Increased communication between doctors, patients, and their caregivers, may lead to better outcomes for people suffering from heart failure, according to a recent report.
Released by the American Heart Association (AHA), the article encourages doctors to have frank discussions with heart failure patients, and any other involved parties, such as the caregiver of an elderly person, about what they want and expect out of treatment.
The concept, called "shared decision-making," is based on the idea that the best treatment for a patient may not necessarily be the one that cures or mitigates a disease if the end result is a reduction in the person's overall quality of life.
Study author Larry Allen, M.D., an assistant professor of medicine at the University of Colorado Anschutz Medical Center, says that the ideal care approach should involve, "talking about goals of care, expectations for the future, and the full range of treatment options, including palliative care."
This is particularly important concept, when dealing with tricky illnesses, such as heart failure.
A progressive disorder, heart failure occurs when a person's heart can no longer pump blood efficiently throughout their body. About 11 percent of seniors 80 years and older are affected by heart failure.
There are a variety of medical interventions available to treat heart failure. But some therapies, like side-effect laden medications or implantable defibrillators, aren't always the best choice for a senior who has other health problems.
As one AgingCare.com member, PT, laments, "My mother is 89. She has congestive heart failure and arrhythmia plus she has Alzheimer's. They want her to get a pacemaker. She is too old to have this done—all she does is sleep and eat. I don't want her to have pain if, in the end, it doesn't work for her!"
The issue of what's better for an elderly loved one: treatment that is causing pain, but keeps a person alive, or making a senior as comfortable as possible, even if it means halting therapy for a potentially deadly ailment, is often brought up on AgingCare.com.
In her response to a caregiver question about an elderly mother who won't take her meds and doesn't want to undergo a PET scan, NancyH offers this perspective: "I guess when and if I get to be 96 years old, I'd want to be left alone too. After a lifetime of taking pills and being bugged by doctors, I think I'd just say forget it."
But, deciding to halt potentially life-saving treatment doesn't mean that a caregiver is giving up on their elderly loved one. As Allen mentions, palliative care, which involves the easing of pain and treatment of symptoms, as opposed to attacking a disease head-on, can sometimes be the best course of action for an elderly person.
In order to improve care for people with heart failure, the AHA report suggests that doctors conduct an, "Annual Heart Failure Review," to discuss a patient's condition and their goals for future treatment. It is also important to respond to milestone changes in a person's health. These can include everything from a cardiac episode to the development of dementia.