Heart Failure and Palliative Care – Supportive Care Component

Reading the words “palliative care” can have a strong impact and may even cause concern. However, it’s important not to misunderstand their meaning. Like any severe chronic illness, heart failure involves two types of treatment.

The first is well known: so-called “active” care, focused on controlling the disease, stabilizing its progression, and improving quality of life. The second, often less well understood, involves palliative care, which aims to enhance patient comfort and well-being.

Five Key Areas

This article explores five essential aspects of care for people living with advanced heart failure:

A review of heart failure and active treatment
Development of a personalized action plan
Supportive care in addition to active treatment
Imminent end-of-life stage
End-of-life care

Palliative or supportive care

Supportive care should be considered as soon as severe heart failure is diagnosed, not just at the very end of life, since the disease is progressive.

Early palliative follow-up has been shown to improve quality of life, reduce the frequency of hospitalizations, and even prolong life expectancy.

This type of care includes several components, all aimed at the patient’s comfort and well-being.

A companion therapy

Contrary to what many believe, palliative care does not mean only end-of-life comfort or stopping active treatments.

Instead, it is added to standard treatments right from the start of care, ensuring that the patient’s well-being is an integral part of daily management.

First contact with the supportive care team

The first meeting with the palliative care team allows the patient and their family to meet the healthcare providers and identify a point of contact, whose information is provided.

This step gives the patient a valuable sense of security and the reassurance that they will never be left alone to face their illness.

It also gives the team an opportunity to assess the patient’s condition, limitations, and better understand their family and social environment.

Patients heavily burdened by illness

At an advanced stage, heart failure leaves patients very vulnerable. The heart is no longer able to meet the needs of vital organs such as the kidneys, liver, and brain.

These patients are often exhausted, depressed, and demoralized, short of breath with the slightest effort — and sometimes even at rest.

They need compassion, attentive listening, and reassurance far more than a simple prescription for antidepressants, whose effects would take too long to help.

Small measures that bring relief

Some simple actions can improve comfort. For example, a fan directed toward the face can reduce the sensation of breathlessness.

A damp towel or a humidifier in the room can also create a soothing effect.

Relieving pain

Physical pain should not be overlooked. People with heart failure often have other health conditions that cause pain.

These pains can and should be managed so they disappear or are greatly reduced. Even mild suffering is unnecessary and should be reported and treated.

When supportive care becomes more intensive

As the disease progresses and the patient’s condition deteriorates irreversibly, palliative care takes on a greater role.

This is often seen through more frequent and longer hospitalizations, loss of independence, or clear inability to recover to a normal functional state.

Reducing medication can be appropriate

At this stage, it may be appropriate to review the treatment plan and reduce the number of medications, especially those whose side effects outweigh their benefits.

Some heart failure treatments can worsen kidney function or cause drops in bloodBlood is composed of red blood cells, white blood cells, platelets, and plasma. Red blood cells are responsible for transporting oxygen and carbon dioxide. White blood cells make up our immune defense system. Platelets contribute to blood pressure, leading to weakness and dizziness.

Adjusting the treatment at this stage aims to prioritize quality of life by reducing the medication burden and minimizing side effects.