When rescue efforts don’t work well, consider hospice referral for in-home CHF management.

Prognosis in heart failure is tricky.  These pieces of history indicate poor prognosis.

• Brittle fluid management, including use of metolazone,
• Spending more than 50% of time in bed or in a recliner due to dyspnea or fatigue,
• Trouble showering due to dyspnea or fatigue,
• Orthostasis severe enough that you cannot use an ACEI, ARB or beta blocker,
• Little or no functional improvement after hospitalization.

For the medical criteria we use for CHF prognosticating, visit Hospice of the Northwest’s website and click the link for Guidelines for Hospice Admission.

For more information, contact Dr. Leslie Estep, Dr. Anita Meyer, or Dr. Erika Pope at Hospice of the Northwest, 360-814-5550, or lestep@hospicenw.org, ameyer@hospicenw.org, or epope2@hospicenw.org.

All Palliative Pearls and other resources can be found by clicking Healthcare Professionals at the top of our website.

If you would like to receive monthly Palliative Pearls via email, please contact Pam at pputney@hospicenw.org.