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3 evidence-based tips for living with heart failure

The Bottom Line

  • Around 600,000 Canadians currently live with a diagnosis of heart failure—facing symptoms such as shortness of breath, fatigue, and fluid retention.  
  • In certain people with chronic heart failure, exercise may help improve physical function and quality of life, compared to not exercising or receiving usual care.
  • Personalized self-care plans, specific psychological strategies (such as cognitive behavioural therapy), and ‘decision aids’ are approaches that can be used to enhance self-care practices.
  • Home visits by a health professional and heart failure clinics can reduce the chances of being readmitted to the hospital and of dying within six months after an initial hospitalization. 
  • Consult your health care provider about the ins and outs of managing heart failure—ask specific questions about exercise, effective self-care practices, and transitional care options. 

Wheezing, feeling tired and weak, trouble focusing, swelling, a fast or irregular heartbeat, being short of breath—during activity and/or rest—and sudden weight gain caused by the body holding fluid. These are just a few of the symptoms that people with heart failure commonly experience (1).


If you have heart failure, you share this journey with the approximately 600,000 Canadians that currently live with this condition (2); and the additional 90,000 adults over 40 who are diagnosed annually (3). Although coming to grips with how to manage such a diagnosis can be daunting, as can coping with the impacts on your everyday life, there are things that you and your health care providers can do to improve certain aspects of your treatment plan and well-being (4; 6-10).


Research on the McMaster Optimal Aging Portal outlines the following three tips for living with heart failure. Click on each title for more information.


1. Get physically active

Heart failure is yet another health condition that calls for you to be physically active. What’s the benefit in this case? Well, engaging in exercise may significantly improve physical function and quality of life in people with chronic heart failure without any worsening of symptoms. These positive effects are seen when comparing those who exercise to those who do not exercise or those who receive usual care. Even better, it appears that details such as the type of exercise performed (specifically aerobic training, strength training, both, or exercise in therapy pools), how long it is done for, how often, at what intensity, and the location may not matter (4). This means that you and your health care provider have multiple options for identifying an exercise prescription that is safe and sustainable for you.


2.  Enhance your self-care practices

As the saying goes, some things are easier said than done. Self-care is one such thing. When it comes to self-care, some people with heart failure find it hard to implement recommended lifestyle changes—like the physical activity we just discussed (5). If you are struggling, a variety of methods exist to bolster your self-care efforts. These include: 1) working together with your health care provider to create a tailored self-care plan that takes into account your symptoms, needs, preferences, and capabilities; 2) using ‘decision aids’ to assist you in making tough choices; and 3) considering psychological strategies—such as cognitive behavioural therapy—that motivate and help you tackle the negative thoughts and conflicting feelings you may be experiencing (6;7).

 

3. Consider different transitional care options

Hospitalization is a reality for some people with heart failure, as is being re-hospitalized shortly after coming home (8). This highlights the importance of transitional care that continues to meet people’s medical needs as they transition from the hospital to their homes (9;10). This type of care can be received remotely through telephone support or in-person via home visits by a health professional or by attending heart failure clinics. Evidence shows that home visiting programs and heart failure clinics can reduce the chances of being readmitted to the hospital and of death within six months after an initial hospitalization due to heart failure. If you are facing the challenge of transitioning from a hospital setting to your home, be sure to speak with your health care provider about the transitional care options available to you (11).


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References

  1. Mayo Clinic. Heart failure. [Internet] 2020. [cited Sept 2020].  
  2. Heart and Stroke Foundation. What is heart failure? [Internet] 2020. [cited Sept 2020]. Available from: https://www.heartandstroke.ca/heart/conditions/heart-failure
  3. Government of Canada. Heart disease in Canada: Highlights from the Canadian Chronic Disease Surveillance System. [Internet] 2017. [cited Sept 2020]. Available from https://www.canada.ca/en/public-health/services/publications/diseases-conditions/heart-disease-canada-fact-sheet.html 
  4. Palmer K, Bowles KA, Paton M, et al. Chronic heart failure and exercise rehabilitation: A systematic review and meta-analysis. Arch Phys Med Rehabil. 2018; 99(12):2570-2582. doi: 10.1016/j.apmr.2018.03.015.  
  5. Spaling M, Currie K, Strachan P, et al. Improving support for heart failure patients: A systematic review to understand patients’ perspectives on self-care. J Adv Nurs. 2015; 71(11):2478-2489.
  6.  Strachan PH, Currie K, Harkness K, et al. Context matters in heart failure self-care: A qualitative systematic review. J Card Fail. 2014; 20(6):448-455.
  7. Jiang Y, Shorey S, Seah B. The effectiveness of psychological interventions on self-care, psychological and health outcomes in patients with chronic heart failure - A systematic review and meta-analysis. Int J Nurs Stud. 2018; 78:16-25. doi: 10.1016/j.ijnurstu.2017.08.006.
  8. Dharmarajan K, Hsieh AF, Lin Z, et al. Diagnosis and timing of 30-day readmissions after hospitalization for heart failure, acute myocardial infarction, or pneumonia. JAMA. 2013; 309:355-363.
  9. Stauffer BD, Fullerton C, Fleming N, et al. Effectiveness and cost of a transitional care program for heart failure: a perspective study with concurrent controls. Arch Intern Med. 2011; 171:1238-1243.
  10. Naylor MD, Aiken LH, Kurtzman ET, et al. The care span: The importance of transitional care in achieving health reform. Health Aff (Millwood). 2011; 13:746-754.
  11. Feltner C, Jones CD, Cené CW, et al. Transitional care interventions to prevent readmissions for persons with heart failure: A systematic review and meta-analysis. Ann Intern Med. 2014; 160(11):774-784.

DISCLAIMER: Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of these blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations such as social distancing and frequent hand washing. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with current social distancing recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.

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