Heart failure – advanced

Although treatment can help to control heart failure symptoms, heart failure can get worse over time so that treatment isn't as effective and your daily life is affected.  

Symptoms of advanced heart failure may include that you: 

• are very short of breath despite not exerting yourself or even at rest, while you are already on quite a few medicines
• need more help with day-to-day chores, such as getting dressed, preparing meals or personal care
• lose your appetite 
• feel weak, with no energy and feel very tired
• have repeated hospital admissions due to heart failure or need to see your doctor multiple times
• are losing weight 
• stay in bed most of the time and move around less. 

If you have advanced heart failure, it's likely that you won't get any better. Your doctor will suggest palliative care treatment to make sure you are living in comfort and to improve your quality of life.

Palliative care aims to manage any distressing symptoms you may have and enables you and your whānau to make decisions about how you wish to spend the remainder of your life. Your doctor is likely to refer you to a palliative care team to talk about some of the choices you may want. Read more about palliative care. 

It is a good idea to plan your future health care and end-of-life care to help prepare you and your whānau for what the future might hold. This is especially helpful if you can no longer speak for yourself, eg, if you get very sick. It also helps your healthcare team know what health care you want or don't want. This is known as advance care planning. 

If you have advanced heart failure and are towards the end of your life, your doctor may stop your heart failure medicines as they are no longer effective in managing your symptoms.

Instead, your doctor may prescribe medicines to relieve your symptoms, such as:

• pain relief medicines to control your pain
• morphine or benzodiazepines to control your breathlessness
• antiemetics if you have nausea or vomiting
• laxatives if you have constipation. 

Read more about common symptoms in palliative care. 

The Heart Foundation NZ(external link) provides resources and support for those living with a heart condition. You can also find a local support group(external link) in your area. Contact them using their online form(external link) or visit their website here(external link).

Extra support is also available if you need it. Talk to your healthcare team to find out how you can access this.

It includes:

• equipment to help with your daily chores, such as chair raisers and shower stools
• mobility parking and taxi vouchers to help you get around your community
• carer support to help support your carer who is looking after you
• counselling or mental health support
• needs assessment if you want to move into a rest home or other residential care. 

Related topics

Heart failure
Heart failure videos

Learn more

Heart failure resources(external link) Heart Foundation of NZ