Advice sought for Stage 4 heart faliure - British Heart Fou...

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Advice sought for Stage 4 heart faliure

IamMe2 profile image
10 Replies

Any advice on what to do for my mother-in-law who has stage 4 heart faliure would be gratefully received.

I find myself in the weird position of looking after this 90 year old lady, with no support, other than 1 weekend at home a month, who has stage 4 heart faliure. Well, I always thought you could live for years with this condition and had high hopes in moving her to somewhere closer to home. This is not going to happen as she is now too frail, too tired and has virtually stopped eating and drinking, her GP is great, but can do nothing else for her, she says I am doing everything right so don't need help but is going to refer ma-in-law to the pallative care team. Frankly I am scared of what comes next, and have no- one to turn to. Any advice from you lovely people?

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IamMe2
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10 Replies
Fortepiano profile image
Fortepiano

I'm afraid the combination of being 90 and class 4 heart failure is not a good one. It is good that your GP is referring her to palliative care, as this is not available everywhere. Don't worry about her not eating, just go along with whatever she feels like.

I would really recommend getting in touch with Marie Curie ( they deal with all terminal illness) for further information and support.

End-stage heart failure symptoms can be controlled, but you need to know who to call, particularly out of hours. I'm sure you will find the palliative care team helpful - you could write down any questions you have.

mariecurie.org.uk/help/support

Also, do call the BHF nurses for advice.

You could also investigate if hospice care is available, which I would recommend. Often this can be combined with palliative care at home. Definitely ask for help.

Emotionally, I would also make sure you talk to your mother. It sounds as if she accepts she is nearing the end of her life. This is a time for having those conversations about life and love.

There have been some very helpful and practical posters on similar situations, and I hope they will come along.

All the best at this difficult time.

IamMe2 profile image
IamMe2 in reply to Fortepiano

Thank-you for taking the time to answer, I will contact Marie Curie to see if they have any advice to offer.

A hospice is out of the question, in a weak moment I promised I would ensure that she stayed in her own home until 'the end'. That was nearly a year ago but a promise is a promise so here I am.

Where do I find the posters you mentioned? I have never seen one!

Thanks again for your kind reply.

Fortepiano profile image
Fortepiano in reply to IamMe2

Sorry to raise your expectations - I know this topic has been covered before and I felt the other posters were more helpful than me! It's difficult though to find old threads on this site.

Most hospice care is at home, but your mother-in-law might accept hospice for a few days to get any symptoms under control, or day or respite care - or indeed as a failsafe for her final days. It's very different from going into hospital. Sometimes these decisions aren't written in stone when circumstances change.

Otherwise you definitely need to ask palliative care what happens if your mother in law gets much more symptomatic at night. You don't want to end up having to call an ambulance. Think about any worries you (or she) have about possible scenarios and ask the palliative care team and your GP so you feel prepared.

This might be a useful read if you haven't already seen it.

ncpc.org.uk/sites/default/f...

Hopefully her death will be quiet and peaceful - at 90 with cancer my father just faded away very swiftly. The main problem with heart failure tends to be breathlessness but morphine helps with that too, and a hospital bed. If her area of the country has heart failure nurses they should be involved. I am sure that once you hear from the palliative care team things will fall into place, but you definitely will need help. It needs a team approach.

IamMe2 profile image
IamMe2 in reply to Fortepiano

I have to smile at my stupidity sometimes. When you said 'posters' I took it to mean those advertising sheets stuck on billboards etc! Talk about taking things literally!

She is beyond the heart teams remit, hence the referral to palliative care, her GP has concluded that we are managing well enough without a hospital bed so all I can really do is wait for someone to turn up with some useful advice. In the meantime I will smile about the posters, which are as tangible as any other help!

Healthyheart1 profile image
Healthyheart1 in reply to IamMe2

Yes you are managing the practicall side of things. You may just be putting a front on. You need emotional support. I see this is your mother I'm law. Quite a dilemma to be in. I will keep you in my thoughts. Good luck and keep the posts going if you need support.

IamMe2 profile image
IamMe2 in reply to Healthyheart1

Me? I've got more front than Brighton and Blackpool put together! 🤫 Don't tell anyone though. Thanks for your kind thoughts.

IamMe2 profile image
IamMe2 in reply to Fortepiano

Thank-you for the link to the pdf file. That was the most informative and helpful advice I have had. I felt much better for reading it.

Fortepiano profile image
Fortepiano in reply to IamMe2

So glad you found it helpful.

Love100cats profile image
Love100cats

It's a case of handing over to those who do palliative care so that you are there to reassure and comfort. Whoever or whatever local support you have will be amazing and will ensure that your mum-in-law does not suffer in any way. This leaves you space to cement fond last memories of her which will help you cope with the loss.xx

IamMe2 profile image
IamMe2 in reply to Love100cats

I am not sure if I accidently deleted my reply . At the risk of repeating myself, Thank you for your kind and helpful reply.

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