Living with and dying from advanced heart failure: understanding the needs of older patients at the end of life

• DOI: 10.1186/s12877-015-0124-y
• Publication Date: 2015-10-15T15:49:12Z
• Authors: Katharina Klindtw...; Peter Oster; Klaus Hager; Olaf Krause; Jutta Bleidorn; Nils Schneider
• Keywords: Limiting

Heart failure (HF) is a life-limiting illness and patients with advanced heart often suffer from severe physical psychosocial symptoms. Particularly in older patients, HF occurs conjunction other chronic diseases, resulting complex co-morbidity. This study aims to understand how old very perceive their disease identify medical, information needs, focusing on the last phase of life. Qualitative longitudinal interview (≥70 years) (NYHA III-IV). Interviews were conducted at three-month intervals over period up 18 months analysed using qualitative methods relation Grounded Theory. A total 95 interviews 25 analysed. The following key categories developed: (1a) dealing ageing, (1b) end life; (2a) perceptions regarding care, (2b) interpersonal relations. Overall, our data show that do not experience as disease. Functional restrictions changed conditions leading problems daily life activities prime concerns. needs priorities vary depending status individual preferences. Pain reduced quality an example major symptom requiring treatment. Many lack sufficient knowledge about condition its prognosis, particularly concerning emergency situations issues, many expressed wish for open discussions. From patients' perspective, there need improvement interaction health care professionals, limits treatment medical are openly discussed. Old acknowledge seriousness severity Their communication physicians predominantly focuses curative Therefore, aspects such self-management disease, end-of-life issues should be addressed more prominently. An planning (ACP) programme people could option improve patient-centred care.