Managing Heart Disease

A health plan can make management of your loved one’s condition easier. Medication, diet, and exercise, should all be considered when developing a plan.

You and your loved one should monitor his or her daily activities 24 hours a day. Making a health plan can help reduce risks of further heart difficulties. Your loved one’s management plan should consist of:

  • Prescribed medicines
  • Diet
  • Daily activities
  • Exercise
  • Lifestyle and health habits
  • Family support

The Importance of Medicines

Taking prescribed medicine regularly is vital to treating heart failure. Depending on your loved one’s symptoms and diagnosis, his or her doctor may start treatment by prescribing one medication and then adding others later. Sometimes, treatment may begin with two or more medicines.

It may take several days or weeks to determine the right dosage of prescribed medications. Encourage your loved one to be patient as he or she and the health care provider work together to find:

  • The right medicines
  • The right amount of each one
  • The best time of day to take each dose

The benefits of medicines will be lost or reduced if your loved one doesn’t take his or her medication as prescribed. Skipping doses or not refilling a prescription can cause serious problems. It is also unwise to take more than the prescribed dose of any medication.

Side Effects

Any medication can have unintended side effects. If your loved one experiences any side effects, make sure he or she tells a doctor right away. If the prescribed medicines do not work as expected, others are available. Your loved one should also ask his or her doctor about possible side effects that may occur if he or she takes heart medications with other prescriptions, over-the-counter medicines, and certain foods.

Regulating Your Loved One’s Medicines

A daily medication schedule can help remind your loved one:

  • Which medicines to take each day
  • What each pill looks like
  • When to take them
  • When each medicine was taken

Developing A Heart-Healthy Diet

In addition to taking medications, your loved one should change and monitor his or her diet. Reduced salt intake can alleviate fluid buildup, which can cause breathing difficulties. If a healthy diet doesn’t reduce the fluid buildup, these symptoms may require hospital treatment.

A health care provider will instruct you how much salt, if any, can be in your loved one’s diet. Together, you may be asked to see a dietitian or other specialist for diet instructions and counseling. The dietitian may also suggest new ways to prepare foods, and help you modify your special, family recipes. Your loved one may be unhappy about giving up certain favorite foods, but you can help by giving them up, too. On the positive side, giving up certain foods provides the opportunity to try something new.

Many foods have “hidden” salt. Always check both the ingredient and nutrition labels for salt content. In general, beware of:

  • Frozen or canned foods
  • Cheeses
  • Processed meats (hot dogs, salami)
  • Canned soups

For a healthy diet, your loved one should consider an intake of:

  • Less than 7 percent of total calories from saturated fat a day;
  • 30 percent or less of total calories from fat a day;
  • Less than 200 milligrams of dietary cholesterol a day;
  • Just enough calories a day to achieve and maintain a healthy weight.

Saturated fat, which raises blood cholesterol more than anything else in the diet, is found mainly vegetable oils and in foods that comes from animals. Your loved one should also avoid food high in cholesterol. A list of foods to consume in moderation or avoid include:

  • Dairy products
  • Meat
  • Poultry skin
  • Coconut oil
  • Cocoa butter
  • Palm kernel oil and palm oil
  • Egg yolks
  • Liver
  • Kidney.

To cut down on saturated fat, total fat, and cholesterol, your loved one should eat:

  • Fish
  • Poultry
  • Lean meats
  • Low-fat foods
  • Low-fat or skim milk and other dairy products
  • Plenty of fruits and vegetables
  • Breads, rice, and pasta made from enriched or whole grains

The goal is to reduce salt, and possibly fat, in your loved one’s food without sacrificing the pleasure of eating. If your loved one has trouble changing his or her diet, ask your health care team for help.

Your loved one’s alcohol intake should be limited to one drink per day. One drink of alcohol is defined as a glass of beer or wine, or a mixed drink containing no more than 1 ounce of alcohol.

Be sure your loved one maintains a healthy weight. Obtain an accurate scale and have him or her weigh each morning after urinating, but before eating breakfast or dressing. If your loved one gained 3 to 5 pounds since last visiting his or her health care provider, inform the doctor immediately. The weight gain may be related to a retention of fluid.

Daily Activities

How heart failure affects your loved one’s daily activities depends on the severity of his or her heart condition. Your loved one should ask his or her doctor about:

  • Work—Can your loved one still work? Full time or part time?
  • Recreation—What exercise is possible? Can your loved one go hiking, play golf, swim, and attend sporting events?
  • Leisure—Can he or she travel, work in the garden, and do volunteer work?
  • Sex—Can he or she safely have sexual intercourse?

Your loved one shouldn’t be afraid to discuss private aspects of his or her life with a physician. Your loved one’s health care team relies on what he or she says to help reduce symptoms and improve the quality of his or her life.

Lifestyle Changes

Heart failure means your loved one may have to change his or her lifestyle and health habits. As your loved one learns to live with heart failure, he or she may discover new satisfactions and pleasures. Changes to daily life can be positive and rewarding. Work restrictions may lead to interesting and enjoyable leisure activities. Recreation may become a valuable part of daily life.

The Importance Of Exercise

Encourage your loved one to exercise regularly within his or her doctor’s guidelines. Many people with heart failure say they feel better when they exercise regularly. Usually your loved one can exercise safely at home or in a supervised rehabilitation setting such as a hospital, health club, recreation center, YMCA, or YWCA. An exercise program can include many activities such as walking, cycling, swimming, and low-impact aerobic routines.

Your loved one may be asked to see a cardiac rehabilitation specialist to help plan and monitor an exercise program. In addition, he or she may need an exercise stress test to see how much he or she can do safely.

Lifestyle And Health Habits

The following changes can reduce the symptoms of heart failure and improve the quality of your loved one’s life. In general, your loved one should:

  • Lose weight if he or she is overweight
  • Avoid smoking or chewing tobacco
  • Eliminate or reduce alcohol consumption
  • Avoid using illegal drugs
  • Avoid exercise that exceeds his or her exercise guidelines
  • Avoid coming into contact with people who have colds
  • Get flu and pneumonia shots

Your loved one may want to make other changes too, such as learning how to reduce stress.

Family Support

Family support can be especially important as your loved one adjusts to lifestyle changes. Let family members know how they can help by:

  • Keeping track of medicines
  • Preparing special, healthy meals
  • Exercising with your loved one
  • Finding more information on treating heart failure
  • Joining a support group with you or your loved one

Monitoring Your Loved One’s Progress

Managing heart failure requires keeping track of symptoms and monitoring how well your loved one follows the instructions set by his or her health care team. Your loved one needs to be responsible in:

  • Monitoring his or her own general health and reporting any changes in symptoms and how he or she feels
  • Taking medicines as prescribed, and immediately reporting any side effects to his or her health care team
  • Following set guidelines for activities and exercise, and speaking up when he or she is not able to do an activity or exercise easily
  • Following a prescribed diet, and reporting any sudden weight changes

If you notice new symptoms or a change in symptoms that you feel warrants attention, you should not hesitate to contact your loved one’s health care provider if your loved one doesn’t. Be prepared to provide the names and quantities of medicines he or she takes and describe symptoms.

Support Groups and Counseling

Diagnosis of heart failure can generate a wide range of feelings. Encourage your loved one to discuss these feelings with his or her health care team. Local support groups also offer the chance for you and your loved one to talk openly about your feelings with other heart patients and families. Ask your health care team about support groups where you live. If none exist, your health care team may help you start one.

© Copyright FamilyCare America, Inc. All Rights Reserved.

Adapted from Living With Heart Disease: Is It Heart Failure? AHCPR Publication No. 94-0614, developed by the United States Agency for Health Care Policy and Research.

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