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Recommended Books:
Success With Heart Failure book cover Breathing Disorders Sourcebook book cover
Handbook for Mortals
Handbook for Mortals Read the online version of this authoritative guide to end of life.

Heart Failure (CHF and COPD)

Caregiver Guides
Download helpful guides to living with Advanced Congestive Heart Failure or Advanced Lung Disease in PDF format provided by the Center for Palliative Care Studies.

Diseases of the heart and circulatory system are the leading cause of death in the United States. Congestive heart failure (CHF) is a progressively debilitating illness that eventually will lead to death. In this disease the heart gradually loses its ability to pump blood effectively. Without a good blood supply, muscles and organs don't get enough oxygen, causing various problems. Because blood doesn't circulate as it should, fluid backs up in the lungs and lower parts of the body. That's why people with this disease often have swelling in the feet and legs. The body is "congested" with fluid, which is why this disease is called congestive heart failure.

CHF may occur along with Chronic Obstructive Pulmonary Disease (COPD), a progressive and irreversible condition in which the airways of the lungs are damaged and unable to process oxygen well. Shortness of breath and coughing are common symptoms. Emphysema and chronic bronchitis are forms of COPD. Direct medical costs for COPD in the U.S. total $18 billion per year, nearly 9 percent of Medicare expenditures. The combination of CHF with COPD is not unusual in advanced illness. Both diseases make it hard for the entire body to get the oxygen it needs everywhere it needs it.

CHF and COPD are chronic illnesses that can go on for a long time. The exact course of the illness may be difficult for your physician to determine. There are usually ups and downs, sometimes requiring acute hospital care. As CHF or COPD get worse, it becomes difficult to perform physical tasks that require moving around. People with advanced disease may need help from family members and other caretakers to do basic things like getting dressed, cooking, or other chores, particularly those that require going out of the home. This makes caregiving a family affair, with impact on everyone in the household.

As it gets harder to do things, quality of life declines. People with advanced disease often realize that they are likely to die, and begin concentrating on how to maintain the highest possible quality of life for as long as life remains. Planning ahead can include learning about hospice care and death with dignity. A key objective in hospice and home care is to obtain high-quality palliative care to control pain and preserve the highest possible quality of life for as long as life remains.