barriers to following their treatment plan while they’re in the
hospital, so that the medical team can work with them to find
solutions, such as:
• Making sure patients and caregivers understand HF and
related conditions they may be managing.
• Teaching them skills (such as how to monitor HF
symptoms and how to choose a low-sodium diet).
• Discussing ways to increase support at home (both
practical support and emotional support).
• Simplifying the medication regimen when possible.
• Substituting medications when drug side effects occur.
“We really want to promote HF self-care while patients
are hospitalized,” Grady said. “We want to ensure that they
are knowledgeable about their discharge plan of care and able
to implement the plan. Being an active partner in developing
the plan of care, while hospitalized, can promote successful
self-care at home.”
THE CHALLENGE OF SELF-CARE
Patients with HF often have a lot to do to take care of
themselves, especially if they have other conditions such
as hypertension, diabetes or kidney problems. This means
that they may have multiple care plans that they’re trying
to follow. “It can really make self-care challenging and
difficult,” Grady said. “Following a diet that addresses
multiple chronic conditions — low fat, low salt, low
sugar, perhaps low potassium — can be very difficult and
frustrating from a patient’s perspective, seemingly almost
impossible,” Grady said. She indicated that a dietitian
should be part of the medical team, and patients should
ask for one, if not.
PATIENTS WITH HF FREQUENTLY
“Depression can contribute to not managing care well at
all,” Grady said. It can definitely affect how well they stick to
their medical regimen.
A lack of understanding health information can also lead
to inappropriate decisions in regards to self-care. “Many
HF patients have limited health knowledge, and that makes
it challenging to adhere to the regimen,” Grady said. “Poor
health literacy can decrease their confidence in taking care of
themselves as well, and it can contribute to poor outcomes
like increased mortality.” For example, some patients may not
understand the term “sodium” when reading food labels for a
Rise Above HF: Get the facts.