1. Heart Talk: Living with Heart Failure
Education for patients, families and caregivers

2. An accompanying patient booklet can be downloaded for free at www
An accompanying patient booklet can be downloaded for free at Search for it and more under “Heart Talk”

3. What is Heart Failure? Weakness of the heart muscle
Sometimes also called:
Congestive heart failure
Pulmonary edema
Fluid on lungs
Retention of fluid

4. Common Symptoms of Heart Failure
Hard time breathing
Swollen ankles, legs, or abdomen (edema)
Feeling weak and tired

5. Heart Failure Can Be Treated
Medications
Procedures
Surgery

6. Heart Failure is Chronic
It requires lifelong treatment.

7. Heart Failure is Common
More than 5 million Americans have Heart Failure. 1
American Heart Association Heart and Stroke Statistical Update. Dallas, TX: American Heart Association; 2008. 7 7

8. 6 Tips for Staying Healthy Following these tips and doing what your doctor tells you will help keep you healthy

9. 6 Tips to Stay Healthy Take Medications as Ordered by Your Doctor
Go to Doctor Appointments
Monitor (watch) Your Symptoms and Weight
Adapt Diet (eating) and Fluids (drinking)
Get Exercise as Directed
Limit Alcohol, Caffeine and Tobacco 9

10. 1. Take Medications as Ordered by Your Doctor

11. What You Need to Know Take Medications as Ordered
Medications for heart failure are necessary even when you are feeling well.

12. How to Keep Healthy Take Medications as Ordered
Go over your list of medications with your doctor or nurse
Make sure you understand how and when to take them
Ask about side effects (reactions) or possible problems with taking medications with other medications and/or vitamins

13. How to Keep Healthy Take Medications as Ordered
Know how to refill your prescriptions
Call your doctor’s office a few days before you run out of your pills
Make sure you have a way to get your
medications
How will you get to the pharmacy?
possibly add - Will your pharmacy deliver?

14. How to Keep Healthy Take Medications as Ordered
Bring your medications or a list of your medications to all of your doctor appointments
Tell your doctor about any side effects or reactions
Do we want to instruct patients on how to read a prescription label… how to know if you have refills left? 14

15. What You Need to Know Take Medications as Ordered
Patients who take their medicines live longer, feel better, and spend less time in the hospital.

16. 2. Go to Doctor Appointments

17. What You Need to Know Doctor Appointments
Heart failure is not simple
The doctor needs to see you often to keep you well

18. How to Keep Healthy Doctor Appointments
Set up an appointment with your doctor before you leave the hospital or other facility
Set it up on the best day and time for you
Make sure you have a ride to your appointments

19. How to Keep Healthy Doctor Appointments
Bring a friend or family member
Bring all medications or a medication list to all appointments
Ask questions!
Your doctor wants to make sure you take care of yourself

20. What You Need to Know Doctor Appointments
Patients who go to doctor appointments live longer, feel better, and spend less time in the hospital.

21. 3. Monitor (watch) Your Symptoms and Weight

22. Monitor Symptoms Common heart failure symptoms: Hard time breathing
Swollen ankles, legs, or abdomen (edema)
Feeling weak and tired

23. Monitor Weight
When your body holds extra fluid (water), your weight goes up
Weight gain from fluid can start up to two weeks BEFORE symptoms
By weighing yourself every day, you can avoid getting sick

24. How to Keep Healthy Watch Your Symptoms and Weight
Get a scale if you don’t have one
Make sure you can read the numbers
Write your weight down every day
Bring the weight chart to your doctor appointments

25. How to Keep Healthy Watch Your Symptoms and Weight
Weigh yourself every morning at about the same time:
After urinating
Before having anything to drink
In the same amount of clothing
Use the same scale

26. How to Keep Healthy Watch Your Symptoms and Weight
Tell your doctor if you gain:
3 pounds in one day
5 pounds in one week

27. 27

28. Talk about what to do…hospital vs. SNF vs. home28

29. Talk about what to do…hospital vs. SNF vs. home29

30. 30

31. What You Need to Know Watch Your Symptoms and Weight
By monitoring for symptoms and weight gain, patients with heart failure can live longer, feel better, and spend less time in the hospital

32. 4. Adapt Diet (eating) and Fluids (drinking)

33. Salt and Water Salt = Sodium
High salt intake will make the body hold extra fluid (water)
Extra fluid leads to swelling and heart failure symptoms
Eating a low salt diet helps patients stay well

34. How to Keep Healthy Eating and Drinking
Do not add salt to any meals
Try to eat less than 2000 mg of sodium a day
One teaspoon of salt = 2300 mg of sodium
If you don’t buy and cook your own food, speak to the person who does

35. Reading a Label Check to see how many servings are listed on the label
Eating more than one serving size increases salt intake more than what is listed on the label

36. Common Food Salt Sources
Canned foods
Frozen dinners
Deli meats
Hot dogs

37. Other Food Salt Sources
Sea salt
Adobo seasoning
Salad dressings
Cheeses
Soy sauce
Jar tomato/pasta sauce
Pickles
Sausages and Kielbasa
Ham and Bacon
French fries

38. How to Keep Healthy Eating and Drinking
If you do eat salt, tell your doctor
Medications may need to be adjusted
More doctor visits may be needed
You may need to talk with a diet specialist
Ask about a diet specialist

39. How to Keep Healthy Eating and Drinking
Eating out: choose heart healthy foods
Baked or broiled foods
Salad dressing, sauce or gravy on the side
Safe dishes: baked chicken or fish, steamed vegetables

40. What You Need to Know Eating and Drinking
By avoiding salt in your diet, you can live longer, feel better, and spend less time in the hospital

41. Fluid Restriction
Sometimes doctors will limit the amount of liquids patients can have every day
Foods that count as liquids are: yogurt, pudding, ice cream, and gelatin
Some fruits have liquid: 1 orange or ½ Grapefruit = 4 ounces of fluid
Fluid Restriction means……

42. Fluid Restriction Space your liquids out over the day
Save liquids to take your medicines
Some patients can take their medicine with applesauce instead of a drink

43. Tips to Battle Thirst
Use ice chips or freeze juice in an ice cube tray
Rinse the mouth
Use a lemon wedge, gum, frozen grapes, strawberries or hard candy

44. 5. Exercise as Directed by Your Doctor

45. Exercise and Activity
Always check with your doctor. Your doctor can tell you what is good for you:
Exercise: Most of the time is safe and good for you
Sex and driving: Most of the time is safe for you
Ask your doctor about what activities are safe for you

46. 6. Limit Alcohol, Caffeine and Tobacco Use

47. Alcohol and Caffeine
You should check with your doctor about alcohol and caffeine use
Alcohol is usually okay in moderation
Less than 2 drinks per day for men
Less than 1 drink per day for women
Caffeine is usually okay in moderation
Less than 1 or 2 cups per day

48. Tobacco If you smoke, please STOP!
Bad for anyone, but especially for those with heart failure
Makes the heart work harder
Can lead to heart attacks
Ask your doctor or nurse about help to quit smoking

49. 6 Tips to Stay Healthy Take Medications as Ordered by Your Doctor
Go to Doctor Appointments
Monitor (watch) Your Symptoms and Weight
Adapt Diet (eating) and Fluids (drinking)
Get Exercise as Directed
Limit Alcohol, Caffeine and Tobacco 49

50. Credits The Hospital of Central Connecticut Shelley Dietz RN, MBA
Qualidigm
Anne Elwell, RN, MPH
Michelle Pandolfi, MSW, LNHA
University of Connecticut Heath Center
Wendy Martinson RN, BSN
Jason Ryan, MD, MPH

51. Special Thanks to:
David Lazauski for sharing his experience as a patient living with heart failure University of Connecticut Health Center Dr. Jason Ryan for his dedication to teaching us all how to live well with heart failure

52. This material was prepared in collaboration with Qualidigm, the Medicare Quality Improvement Organization for Connecticut, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. Pub #CT The views and opinions expressed here do not reflect the policy or position of the Centers for Medicare and Medicaid Services, nor of Qualidigm. Examples and information provided are for educational purposes only and should not be construed as medical advice. Any person with questions or concerns relating to any medical condition or treatment should consult with a qualified health care professional.