Patient Referral

doctor with chf patientHeart failure affects nearly 6 million Americans, and in honor of heart month, we’d like to talk about living with congestive heart failure (CHF). CHF is a condition that requires extensive daily management. As a result, it impacts not only the patient, but also his or her family and friends.

Without careful monitoring, your loved one can end up with symptoms that often result in hospitalization. However, daily monitoring of dietary restrictions, weight, and blood pressure can minimize CHF flare-ups.

What A Caregiver Should Know About the Daily Life of a CHF Patient

As a caregiver, it’s difficult to watch your loved one deal with the more difficult symptoms of CHF. However, there are some things you can do to make his or her life a bit easier and to lessen the negative impact of CHF.

Managing CHF and Circulation

A heart weakened by CHF has a hard time pumping blood around the body. As the circulation slows down:

  • The blood returning to the heart backs up, causing “congestion” (swelling) in the tissues.
  • The kidneys cannot efficiently rid the body of water and salt, causing water gain in the legs, ankles, feet, and abdomen.

The swelling that results from this retention of fluid is called edema.“ It adds pounds to the body’s weight – and any extra weight means extra work for an already stressed heart. When this cycle of fluid buildup spirals out of control, it can trigger a medical emergency and the need for hospitalization.

To avoid a crisis, check for these signs EVERY DAY:

  • Sudden weight gain or loss. Have your loved one weigh first thing in the morning, right after urinating, and before drinking or eating.
  • Ask your doctor about the acceptable daily weight change. How many pounds is too much? Know when you need to call the office.
  • Look for swelling in the abdomen: Check how clothing fits; look for tightness, tenderness, or bloating at the waist.
  • Be aware of signs of fatigue or shortness of breath. Note any complaints of weakness or desire to reduce activity.

If you observe any one of these symptoms, contact your family member’s doctor immediately for guidance. The doctor may recommend changes in the day’s diet or fluid intake or may modify other aspects of treatment.

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Communicate with the Doctor

Good communication with the doctor about symptoms observed at home is the simplest way to stay out of the ER. Plus, it keeps the doctor informed about the patient’s health. Check with the doctor about other self-care activities that may help reduce the likelihood of edema. For example:

  • Sitting or lying down with legs elevated to help blood flow to the heart.
  • Wearing specialized stockings to help minimize fluid buildup in the legs.

Eliminate Commercially Prepared Foods.

An entire day’s “salt budget” is easily consumed in a single serving of prepared dinners, luncheon meats, quick breads/cereals, and common condiments and marinades. But you don’t have to spend hours in the kitchen cooking from scratch. Instead, you can:

  • Reduce salt intake. Food is one of life’s pleasures and salt (sodium) is a key flavor enhancer. The simplest solution is to remove the main sources of salt, add new flavors in its place, and eliminate commercially prepared foods.
  • Take the saltshaker off the table.
  • Remove the salt supply from the kitchen.
  • In cooking use fresh or dried savory herbs (basil, thyme, sage), exotic spices (curry, ginger, chipotle pepper), citrus juice, and grated citrus rind.
  • Do not use a commercial “salt substitute” without the doctor’s permission.
  • Cook in bulk. Roast a whole chicken, pork roast, or meatloaf. Leave the leftovers for sandwiches. Save the bones and bits for a savory soup base.
  • Use a crock pot. A slow cooker allows flavors to develop in stews and casseroles. Put the ingredients together when it’s convenient for you. Use fresh, frozen, or low-sodium foods.
  • Creating toppings. Sautéed mushrooms, browned onions, homemade pesto, or chutney are extremely flavorful options. Freeze in small portions that are easy to grab and warm at mealtime.
  • Make mixes. Avoid pre-made mixes and consider low-sodium alternatives for pancakes, cornbread, and muffins.

Help Your Family Member Conserve Energy

Conserving physical energy is important so he or she has enough “fuel” to enjoy special activities and exercise according to doctor’s orders. It’s a simple strategy – there’s a limited amount of energy each day. If you’re careful of how you use it for routine tasks, you will have enough left over for necessary exercise.

Help the patient living with CHF by planning for the entire day and pace activities. Encourage your loved one to:

  • Allow ample time for what needs to be done. Rushing wastes energy.
  • Alternate activity with rest. Divide large chores into smaller tasks spread across the day or week.
  • Work smarter. Minimize trips up and down stairs. Shop with a list and in as few stores as possible. Cook in quantity and freeze the extra; soak dishes first for less scrubbing later. After a bath, slip on a terrycloth bathrobe instead of drying with a towel.
  • Get help when you can.
  • Have medications and groceries delivered.

Throughout the day, consider your loved one’s opportunities to reduce standing, walking, lifting, and bending. Remind them to:

  • Sit down whenever possible. When cooking, cleaning, bathing, dressing, or grooming face and hair, have a stool or seat handy.
  • Create task stations. Lay out supplies at waist height so everything is within easy reach before cooking, cleaning, bathing, or dressing.
  • Wheel or wear; don’t fetch. Use a cart on wheels, a walker with a basket, a pocketed apron, or a fisherman’s vest to keep supplies at hand.

By learning to operate on “cruise control” whenever possible, your loved one can get further on a day’s tank of energy.