Hospitalization as an opportunity to integrate palliative care in heart failure management.
OBJECTIVE
Hospitalization for heart failure is a critical event associated with high rates of readmissions, morbidity, and mortality. This review examines the role of hospitalization for heart failure as an opportunity to assess comprehensive patient needs including palliative care needs.


RESULTS
Recent evidence demonstrates that institution of a comprehensive care plan at discharge reduces the high rates of readmissions and death seen in patients with heart failure. The chronic progressive nature of heart failure, with its concomitant limitations in functioning, significant psychosocial distress, and risk of death at all stages of illness creates a need for palliative care services that span the disease trajectory. These services include symptom management, psychosocial care, advance care planning, assistance in defining goals of care, and family/caregiver support and should be provided simultaneously with optimal medical management. Hospice is also underutilized.


CONCLUSIONS
Hospitalization for heart failure should serve as an opportunity to assess, introduce, and provide comprehensive care that includes palliative care alongside optimal medical management. Palliative care services have the potential to positively impact the health and quality of life of patients with heart failure and should be integrated as an ongoing key component of their care.
Widera
Eric
E
Division of Geriatrics, University of California at San Francisco, USA.
Pantilat
Steven Z
SZ
D000368:Aged; D003266:Continuity of Patient Care; D006333:Heart Failure / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D010166:Palliative Care; D010347:Patient Care Planning