Advanced heart failure: impact on older patients and informal carers

Prognosis in heart failure is poor with more than one third of patients dying within 12 months of diagnosis. End of life symptoms are distressing and poorly controlled. This qualitative research focused on the patients' and their carers' understanding of the condition and the impact it had on their lives. The researchers found that patients with heart failure had limited understanding of their condition; concerns about their future were commonly expressed but few had been explicitly told about their prognosis. This supports earlier reports that there is a need for better patient information including discussion of prognosis. Further findings were that patient wishes were frequently not supported. People were often reluctant to contact their GP fearing inappropriate hospital admission. The study demonstrated that the condition has a profound impact on the lifestyles of patients and carers with isolation being a particular problem.