Making Shared Decisions About Heart Failure

Working through challenges

When heart failure gets worse, it can be hard to make decisions. You might face emotional struggles. But you don’t have to do it alone. You can work with your health care team to find answers.

Here are some common barriers people face — and how to deal with them.

Barriers and solutions to shared decision-making: 

• Barrier: Fear, anger, stress or other emotions 
  Solution: Strong emotions can make it hard to think clearly and make good decisions. Share your feelings with your health care team so they can help you manage them. 
  
  For example, if you’re scared about a procedure, they can connect you with someone who has been through it before. They can also give more details about the test or procedure.
  
  
• Barrier: Depression and anxiety
  Solution: Depression and anxiety are common in people with advanced heart failure. It’s normal to feel sad or worried when your condition gets worse. Talking about your feelings with people you trust can help. If you’re still anxious or very sad, counseling, medication or both may help you.
  
  
• Barrier: Unable to understand complex health information 
  Solution: You might feel overwhelmed by all of the information you receive. But you don’t have to understand everything right away.
  
  Ask questions and make sure you understand the answers. Repeat what you hear to your health care professional so they can clarify if needed. If you need extra help making a decision, ask for a decision aid. These aids can help you consider your options based on your values and preferences.
  
  
• Barrier: Family dynamics
  Solution: Some families avoid talking about end-of-life decisions. But it’s important to discuss your preferences and goals for care with your family. Advance care planning helps your family know what care you want.
  
  Learn how advance directives can help you make health care decisions.
  
  
• Barrier: Cultural and religious differences
  Solution: Your culture and religion can affect your care choices. Share how your beliefs affect your treatment decisions with your care team. The palliative care team, a hospital chaplain or a social worker can help if needed.
  
  
• Barrier: Language differences
  Solution: If English isn’t your first language, ask for an interpreter. Some hospitals have trained medical interpreters to help patients communicate with their health care team.
  
  
• Barrier: Not enough time with the health care professional
  Solution: Lack of time can be an obstacle to shared decision-making. Time to talk with your health care professional during an appointment can be limited. So, make the most of your time by being prepared and organized. Take a list of questions and concerns. 
  
  Make sure you get the answers and help you need. If you need more support, ask for help from a palliative care specialist or social worker.
  
  
• Barrier: Disagreeing with the health care professional 
  Solution: In shared decision-making, you and your health care professionals are partners. Sometimes partners disagree. Communication is key when this happens. If you are told a treatment isn’t suitable for you, ask why. Then, talk about other options that might work better for you. 
  
  Learn about finding the right health care professional and getting a second opinion.