Hospice for Heart Disease

When is hospice appropriate for someone with heart disease or heart failure?

A person with heart disease or CHF (Congestive Heart Failure) lives with increasing shortness of breath and discomfort, along with a decline in day-to-day function. Hospice is appropriate for your loved one in this condition, particularly when they have decided to forego further medical treatment.

Signs that their condition has changed and it might be time for hospice include:

• Being physically inactive and the smallest amount of activity, such as walking a few steps, causes shortness of breath, weakness, and fatigue.
• Feeling like they’re gasping for breath, even when at rest.
• Recurring chest pain, pressure, or squeezing, such as that associated with angina.
• Having trouble sleeping.
• Experiencing changes in appetite.

What is the hospice eligibility criteria for heart disease?

For your loved one with heart disease to be eligible for hospice, they must meet a set of criteria.

• Your loved one is diagnosed as having six months or less to live by a physician. This means they have end-stage heart disease.
• Your loved one’s doctor, perhaps including a cardiologist, have done all they can to treat their condition, such as adjusting medications without any improvement.
• Their heart failure and other conditions, such as kidney disease, limit the ability to try other treatment options.
• Documented heart-related concerns such as a past cardiac arrest.
• Other medical measurements that show the heart muscle has weakened.
• Your loved one decides to decline invasive procedures. They decide they don’t want any treatment options besides their current medications and those related to comfort.

Do certain hospice providers specialize in heart disease or CHF?

Most hospice providers are proficient in treating patients with heart disease. Ask providers to confirm they have appropriately educated professionals who are experienced in caring for people with advanced heart disease. It will benefit your loved one if they are able to provide specialized attention to assure that:

• A patient’s fluid balance is closely monitored.
• Support is provided to reduce breathing distress.
• Medications are adjusted as needed to promote comfort.
• Frequent nourishment is available.

What Can Hospice Do for a Patient with Heart Disease?

Hospice has a primary focus of promoting comfort and quality of life. To do so for your loved one with heart disease, hospice:

Provides physical supports by:

• Helping you to access equipment and supplies that will add to comfort in the home setting. This includes a hospital bed, oxygen, a wheelchair, and skin protection, among others.
• Including guidance on how to manage pain and agitation in the plan of care.
• Showing you tips to assist with eating and drinking, as needed.
• Helping to assure that safety measures are in place to help your loved one move. This includes being sure you know methods for keeping yourself safe from injury.

Offers emotional supports that:

• Allow your loved one to talk with a social worker or nurse about their concerns or anxiety.
• Assure their spiritual needs are addressed.
• Help your loved one convey their thoughts to family and friends.
• Provide information about changes in condition with your loved one, unless they don’t want to know.
• Include volunteer visits to provide companionship for your loved one while you run errands or do household tasks.

What can hospice do for the family of a person with heart disease?

Hospice assures that you and your family have the information and support needed to best care for your loved one and handle the emotional challenges that many caregivers experience during and after hospice. They do so by:

• Helping you to access necessary equipment and supplies in a timely manner.
• Providing you with information and tips about feeding, elimination, breathing, skin care, and movement.
  • This includes what you need to know now and in the coming days.
  • Knowing what to expect helps you to prepare emotionally.
  • It helps you to know what you need to have on hand to promote comfort and safety.
• Letting you know how to reach them at all hours, day, night, and on the weekends.
• Setting aside time on their visits to talk with you about your observations of your loved one’s condition.
• Offering emotional and bereavement supports that include:
  • Having volunteers available to offer you respite time to care for yourself.
  • Bereavement services for you and other family members before and after your loved one passes.
  • Social worker services that let you talk confidentially about your caregiving role. This may include how to negotiate deep emotions or family strains.

What should you expect at the end stages of heart failure?

The later stages of heart failure include continued decline of your loved one’s ability to care for self and interact with others. This is because the heart muscle has weakened, making it hard to:

• Breathe and talk.
• Move in bed or a chair.
• Eat because of a lack of appetite.
• Manage bodily functions like elimination.
• Be comfortable and free of pain.

Signs like these mean that your loved one may be helped by medications for anxiety, agitation, and pain, along with those they’ve taken for a while.

Your loved one may have some of the above symptoms, but not all. They may also have these signs that they are having further decline:

• Swelling, including in their extremities and abdomen, as the heart is unable to pump fluid.
• Continual coughing and wheezing due to fluid gathering in their lungs.
• Confusion, including being out of touch with reality.
• A rapid pulse as the heart goes faster in an effort to make blood flow.

Your calming voice and touch helps your loved one to know they are not alone. The hospice team will support you with things to do that promote peace. And they are there to listen to and address your concerns.

Does Medicare cover hospice for heart disease?

Medicare pays for hospice care for heart disease when the criteria outlined above are met. Ask your loved one’s doctor if these have been met. You can also ask hospice agencies if they offer guidance to families to assure family members are eligible.

Does Medicaid cover hospice for heart disease?

Medicaid covers hospice for heart disease based on state guidelines and eligibility requirements. You can talk this over with your loved one’s doctor or by reaching out to your state’s Medicaid Office.