It's important to talk with your loved ones about your values and wishes regarding health care, in case you become unable to make decisions for yourself in the future. Having these conversations now can provide comfort and ensure you receive the type of treatment you want.
Everyone should have a health care proxy—a person who can speak on your behalf if you lack the capacity to do so. Discuss the choices you would make for yourself with your proxy to avoid burdening them with difficult decisions later on.
Advances in treatment have greatly extended the lives of people with heart failure. While cardiovascular disease remains the most common cause of death, many people with heart failure now survive into old age. However, this also means facing more uncertainty about the future.
No doctor can predict exactly how long someone with a serious illness like advanced heart disease will live. People with advanced heart failure may have both good and bad days, and they face an increased risk of dying unexpectedly from sudden rhythm disturbances. Accepting this uncertainty is a fundamental aspect of the human journey.
Only about a quarter of adult Americans have an advance directive, which helps guide future care. After choosing a health care proxy, consider using a health decision worksheet to explain your goals for care in detail. This worksheet includes questions about:
Your fears about the final stages of life
Aspects of your life that are most crucial to you
What will bring you joy
Preferences regarding artificial nutrition, hemodialysis, and comfort-focused care
Review your advance directive every few years while healthy, or more urgently if you have new diagnoses or major life changes. For free copies of a health decision worksheet and health care proxy form, visit /ADforms. For a detailed report on advance care planning from Harvard Health Publications, see /lw.
Having difficult discussions now will simplify difficult decisions in the future. Sharing your wishes with loved ones can reinforce vital connections and provide a sense of relief, even if the conversations feel awkward or emotional at first.
People with advanced heart failure may eventually reach a point where symptoms become hard to manage. Palliative care specialists can help keep them comfortable and pain-free using measures like low-dose narcotics. Those with implantable cardioverter-defibrillators (ICDs) may want to discuss with their physician when to disable the shock feature, as keeping it functioning can interfere with a more natural death.
By engaging in advance care planning and discussing your wishes with loved ones, you can ensure that you receive the care you want and provide comfort to your family during challenging times. For more information on end-of-life care and advance directives, visit the National Institute on Aging, National Hospice and Palliative Care Organization, or American Bar Association websites.
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