Palliative Care in the Treatment of Advanced Heart Failure

Palliative care in a hospice reduces costs and addresses the needs of patients with advanced heart failure. The transition from hospital to hospice requires coordination and planning among patients, family members and medical staff.

Recent guidelines recommend palliative and hospice care referral for end-stage heart failure. However, few individuals with end-stage heart failure receive palliative care consultations. This literature review is a primer on palliative care for advanced heart failure.

The authors provide an overview of palliative care; discuss the transition to a hospice; offer evidence that palliative care allows patients to live longer while avoiding unnecessary procedures; state the cost savings that palliative care services can generate; summarize the sources of suffering (e.g., fatigue, depression) in end-stage heart failure; and, consider appropriate strategies for shifting the focus of care from medical solutions to palliative care.

Key Findings:

  • A non-randomized study of hospice care found that patients with end-stage heart failure lived an additional 81 days if they were in a hospice.
  • In palliative care, patients, family members, and the medical team make shared decisions; however, patients must establish the circumstances in which they would prefer to end medical solutions.
  • A recent study found that patients receiving hospital palliative care services saved $4,908 per admission and $374 in costs per day.

Patients living with serious illness have identified their top health care needs as: adequate pain and symptom management, shortening the process of dying, and lessening the burden on family members. Palliative care aims to relieve suffering by addressing the physical, emotional, spiritual and logistical needs of patients and caregivers.