[A Case of Home Care for Heart Failure]

A female in her 80s with a history of cerebral infarction and atrial fibrillation had repeated hospitalizations because of heart failure caused by ischemic myocardiopathy. She lived alone and received home care and support for self-care with involvement of multiple providers, enabling early detection of disease exacerbation and subsequent intervention. A new ischemic event was managed with percutaneous coronary intervention. With deterioration of renal function, her response to diuretics decreased, and dialysis was initiated. Home therapy was continued in cooperation with a dialysis center. Finally, the patient was admitted to a convalescent-type hospital equipped with dialyzers for ongoing dialysis. This case highlighted both the potential and limits of home therapy in management of heart failure. Active treatment and support for decision-making were also considered important.