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"Care Dimensions’ expertise in palliative care and hospice allows us to assess and treat symptoms so people can live well with their heart failure," says Kristen Schaefer, MD, HMDC, FAAHPM.
"Care Dimensions’ expertise in palliative care and hospice allows us to assess and treat symptoms so people can live well with their heart failure," says Kristen Schaefer, MD, HMDC, FAAHPM.

Living Better with Heart Disease

Posted on February 2, 2022 by Kristen Schaefer, MD, HMDC, FAAHPM

If you have a chronic heart condition, you likely see a cardiologist or your primary care provider (PCP) regularly.

What if you could add a specialist to your care team who could help you manage your symptoms for a better quality of life, even if your heart disease is progressing?

And what if you were able to have more care at home, with fewer trips to the hospital or doctor’s office?

All this is possible with a palliative care specialist who is specially trained to assess and help manage your symptoms, allowing you to be in control of the type of care and quality of life you want.  

Living with heart disease

Patients with advanced heart disease often can have increasing symptoms and crisis episodes for many years. They have close relationships with a primary care physician or a cardiologist who has carried them through periods of decline and improvement. Their symptoms bounce between better and worse with a lot of fine-tuning of medications and medical management over the course of the disease.

There comes a point when symptoms worsen and happen more frequently. These can include chest pain, breathing distress, cough and fluid build-up, fatigue, difficulty walking, increased anxiety, and more. Patients and families work harder and harder to stay on top of those symptoms. Care Dimensions’ expertise in palliative care and hospice allows us to assess and treat symptoms so people can live well with their heart failure. 

Palliative care for cardiac patients

For patients with advanced heart disease who continue to receive curative treatment from their cardiologist and other doctors, we offer palliative care – a consultative service that adds a layer of support for them and their families.

Care Dimensions palliative care physicians and nurse practitioners meet with patients at their home to learn about the patient’s symptoms and understand how those symptoms are affecting quality of life, what issues might be causing stress for the patient or family, and the patient’s goals. We work with the patient and their existing health care team on a coordinated care plan that aligns with the patient’s goals of care because we know that is a recipe for success.

In addition to home visits, we can set up telemedicine equipment in the patient’s home to facilitate daily check-ins on their weight, key vital signs, and how they're feeling. The data helps us see changes in the patient’s condition and medications can be adjusted quickly.

Palliative care can be offered at any age and any stage of a serious illness, and it can be provided along with curative treatment.

Specialized cardiac hospice care

If curative treatment is no longer pursued, the Care Dimensions hospice team can work with patients, families, and health care providers to address symptoms, reduce crisis situations, and maximize quality of life. Our interdisciplinary hospice team brings together the skills of a physician, nurse case manager, hospice aide, social worker, chaplain, complementary therapist, and volunteers. The specialized cardiac program provides:    

  • Pain and symptom management to reduce hospital visits
  • Daily calls from the clinical team
  • Telemonitoring devices to help track daily vital signs and symptoms, which are reviewed by the clinical team to alert them before symptoms become critical
  • Kaplan House or the Care Dimensions Hospice House for respite care or acute symptom management to avoid hospitalization
  • Medication and equipment management
  • 24/7 nursing support by phone and clinical visits as needed
  • Symptom management procedures to guide patients and caregivers to better control symptoms at home
  • Patient and caregiver education
  • Complementary therapies to provide stress relief and improve quality of life
  • Grief support

Care Dimensions’ long-standing Advanced Cardiac Care program for hospice patients served as the foundation for a new national program launched in 2021 in collaboration with the National Partnership for Healthcare and Hospice Innovation (NPHI) and the American Heart Association (AHA), which released a patient and caregiver guide.

Recognizing the huge unmet need of patients across the country with advanced cardiac disease—only 5% of heart failure patients discharged from the hospital utilize hospice services—Care Dimensions joined with five other NPHI members with established cardiac programs to lead the development of this new national model of care for hospice and palliative care patients with advanced cardiac disease.

Gain control of heart disease symptoms

If you're noticing that your symptoms are harder to control, if your shortness of breath is acting up and really getting in the way of your quality of life, or your lack of sleep or mood or pain is causing you stress and you're not able to have the quality of life that you want, that's a time to talk with your doctor about whether an added layer of palliative care or hospice could be helpful to you.

Download a copy of our Advanced Cardiac Care Patient and Caregiver Handbook at www.CareDimensions.org/CardiacGuide or call 978-750-9370 to request a copy. 

Learn more about our palliative care service.

Learn more about our specialized cardiac hospice program.

About the author
Kristen Schaefer, MD, HMDC, FAAHPM, is Care Dimensions’ Medical Director for Greater Boston and Director of Fellow and Medical Resident Education.

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Since 1978, Care Dimensions, formerly Hospice of the North Shore,  has provided comprehensive and compassionate care for individuals and families dealing with life-threatening illnesses. As the non-profit leader in advanced illness care, we offer services in over 100 communities in Massachusetts.

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