by Mary Keen
Congestive Heart Failure (commonly referred to as CHF) is one of the most common chronic conditions in the U.S., one that particularly impacts the quality of life for older adults. More than 5% of persons aged 60-69 have CHF, and it is the most widespread diagnosis in hospital patients 65 years and older*. You can’t reverse many conditions that lead to CHF, but it can often be successfully managed.
What is Congestive heart failure?
Congestive Heart Failure (CHF) is a condition in which the heart is unable to pump enough oxygen-rich blood to meet the needs of the body’s other organs. The heart pumps much more inefficiently than a healthy heart and, as the heart’s pumping action weakens, blood backs up into lungs and other tissues. The body retains more fluid than usual, resulting in swelling of the ankles and legs. The symptoms can vary depending on how much of the heart’s pumping capacity has
been affected, but these are the major ones: shortness of breath during rest, exercise, or while lying flat; weight gain; visible swelling of the legs and ankles; fatigue and weakness; loss of appetite; nausea and abdominal pain; and persistent cough.
Treatment for CHF is a very complex process, with special staffing needs, equipment requirements, and more. Recognizing the critical need for specialized care for patients with this condition, combined with the increased prevalence of CHF among its patients, CJE SeniorLife recently opened the Lieberman Center for Heart Health. This 11-bed specialty unit provides outcome-driven after- hospital care and rehabilitation utilizing evidence-based practices. Patients in private rooms have access to the most current methods of treatment to manage their heart health recovery process. The beds feature pulse oximeters for monitoring patients’ pulses and oxygen levels. In addition, thera peutic recliners are available to assist with the flow of fluids in the body which can help to reduce swelling.
Caesar DeLeo, M.D., a board-certified cardiologist with numerous years of practice in heart care and extensive experience in the field of heart failure diagnosis and treatment, is heading up the new Lieberman Center for Heart Health. As its Lead Physician, his goal is to see that patient care is optimized and that the Center’s Heart Health outcomes are positive. As with all of Lieberman Center’s healthcare programs, a major aim is to reduce readmissions to hospitals after discharge. Explains Dr. DeLeo, “The readmission rate is the single most important health systems challenge currently, and it speaks to the need for a different model for treatment of congestive heart failure.”
- Control of Sodium Intake. At Lieberman’s Center for Heart Health, patients’ sodium intake is controlled by a diet that includes less that 2000 mg of sodium per day. An excess in salt intake or sodium burden has been one of the major forces contributing to worsening heart failure.
- Daily Weight Measurement. Patients in the program are weighed daily to determine if they have added weight. The gain of two to three pounds shows that a person is retaining fluid, and the anticipation is thatthe symptoms of hear failure will either emerge or worsen over time.
- Constant Medication Management. Lieberman staff members administer medications prescribed by physicians and the plan of care. Beta blockers (they not only slow the heart rate but also remodel the heart muscle), along with various blood pressure medications (they also have a beneficial effect on the ability of the failing heart to improve) and any number of water pills (alone or in combination) are just a few of the chemicals available to physicians in the treatment of heart failure.
This new model is based on evidence that the best way to control congestive heart failure is to control risk factors and the conditions that cause CHF.
Dr. DeLeo emphasizes the importance of a holistic approach to treating CHF: “We look at the whole patient. Through education, we try to reduce risk factors significantly by helping patients make lifestyle changes to improve their quality of life. We encourage them to stay active, relieve stress, lose weight and quit smoking. We attempt to instill good habits so that when patients are discharged they will continue following our recommendations. By limiting the progression of the condition by closely monitoring symptoms, tracking dietary and medication compliance and ongoing education, we can prepare for the best outcomes.”
- Heart attack recovery
- Coronary artery disease (CAD)
- High blood pressure—hypertension
- Cardiomyopathy—heart muscle disease
- Heart valve diseases
- Abnormal heartbeats—arrhythmia
- Congenital heart disease
- Thyroid disorders
The Lieberman Center for Heart Health is committed to a multidisciplinary approach that provides comprehensive, cutting-edge care from a team of specialists who can fulfill the diverse needs of CHF patients. In addition to Dr. DeLeo, the heart health team includes a physiatrist, nurse practitioner, registered dietician, social workers, rehabilitation therapists and pastoral staff. As a result, patients enjoy improved outcomes via a range of management strategies that they can continue once they return home. For example, rehabilitation therapists demonstrate exercises that keep oxygen levels up; dieticians teach individual meal planning; and social workers provide ongoing emotional support and facilitate a successful transition back home. Emerging research shows that Transitional Care is a very important component in reducing hospital readmissions. Also the Lieberman Center for Heart Health utilizes CJE SeniorLife’s comprehensive network of programs and services to provide patients with a range of supportive resources upon discharge from rehabilitation.
Lieberman Center for Heart Health provides patient-centered, outcome-oriented care that takes into account the varied causes of CHF, how far the symptoms have progressed and a patient’s overall health and strength. Whether early stage or advanced, whatever the cause, the Lieberman Center for Heart Health is equipped to provide compassionate care with the goal of achieving exceptional outcomes for patients with congestive heart failure.
For more information, contact Ron Benner, Executive Director, Lieberman Center for Health and Rehabilitation at 847.929.3320 or visit our website at www.cje.net/centerforhearthealth.
*Heart Disease and Stroke Statistics--2011 Update: A Report from the American Heart Association.
This article originally appeared in the Spring 2013 issue of LIFE, CJE SeniorLife's quarterly magazine.