Is congestive heart failure hospice treatment premature?

1 answer | Last updated: Nov 13, 2016
Karenjoy asked...

Is congestive heart failure hospice treatment premature? My father has been told that he is dying because of the CHF he has had and has worsened over the years. He has been told he has 6-12 months to live. He is now on Hospice care and doing very well, they have him stablized with his medications. He is now starting to feel like he wants to do his laundry, and do some of his cooking, like breakfast. He lives in a retirement/assist living facility and lately has gone down to eat dinner with his friends in the dining room. Now I am wondering if having hospice there was a little premature?? He now has all of the fluid of his body, has lost 33 lbs in 1 1/2 months, and is feeling much better and is doing things again. Is this the pattern we will see over and over again??? When will we be able to tell if this really is the time or when his heart really does fail? His EF is 35, he had an echo in Feb 2009, and that is when they(doctors decided that the medication and the enhancement center was not improving his condition.

Expert Answers

Jennifer Serafin, N.P. is a registered nurse and geriatric nurse practitioner at the Jewish Homes for the Aged in San Francisco.

I am glad that your father is doing better.  It sounds like the medications they are using have really helped him. 

Hospice care is started when someone is nearing the end of their life, usually with a time frame of 6 months or less.  Your dad was told that he had less than one year to live, and only time will tell if that is true.  Hospice focuses on quality of life and comfort.  They probably stopped some of the medications and treatments that weren't helping your father, and sometimes this can help improve the way people feel.  It sounds like it worked for him, and that is good.

Remember, the doctors gave an estimate how long your dad is expected to live given his heart problems.  That doesn't mean it is written in stone.  He could absolutely outlive their estimates, although it is rare that this happens.  I know it is emotionally hard to not know what is going to happen, but you should focus on the fact that he is feeling better and his quality of life is good.  Since this could change at any time, I would recommend taking each day as it comes.   

As for your question about when you will be able to tell when his heart is "really failing"- this will occur when the fluid builds up again, but the medications do not help to relieve that.  This may occur faster if the kidneys are not working well. 

You also wanted to know if hospice is prematurely involved.   I would say that most times, hopsice is called when it is too late.  You have already seen the benefits that hospice care can bring.