (more frequently if medicines are altered – see above) to ensure that the medicines are working effectively and there are no problems or side effects.

A review usually explores:
a) whether there has been any deterioration,
b) whether the medications should be changed,
c) if any other procedures or interventions should be considered,
d) whether referral to another member of the multidisciplinary team is needed

These programmes can help to prevent heart failure from worsening, reduce the risk of future heart problems and improve quality of life.

They include help and support with taking exercise, understanding the condition and lifestyle advice.

If your parent is well enough to attend, and their chronic heart failure is stable, a suitable exercise-based programme of cardiac rehabilitation can be arranged.

This British Heart Foundation booklet will help you understand more about cardiac rehabilitation programmes.

Helping a parent with chronic heart failure is much easier if they have a care plan. Care plans are recommended and you can request one – they usually cover:

a) plans for managing the problem, including arrangements for follow-up, rehabilitation and any social care
b) symptoms to look out for in case of deterioration
c) how to access specialist care if it is needed in future
d) how to find more information about heart failure

People with heart failure should be offered:
a) Annual flu vaccine (new injection every year usually autumn)
b) Pneumococcal vaccine (once only injection at any time of year)

What Our Carents say

Dads feet were so swollen that his shoes and socks were really uncomfortable - the podiatrist told us where to get some better fitting footwear

Mum's nurse weighed her regularly so we could tell early on if she was getting worse and retaining more fluid

Dad found extra pillows helped to prop him up so he was less breathless during the night

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May 2020 – updated March 2021

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