Hinganga wawe ā-manawa Advanced heart failure
Heart failure can often be managed for many years using modern therapies and healthy lifestyle measures. But if you have complications or your heart is just getting weaker, the treatments may be less effective. You may develop symptoms that do not disappear so quickly with treatment and start to affect your day-to-day life.
Symptoms of advanced heart failure
Some of the things you may notice include:
- needing more help with personal care such as getting dressed and preparing meals
- spending more time in a chair and being unable to walk far
- having more admissions to hospital or visits to your healthcare provider
- losing weight, feeling sick (nausea) and not feeling hungry
- getting short of breath while doing very little, despite taking your medicines
- being tired
- feeling more anxious and worried about your future
- having more chest pain.
If you have these symptoms, your heart failure may be becoming more advanced. Speak to your healthcare provider or specialist if you are worried or unsure.
Diagnosing advanced heart failure
Advanced heart failure is usually diagnosed from your symptoms by your healthcare provider.
Treatment changes for advanced heart failure
Sometimes when heart failure becomes more advanced, you cannot get any better. Then your treatment plan might focus on giving you a good quality of life, rather than saving your life at all costs.
Some treatments may become less important and others may be added to help control your symptoms.
Usually your healthcare provider will keep providing you with heart failure medicines for as long as possible to help with your symptoms. Other medicines may be used to help with:
- breathlessness
- feeling sick
- difficulty passing poo (constipation)
- pain.
Talk about what comes next
It is helpful to have a discussion with your whānau about what is important to you, especially your future care needs. Things to consider include:
- where you want to be cared for when you are less well
- what is most important to you now
- what treatments you will accept at this time of life, including resuscitation
- making a will and appointing an enduring power of attorney.
An advance care plan is a really helpful way to document all of these discussions. It is a plan that gives you a voice when you cannot communicate and it tells your whānau what you want to happen.
Promoting enduring power of attorney (EPA) — Te tari kaumātua | Office for Seniors (external link)
What is advance care planning? — Tō tātou reo | Advance care planning (external link)
Getting extra help
Other community support is available. This may include:
- equipment to make doing everyday things easier, such as chair raisers, bed levers and shower stools — to access equipment your healthcare provider might refer you to a physiotherapist or occupational therapist, or you can pay to see one privately
- carer support arranged through your healthcare provider — this may include temporary respite care in a residential care facility to give your carer a break, or arranging a regular sitter so your carer can do other activities for a few hours each week
- needs assessment if you need support services at home, want respite or are thinking about moving into residential care
- counselling through your healthcare provider
- funding through your healthcare provider or through having a community services card to help with the cost of healthcare provider visits — ask your healthcare provider about this.
Home medical equipment (internal link)
Needs assessment service (internal link)