Eliminating smoking

If you, the patient, or another caregiver smokes, now is the time to stop. Smoking decreases lung function, which makes the symptoms of congestive heart failure worse. But recognize that it's not easy to stop smoking. Here are a few ways you can help:

• Ask the patient what he thinks would make it easier for him to stop smoking. He may have suggestions you haven't thought of.
• Encourage him to talk about his feelings and what he's going through. Smoking may be a comforting lifelong habit; let him mourn a little.
• You may be tempted to nag or yell if he slips up, but it's more effective to be supportive. Be positive and encouraging -- and vent your own frustration to a friend instead.
• Help him avoid situations that may trigger the desire to smoke. If he's used to enjoying a cigarette after meals, try going for a short walk outside instead.
• Be understanding as he goes through withdrawal. Try not to take it personally if he's especially irritable, short-tempered, and tired.
• Quit smoking yourself. If you must smoke, don't do it around the patient. Not only will your smoking make quitting more difficult for him, but the secondhand smoke may worsen his heart failure symptoms.

If he finds it too difficult to quit on his own, talk to his doctor. Nicotine replacement therapy, support groups, and counseling may all be helpful.

Keeping comfortable

Symptoms of congestive heart failure, such as swelling and shortness of breath, can be very uncomfortable. Here are some ways you can help someone feel better:

• Comfortable, nonbinding clothing and shoes may make it easier for him to tolerate the leg and ankle swelling that often accompanies heart failure.
• Support stockings, which you can purchase at your local drugstore, may alleviate leg swelling during the day.
• Pillows that elevate a person's head at night may help him breathe more easily while sleeping.
• Limited amounts of salt and liquids can minimize retention of fluids, significantly lessening his symptoms.

Staying on top of medications

One of the most important things for managing congestive heart failure is to take medications consistently and according to instructions. Know which drugs the person you're caring for needs to take and how often he should take them. Also find out what to do if he misses a dose.

If he lives alone, you can fill a pillbox with the medications he should take each day of the week. You can also post a simple daily medication schedule on his refrigerator or in his bathroom so he can check off each dose as he takes it.

If he has difficulty following the schedule, you might want to call him at regular intervals to make sure he's taken his medications.