Destination to Nowhere: A New Look at Aggressive Treatment for Heart Failure—A Case Study

O’Neill, Brian J.; Kazer, Meredith Wallace

doi:10.4037/ccn2014442

Cited by 4 publications

(3 citation statements)

References 25 publications

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“…28 Discussing advanced directives and advanced care planning early and throughout the illness trajectory as part of lifesaving care empowers the patient and helps make explicit to the team the patient's wishes. 29 As HF progresses, patients experience multiple symptoms and poor QOL. The symptoms include fatigue, dyspnea, pain, depression, systemic edema, insomnia, anxiety, confusion, cognitive impairment, anorexia, nausea, and constipation.…”

Section: Palliative Care For Persons Managed In a Heart Failure Centermentioning

confidence: 99%

Application of Transformational Leadership Principles in the Development and Integration of Palliative Care Within an Advanced Heart Failure Program

George

Leasure

2016

Dimensions of Critical Care Nursing

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Heart failure (HF) is a major health problem in United States, and it has reached epidemic proportions. Heart failure is associated with significant morbidity, mortality, and cost. Although the prognosis of HF is worse than many forms of cancer, many patients, families, and clinicians are unaware of the dire prognosis. As the disease progress to advanced HF, patients are faced with many challenges, such as poor quality of life due to worsening symptoms and frequent hospitalizations. Heart failure management adds significant financial burden to the health care system. Palliative care can be integrated into HF care to improve quality of life and symptom management and to address physical, spiritual, and psychosocial needs of patients and families. Palliative care can be used concurrently with or independent of curative or life-prolonging HF therapies. Transformational leadership principles were used to guide the development of a plan to enhance integration of palliative care within traditional advanced HF care.

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Section: Palliative Care For Persons Managed In a Heart Failure Centermentioning

confidence: 99%

Application of Transformational Leadership Principles in the Development and Integration of Palliative Care Within an Advanced Heart Failure Program

George

Leasure

2016

Dimensions of Critical Care Nursing

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“…25,39 Thus, the establishment of the patients' advance directives and the documented discussions that outline the conditions under which the patients desire the device to be withdrawn is critical to ensure the patients' wishes are met. [39][40][41] Discussions need to include PC and EOL care wishes relative to the VAD particularly for patients with VAD support for long periods of time or patients who are living with unpleasant symptoms caused by complications of VAD support. 38 Of 20 patients with a VAD who actively participated in VAD care preference discussions, retrospective review showed that 17 chose to actively withdraw support and three chose to wait until they lost consciousness before having the device withdrawn.…”

Section: Ventricular Assist Devicesmentioning

confidence: 99%

“…Therefore, patients need to understand the immediacy of death following VAD withdrawal, queried about the conditions under which they would desire the device be withdrawn, and the VAD care preferences should be documented to ensure the patients' wishes are met. [39][40][41]…”

Section: Ventricular Assist Devicesmentioning

confidence: 99%

Nursing concerns with palliative care and at the end-of-life in patients with heart failure

Westlake

Smith²

2015

NRR

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Patients with chronic heart failure (HF) suffer from numerous symptoms and quality-of-life (QOL) concerns, and thus, palliative care, a multidisciplinary approach that includes the family and focuses on the improvement of patients' and their families' QOL through the relief of physical, psychosocial, and spiritual suffering, is needed. The transition to hospice care is made when HF is refractory to medical therapy or when the potential harm of treatment outweighs the potential benefits. Nurses are key persons for patients with HF as they may initiate and support palliative and hospice care, focus on delivering patients' goal-directed, well-coordinated care, champion patients' and caregivers' needs, and facilitate optimal QOL. Despite the inclusion of palliative and hospice care for HF patients in published guidelines, health care providers are frequently unfamiliar with palliative and hospice care and the needs of HF patients and their families. Therefore, this paper addresses the nurses' role in determining for whom, and when palliative and hospice care is appropriate; where and how palliative and hospice care should be provided; and the communication needs of patients and their families regarding referral to hospice, emergencies, implantable cardioverter-defibrillator therapy, ventricular assist devices, and continuous intravenous inotropic or vasoactive support at the end-of-life.

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The Art of Healing

McCray¹

2016

Journal of Hospice & Palliative Nursing

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Destination to Nowhere: A New Look at Aggressive Treatment for Heart Failure—A Case Study

Cited by 4 publications

References 25 publications

Application of Transformational Leadership Principles in the Development and Integration of Palliative Care Within an Advanced Heart Failure Program

Application of Transformational Leadership Principles in the Development and Integration of Palliative Care Within an Advanced Heart Failure Program

Nursing concerns with palliative care and at the end-of-life in patients with heart failure

The Art of Healing

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