End stage CHF symptoms?

Specialties Hospice

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My mother has been hospitalized twice in the past 2 months. She has CHF and always has a cough and problems with fluid retention. I do not think she is ready for hospice. I am just curious. How exactly do they determine that a patient is in end stage CHF? Thanks

Sorry about your Mom and I am glad she is doing better now. You have got some great advice here but really it is a question from your heart because, well, it's your Mom. You are probably sensing that the treatments just aren't working as well or for as long as they once did. Hospice will still treat her symptoms focusing on Mom and how she feels and not the disease. They will also help mom and everyone that loves her cope with what is happening. No one can predict the best time to bring in hospice. There are just too many variables. What's your Mom's feelings on all this?

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Glad to hear your mom is doing better!

My husband and I use to take care of his father who has CHF. On average he was hospitalized every two months for a six day stay. His lungs would fill with fluid, his BNP would be around 850 and his EF at one point was 14. But he kept recovering thanks to lasix and getting away from the high sodium diet he adores. In the hospital he was on a low sodium diet, he would get discharged and head straight for KFC and the cycle would begin again.

CHF is weird. It can look for all the world like they are on deaths door and then once the fluid is gone, they are back to their old selves again. At one point, we had a doctor tell us that he would be shocked if he lived for another six months, that was over two years ago. Of course dear ol' dad still eats salt like it's going out of style, works aggressively in the yard on hot southern Mississippi days, eats candy like a six year old, misses his meds as often as he can and the whole time wonders why he gets short of breath and experiences syncope. That's a real puzzler ain't it? :uhoh3:

So after three years of carting him to the hospital after his marathon sessions in the yard and a buffet of salt, we got sick of it and moved on. He'll probably be around for another ten years. That's the tricky thing about CHF, when they're symptomatic, it can look like they are on deaths door, but once the crisis is over, they recover quickly.

I'd wait on the hospice care until a doctor suggests it.

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Thanks all.:wink2: Mom is back to her ornery self now. In addition to CHF, she also has alzheimer's so it is a real challenge to get her to stick to her low salt diet and to use her oxygen. Yes, when she does get sick it seems like she must be on death's door but then she recovers just fine. Yes, it does seem like she too is fine for 2 months then whammo she's as sick as can be and back in the hospital again.

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Specializes in NICU, Educ, IC, CM, EOC.

My Mom had CHF and Asthma...the last time she was in the hospital for decompensated CHF she said to me and my siblings, "you guys are going to make me live forever, aren't you?" I told her, no, we would not do that. I asked what she wanted and she said she wanted to go home and be able to "go out feet first like Dad." Her doc agreed to hospice, that meds would be stopped when she was ready. She went home with 24/7 caregiver. I told her that her meds would keep her going for quite a while, and when/if she was ready she could stop taking them whenever she wanted. She stopped meds about 5 weeks after going home, and died within a week. I did have to butt heads with hospice a couple of times because she wasn't "actively dying". She actively died when she stopped the meds, so those arguments didn't really serve much purpose other than to stress me out. Oh well.

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Sorry to hear about the loss of your mother.Thank you for sharing your experience. My mother is still going strong.

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If you have the option, check into home care. We see many CHF pts on homecare and can help them and the family and the MD make the adjustment and decision for hospice.

With our agency, the pt/family can get to know the hc nurse and then with time, if they chose hospice, that same nuse can provide continuity--plus there is already trust.

I've seen quite a few CHF pts so not ready to quit, yet their body is done.

Ejection fraction, BNP, symptoms and QUALITY OF LIFE.

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