This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (19)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Congestive Heart Failure/ Cardiomyopathy  • End-of-life Care/ Palliative Medicine  • Alert me on articles by topic

Paul J. Hauptman, MD; Edward P. Havranek, MD

Arch Intern Med. 2005;165:374-378.

Heart failure is a condition for which both palliative care and hospice care can be appropriate. The disease’s increasing prevalence and predilection for elderly patients with significant comorbidity underscore the need to integrate these modes of care with the acute care approach that has dominated heart failure treatment. We propose integration of a palliative care approach early in the course of heart failure treatment and a tiered process for selecting patients for hospice care. A transition of the focus to palliative care rather than mortality reduction should occur over time, when clinical status deteriorates and advanced therapeutic options become inappropriate or ineffective. Failure to respond to the need for palliative care puts at risk the mandate to treat the patient with heart failure during the entire course of illness.

Author Affiliations: Division of Cardiology, Saint Louis University School of Medicine, St Louis, Mo (Dr Hauptman), and the Denver Health Medical Center, Denver, Colo (Dr Havranek).

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Discordance Between Patient-Predicted and Model-Predicted Life Expectancy Among Ambulatory Patients With Heart Failure
Allen et al.
JAMA 2008;299:2533-2542.
ABSTRACT | FULL TEXT  

Characteristics of Patients Hospitalized With Acute Decompensated Heart Failure Who Are Referred for Hospice Care
Hauptman et al.
Arch Intern Med 2007;167:1990-1997.
ABSTRACT | FULL TEXT  

Improving end-of-life care for patients with chronic heart failure
Thompson
Heart 2007;93:901-902.
ABSTRACT | FULL TEXT  

Improving end-of-life care for patients with chronic heart failure: "Let's hope it'll get better, when I know in my heart of hearts it won't"
Selman et al.
Heart 2007;93:963-967.
ABSTRACT | FULL TEXT  

Dying in hospital of terminal heart failure or severe dementia: the circumstances associated with death and the opinions of caregivers
Formiga et al.
Palliat Med 2007;21:35-40.
ABSTRACT  

Palliative Care Published Research Reviews, 2000 to 2005
DePalma
Home Health Care Management Practice 2006;18:482-485.
 

Drug Therapy Recommendations from the 2005 ACC/AHA Guidelines for Treatment of Chronic Heart Failure
Howard et al.
The Annals of Pharmacotherapy 2006;40:1607-1616.
ABSTRACT | FULL TEXT  

Palliation in heart failure: When less and more are more
Hauptman
AM J HOSP PALLIAT CARE 2006;23:150-152.
 

The diagnosis and management of chronic heart failure in the older patient
Gillespie
Br Med Bull 2006;75-76:49-62.
ABSTRACT | FULL TEXT