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My Loved One in a Nursing Home Has Congestive Heart Failure

My Loved One in a Nursing Home Has Congestive Heart Failure. ltcpractice.com. Congestive Heart Failure: Prevalence. Affects 4.6 million Americans each year Leading cause of hospitalization > age 65. Understanding Congestive Heart Failure.

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My Loved One in a Nursing Home Has Congestive Heart Failure

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  1. My Loved One in a NursingHome Has Congestive Heart Failure ltcpractice.com

  2. Congestive Heart Failure: Prevalence • Affects 4.6 million Americans each year • Leading cause of hospitalization > age 65

  3. Understanding Congestive Heart Failure Heart is unable to pump blood as much as needed to keep up with the body’s needs In response the heart walls stretch & thicken to hold more blood & to attempt to maintain pump efficiency

  4. Understanding Congestive Heart Failure • Over time these compensations fail • Heart’s ability to stretch & snap back decreases • Heart muscle wears out & blood flow backs-up into feet, ankles, legs, liver, arms & lungs • The body is overloaded with fluids – hence “congestive” heart failure

  5. Congestive Heart Failure: Causes Coronary artery disease (CAD): • Blocked arteries reduce flow to heart which can lead to a heart attack • A heart attack can leave the heart muscle damaged • This can further reduce the heart’s ability to pump efficiently

  6. Congestive Heart Failure: Causes Cardiomyopathy: • The heart can be damaged by infection, drug or alcohol abuse, or for no apparent cause • The damage to the heart leaves it unable to meet the body’s needs for oxygen and nutrients

  7. Congestive Heart Failure: Causes An overworked heart from: • High blood pressure or valvular heart disease • Thyroid disease • Kidney disease • Diabetes • Obesity • Anemia

  8. Congestive Heart Failure: Symptoms • Shortness of breath or cough from fluid back-up in lungs • Increased weight or swelling from kidneys retaining fluid • Dizziness from decreased blood pressure and decreased blood supply to brain • Fatigue or weakness from decreased blood to major organs and muscles • Irregular or rapid heart beat from heart pumping faster attempting to meet needs

  9. Congestive Heart Failure: How will it be diagnosed? • The Doctor or Nurse Practitioner will take a history and do a physical examination. • They may order one or more of the following: blood work, chest x-ray, electrocardiogram (EKG), echocardiogram. These tests give a general overview of heart function and the body’s response to the heart failure. • They may also order medications to relieve symptoms while awaiting results of tests.

  10. Congestive Heart Failure: How will it be treated? Treatment will be aimed at: Relieving symptoms Managing risks that would worsen condition Reducing need for hospitalizations

  11. Congestive Heart Failure Treatment: Relieving symptoms • Intake of fluids and salt may be reduced • Medications to eliminate retained fluids or strengthen heart action may be ordered • Oxygen will be provided if needed

  12. Congestive Heart Failure Treatment: Managing risks that could worsen condition • Weight reduction may be recommended if obese • Exercise will be increased if possible • Cessation of smoking will be recommended • Medications that can worsen condition may be discontinued • Hypertension & diabetic control will be continued

  13. Congestive Heart Failure Treatment: Reduce need for hospitalizations by • Close monitoring by nursing staff checking weight, blood pressure, pulse, blood oxygen level. Of these, the most important is watching the weight. • Preventing respiratory infections with pneumonia & influenza vaccinations • Blood work, chest x-rays, Doctor or NursePractitioner visits as needed

  14. Congestive Heart Failure Prognosis: • Outcome for most is poor • Even highly specialized cardiac medications do not alter the inevitable and often fairly rapid course towards death • Heart transplants are not available for frail elderly patients

  15. Congestive Heart Failure: Family Involvement • Comfort and Quality of Life are always important for a nursing home resident • Over time the heart failure will worsen even with aggressive treatment • You may be asked to make decisions about aggressiveness of care or hospitalization for or with your loved one

  16. Congestive Heart Failure: Family Involvement • Whenever possible talk to your loved one about their wishes for care • Discuss with the Doctor, Nurse Practitioner, Social Worker or RN your wishes and expectations for care • Assist your loved one in appointing a Health Care Proxy and requesting a Do Not Resuscitate order

  17. Congestive Heart Failure: Final Thoughts • Relief of symptoms, even with advanced Congestive Heart Failure, is usually possible • Relief of symptoms and Quality of Life are always the goals of care • Interactions with families and residents are valuable in achieving these goals

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