Authors: Dr. Ruth Thomson, Four Seasons Chief Medical Officer, and Leisl Vale, Four Seasons Marketing Coordinator 

In partnership with the National Partnership for Healthcare and Hospice Innovation (NPHI) and the American Heart Association (AHA), Four Seasons is honored to provide an Advanced Cardiac Care Program for those in living with advanced heart disease in Western North Carolina.

Given that one person dies every 37 seconds from cardiovascular disease in the United States (National Center for Chronic Disease Prevention and Health Promotion, Division for Heart Disease and Stroke Prevention), a consistent and proactive approach to advanced cardiac care is critically needed. Despite frequent visits to the doctor’s office, emergency room, and hospital, many people living with advanced heart disease do not seek the support of hospice or palliative care. Patient and caregiver awareness of these services could help manage or prevent breathing difficulties, fatigue, and other distressing symptoms.

What is Heart Failure?

Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump well enough to meet the body’s needs for blood and oxygen. In other words, the heart can’t keep up with its workload (AHA Website).

Assessment and Eligibility

A detailed clinical assessment and plan of care specific to the disease process is essential to provide excellent care and symptom management for a cardiac patient. Key areas of focus include vital signs, weight, fluid and respiratory status, medication review, and psychosocial support. These support the critical thinking of the clinical staff and help to direct potential interventions, guide documentation, and foster communication among staff and medical providers.

Anyone living with advanced coronary artery disease or heart failure is a good candidate for palliative care. Palliative care can be provided alongside specialist cardiac care to support the patient and their family as they live with their disease and receive active treatment. Patients with advanced heart disease who desire hospitalizations and acute medical care can benefit from palliative care. Palliative care also can provide added support for those needing more aggressive interventions to help the heart pump such as inotrope infusions or an implanted ventricular assist device (VAD).

Those with New York Heart Association (NYHA) class IV disease are eligible for hospice care. NYHA class IV disease is characterized by symptoms like trouble breathing or chest pain (AHA website) while resting, which increases with any activity. Some patients with class NYHA class III disease may qualify for hospice, particularly if they have needed frequent ER visits or hospitalizations, or have other significant medical conditions, such as emphysema, kidney disease, or dementia, contributing to their symptoms and decline (AHA website).

Four Seasons Cardiac Care Program

At Four Seasons, we are committed to providing excellent, evidence-based care for our patients living with heart disease. In collaboration with NPHI and the American Heart Association, we offer our Patient and Caregiver Handbook (Viewable Here). The handbook provides educational information about heart failure and medications to treat heart failure, a wide array of management, diet, and self-care tips, and guidance on when to call your doctor, hospice, or palliative care team. It even includes diaries to record your symptoms, blood pressure, and weight to help your doctor, hospice, or palliative care team take the best care of you.

If you are living with advanced heart disease and would like more information about palliative and hospice care and services, please call Four Seasons at 828.692.6178. If you think you may qualify for palliative care or hospice, you can ask your cardiologist or primary care provider to make a referral to Four Seasons. You can even refer yourself or a loved one by calling Four Seasons at 828.692.6178 or submitting an online request care for care, and we will contact the specialist or primary care provider for you to request the referral and gather more clinical information.