Heart Failure and Palliative Care – The Individualized Action Plan 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
- Imminente end-of-life stage
- End-of-life care
An individualized action plan
The success of treating a severe chronic disease like advanced heart failure largely depends on implementing an individualized action plan.
This plan outlines clear instructions to follow in case your condition worsens, as well as medication adjustments to make in those situations. Its purpose is to intervene quickly before the situation becomes critical.
A concrete example
Imagine your weight suddenly increases, your legs become more swollen, and your breathing becomes more difficult. These signs indicate your heart is struggling to circulate 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 effectively and must be addressed immediately.
Your care team has likely already provided you with an action plan urging you not to delay in applying the recommended measures, whether medical or related to your lifestyle. The goal is to prevent hospitalization as soon as your weight exceeds your personal limit (called your “dry weight”), your legs swell more, or your shortness of breath worsens.
A contact person
Any significant weight loss, an infection such as the flu, diarrhea, or any other health issue should also be reported to your care team.
The phone number of a contact person (nurse or doctor) is included in the plan: you should call them the same day.
What does the action plan include?
Often, the plan advises you to stay home and postpone any outside activities until your condition improves. You must continue weighing yourself daily, and if your fluid intake needs to be further limited, this limit will be clearly indicated — for example, a maximum of 1.5 liters per day.
The plan also explains how to adjust your diuretics — medications that increase urine production to reduce water retention. Extra tablets are usually provided in advance, along with instructions on the dosage to take if needed.
Tools to avoid hospitalization
Thanks to this action plan, you, your loved ones, and your healthcare providers have tools to handle urgent or unexpected situations. It includes prescriptions pre-established by your doctor to allow a quick response if your condition worsens and to avoid, as much as possible, an emergency room visit or hospitalization.
Finally, it is important to remember that insufficient understanding of your disease increases the risk of death within two years following a hospitalization for heart failure.
This is why it’s essential to know your action plan well and ask for clarification if anything is unclear.
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