many homecare agencies have chf programs that do intensive visits first 2 weeks (3x wk, some dailyx3) as most frequent rehospitalization is in first 21 days post discharge. insist on this if not already receiving home care.
heart failure is graded on the extent of their fatigue and dyspnoea; a tool often used to assess their condition is the new york heart association classification
new york association heart failure classification
[font=verdana, arial, helvetica, sans-serif]class 1 no limitation. ordinary activity does not cause undue fatigue, dyspnoea, or palpitations
class 2 slight limitation of physical activity. comfortable at rest, but ordinary physical activity results in heart symptoms.
class 3 marked limitation of physical activities. comfortable at rest, but less than ordinary activity causes heart failure symptoms.
class 4 symptoms of heart failure are present at rest. if any physical activity is undertaken, discomfort is increased.
ejection fraction < or = 20% patients been managed on home care too. homecare manages many patients in class 4 until patient decides it's their time, then we transtion to hospice. with vigilant diuretic use along with newer meds, many patients survive longer than expected. minimal appetite despite meds to improve appetite usually tipping point...along with too tired to go on.
telemedicine big in homecare for chf pts too:
uc davis health system - chf home care study
palliative care and chronic heart failure
the role of the heart failure specialist nurse
management of the patient with congestive heart failure using ...
here's hoping that she receives optimal care to maximize quality of her life.