Question: When should a heart failure patient consider end-of-life care, such as hospice?
Answer: When heart failure reaches its most advanced stage and a patient is dying from failure of the heart to be able to pump to the body, there are often many therapeutic options that remain. But many of these options are very aggressive and involve surgery, implantation of mechanical devices and other aggressive therapies.
When you the patient decide that you don't want to pursue aggressive therapy any longer and you want to focus on relief of symptoms and comfort, hospice may be an appropriate choice at that point. Hospice care is focused on relief of symptoms, comfort and living each day as comfortably as possible. Now, I would say that in a good heart failure management plan, that should be an emphasis everyday any way.
But when you want that to be your primary focus and you know that you're dying of heart failure, discussion of hospice is very appropriate. Unfortunately, physicians don't often bring up hospice as an option, and it's very appropriate for you as a patient when you feel that you no longer want to pursue aggressive therapy for your heart failure to initiate a discussion about the potential of hospice as a treatment option for you with your physician.