Communication and Decision Making in Advanced Heart Disease

Part 1: Introduction

< /
|
1
|
2
|
3
|
4
|
5
|
6
|
7
|
8
|
9
|
10
|
11
|
12
|
13
|
14
|
15
|
16
|
17
|
18
|
19
|
/ >

Events triggering discussion




    Annual HF review
  • Scheduled clinic visit that assesses symptoms, QOL, and function, review of current status, sharing of prognosis
  • Loss of independent ADLs, falls, transitions in living arrangements (assisted vs independent)
  • HF hospitalizations
  • Serial escalations in diuretic dosages
  • Refractory fluid retention or reduced renal function
  • ICD shocks or arrhythmias
  • Need for IV inotropic support, renal replacement
  • New diagnosis of other co-morbid illness
  • Major life event, death of partner, other