Optimizing Skilled Nursing Care for Residents with Heart Failure

February, American Heart Month, seems an appropriate time to focus on the nuances of caring for residents with heart failure. According to the Heart Failure Society of America’s 2024 statistics, approximately 6.7 million Americans over age 20 have heart failure. That number is predicted to increase to 8.7 million in 2030. In 2021, heart failure accounted for 45% of cardiovascular deaths in the United States, and heart failure hospitalizations have increased since 2014. With heart failure such a significant health risk, caring for residents with the condition is a common challenge in senior care settings.

The Challenges of Caring for Residents with Heart Failure

A study published in Mayo Clinic Proceedings revealed that patients with heart failure who transition into skilled nursing facilities after a hospital stay often return to the hospital. The analysis of medical records of 1,498 patients in Minnesota found that heart failure patients in skilled nursing facilities were 50% more likely to return to a hospital than patients who were able to go home after their initial hospital stay.

Increased hospital readmissions are just one piece of the puzzle. Caring for residents with heart failure requires staff to manage complex medical needs while continuously monitoring residents and rapidly responding to any changes in their condition. “Challenges include administering and adjusting medications accurately, monitoring fluid retention, dealing with comorbidities, and ensuring that staff can recognize early signs of worsening heart failure,” says Kimberly Langdon, M.D., a medical doctor with Farr Institute. Additionally, the chronic nature of heart failure can put significant emotional and physical strain on residents and caregivers.

Several factors can contribute to higher readmission rates for residents with heart failure. This may include inadequate staff training on heart failure management, the complexity of the resident’s overall health conditions, less individualized care, and potentially slower times in modifying a resident’s treatment regimen. “Additionally, communication barriers between the care facilities and regular healthcare providers might delay interventions that could prevent readmission,” notes Langdon.

How to Ensure Supportive Care for Residents with Heart Failure

It’s essential to train staff in how to care for residents with heart failure. Langdon encourages skilled nursing facilities to implement ongoing training programs that focus on the latest heart failure management practices. This might include certification programs offered by cardiovascular health organizations or continuing education courses on topics like medication management, symptom monitoring, and emergency response. Senior care communities can also partner with local hospitals or medical experts to provide staff with hands-on training opportunities.

“Residential care communities should encourage exercise tailored to the individual abilities of residents with heart failure,” says Langdon. Such programs could encompass supervised waling, seated aerobics, or light resistance exercises to help maintain cardiovascular fitness without overexerting residents. “Facilities should ensure these activities are led by professionals trained in elderly fitness or cardiac rehabilitation,” she notes.

Since diet plays a crucial role in managing heart failure, facilities should work with dietitians to develop heart-healthy menus, such as meals low in sodium and rich in nutrients to support heart health.

In addition to physically supporting residents with heart failure, emotional support is an essential component of care. Langdon explains that many residents with heart failure experience depression and anxiety, so facilities need to be prepared to meet those mental health needs. Providing access to psychological counseling, facilitating support group meetings, and providing social activities that promote engagement and help prevent isolation can be helpful ways to support residents emotionally. Staff should also be trained to recognize symptoms of depression, which will allow senior care communities to promptly ensure that residents get the support they need.

The Importance of Coordinating with Exterior Providers

Langdon highlights the importance of maintaining strong communication with a resident’s healthcare providers. “This ensures continuity of care and can help prevent complications that lead to hospital readmissions,” she says. “Regular review and adaptation of care plans as the resident’s condition evolves is also crucial in managing heart failure effectively in a residential setting.”

Additionally, end-of-life planning is essential for residents with advanced heart failure. Langdon suggests facilities provide resources including access to social workers, legal advice for drafting living wills and healthcare proxies, and counseling services to discuss palliative care options. “Regular family meetings can help ensure that residents’ preferences are understood and respected,” she says.

Just as in caring for any other resident, providing individualized, attentive care is essential when caring for residents with heart failure. Recognizing and meeting the unique needs of these residents can help reduce hospitalizations and support the residents’ overall wellness and quality of life.

Paige Cerulli

Paige Cerulli is a contributing writer to i Advance Senior Care.