title: The complex symptom burden of the aged heart failure population.
abstract: OBJECTIVE
  The primary remit of terminal care in heart failure is to relieve suffering, which begins with a routine and standardized assessment of symptoms using validated instruments. The scope of this review is to explore symptom burden and control, and to examine some instruments used to assess and monitor heart failure patients' distress.
  
  
  RESULTS
  Elderly heart failure patients have many complaints and poor global health status. Symptoms are both of cardiac and noncardiac origin, attributable to the high frequency of comorbidities, side effects of medication and the psychosocial consequences of a chronic progressive illness.
  
  
  CONCLUSIONS
  Continuity of care, familiarity with the patient and the quality of inter-personal relationships between patients, relatives, nurses and physicians are essential to obtain high-quality end-of-life care. Validated instruments to measure symptom burden may be useful tools to quantify patients' distress and to evaluate the efficacy of care.
authors.affiliation: Salvatore Maugeri Foundation, IRCCS, Department of Cardiology, Scientific Institute of Pavia, Pavia, Italy. cristina.opasich@fsm.it
authors.forename: Cristina
authors.initials: C
authors.lastname: Opasich
authors.forename: Alessandra
authors.initials: A
authors.lastname: Gualco
mesh_terms: D000367:Age Factors; D000368:Aged; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D010166:Palliative Care / Q000379:methods*; D013727:Terminal Care