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Review
. 2018 Nov;33(6):1039-1049.
doi: 10.3904/kjim.2018.106. Epub 2018 May 23.

Palliative and end-of-life care for heart failure patients in an aging society

Takahiro Okumura  1 , Akinori Sawamura  1 , Toyoaki Murohara  1
Affiliations
Review

Palliative and end-of-life care for heart failure patients in an aging society

Takahiro Okumura et al. Korean J Intern Med. 2018 Nov.

Abstract

The populations of Asian countries are expected to age rapidly in the near future, with a dramatic increase in the number of heart failure (HF) patients also anticipated. The need for palliative and end-of-life care for elderly patients with advanced HF is currently recognized in aging societies. However, palliative care and active treatment for HF are not mutually exclusive, and palliative care should be provided to reduce suffering occurring at any stage of symptomatic HF after the point of diagnosis. HF patients are at high risk of sudden cardiac death from the early stages of the disease onwards. The decision of whether to perform cardiopulmonary resuscitation in the event of an emergency is challenging, especially in elderly HF patients, because of the difficulty in accurately predicting the prognosis of the condition. Furthermore, advanced HF patients are often fitted with a device, and device deactivation at the end of life is a complicated process. Treatment strategies should thus be discussed by multi-disciplinary teams, including palliative experts, and should consider patient directives to address the problems discussed above. Open communication with the HF patient regarding the expected prognosis, course, and treatment options will serve to support the patient and aid in future planning.

Keywords: Aged; Aging; End-of-life care; Heart failure; Palliative care.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1.
Figure 1.
Population aging in Asia. (A) Annual trend of aging rate. Aging rate is defined as the percentage of population aged 65 or over. (B) Top 10 countries/areas with high percentage of population aged 60 or over. Asian countries/areas are highlighted in red.
Figure 2.
Figure 2.
Palliative and end-of-life care in the time course of heart failure. NYHA, New York Heart Association; HF, heart failure.
See this image and copyright information in PMC

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MeSH terms