Healthier and More Independent: the FMH Heart Failure Program

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Very little had changed in Joe Taccino’s routine, so when he experienced a sudden spike in his weight, swelling in his arms and legs, abnormal fatigue and shortness of breath, the 84-year-old widower wasted no time getting in to see his doctor.

Joe’s doctor diagnosed him with Congestive Heart Failure (CHF), a debilitating syndrome that occurs when the heart becomes too weak to pump oxygen-rich blood throughout the body. This had caused fluid to collect in Joe’s lungs, legs, arms, abdomen and other tissues, causing swelling and rapid weight gain. Less blood moving through his body also accounted for his shortness of breath and tiredness.

Almost as alarming as these statistics is the hospital readmission rate for patients like Joe. Nearly 80 percent of patients diagnosed with Heart Failure return to the hospital 1-2 weeks after discharge. To help reverse this trend locally, FMH has started a Heart Failure program that begins in discharge planning, and follows the patient home through Home Health services.

“The guidelines from the American College of Cardiology and the American Heart Association are very explicit about how to manage the patient with heart failure,” says Kathy Troupe, Coordinator of the new program. “Their full implementation involves the skilled services of nurses, physicians, pharmacists, physical and occupational therapists, dietitians, care managers and even Information Technology specialists.”

“We work as a team and, together, we have one goal: to help the patient understand Heart Failure, recognize its signs and symptoms and make the changes needed to live longer, more comfortable lives.”

Knowledge is Power: A Success Story
While the readmission rate for Heart Failure patients is staggeringly high, Joe Taccino proved to be the exception to the rule.

An important part of each visit involved monitoring Joe’s weight. A rapid weight gain could indicate a potentially dangerous fluid build-up that can lead to shortness of breath and swelling. Jackie encouraged Joe to record his weight each morning before breakfast, and to report any gains of two pounds or more in a day. Monitoring other symptoms such as cough, weakness or a feeling of increased heart rate is also important.

The two also spent time discussing Joe’s diet. Because too much salt causes the body to hold onto water, which leads to swelling, shortness of breath and fatigue, Jackie encouraged Joe to choose foods whose sodium content totaled less than 2 grams (2000 mg) per day. She also recommended he replace table salt with other flavor enhancers like pepper, onion, Mrs. Dash and lemon juice, and to replace high sodium foods such as deli meats, cheese, pickles, many canned foods, frozen dinners and fast foods with fresher, whole grain alternatives.

“A lot of people don’t realize how much sodium is hidden in the foods we eat,” said Nurse Dennis. “Many seniors rely on the convenience and portion-control of packaged foods, never suspecting how much salt is in a boxed meal or a can of most soups.”

While Joe was vigilant about making and keeping his doctors’ appointments and taking his medications carefully, some patients need more reminding, said Nurse Dennis. “We also talk about the importance of finding some light, regular exercise they can really keep up with,” she said.

“Joe is a great patient,” said Nurse Dennis. “He really understands that knowledge is power over his condition, and that if he learns as much as he can, and concentrates on doing the right things, he can live a healthier, more independent life.”


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