living-with

Looking after yourself

It's very important to take good care of yourself if you have heart failure.

Some of the main things you'llbe advisedto do are outlined below.

Take your medication

It's very important that you take any prescribed medication, even if you begin to feel better. Some medicines are designed to protect or heal your heart. If you don't take them, they can't help.

It's also useful to read the information leaflet that comes with the medication about possible interactions with other medicines or supplements.

Check with your care team if you plan to take any over-the-counter remedies, such as painkillers or nutritional supplements. These can sometimes interfere with your medication.

Also speak to your care team if you have any concerns about the medication you're taking, or if you're experiencing any side effects.

Have a healthy diet

Ahealthy, balanced dietcan help improve your symptoms and general health.

Abalanced diet should include:

• plenty of fruit and vegetables aim for at leastfive portions a day
• meals based onstarchy foods such as potatoes, bread, rice or pasta
• somedairy or dairy alternatives
• some beans or pulses, fish, eggs,meat and other sources of protein
• low levels of saturated fat,salt andsugar

You may also be given advice about dietary changes that can specifically help with heart failure, such as limiting the amount of fluid you drink.

Exercise regularly

Regularphysical activity can also help improve your symptoms and general health.

You may find exercise very difficult if you have heart failure, particularly if it's severe. Try to do whatever you can without overexerting yourself, and make sure you rest often.

You may be advised to get involved in a cardiac rehabilitation programme, which will usually involve specialised exercise classes for people with heart conditions.

Stop smoking

If you smoke, stopping smokingcan improve your overall health and reduce your risk of many other health problems.

Speak to your GP or anNHS stop smoking service if you think you'll need help quitting. They can provide support and, if necessary, prescribe stop smoking treatments.

Limit your alcohol consumption

You can usually continue to drink alcohol if you have heart failure, but it's advisable not to exceed the recommended limitsof more than 14alcohol units a week.

If your heart failure is directly related to drinking alcohol, you may be advised to stop entirely.

Read some tips on cutting down on alcohol.

Get vaccinated

Heart failure can put a significant strain on your body and mean that you're more vulnerable to infections.

Everyone with heart failure is encouraged tohavethe annualflu jaband the one-off pneumococcal vaccination.

You can get these vaccinations at your GP surgery ora local pharmacy that offers a vaccination service.

Want to know more?

• British Heart Foundation: living with heart failure
• Heartfailurematters.org:adapting your lifestyle
• healthtalk.org: real stories about living with heart failure

Cardiac rehabilitation

Cardiac rehabilitation is a specialist service led by healthcare professionals for people with heart conditions.

Theprogrammes vary widely across the country, but most cover one or more of the following:

• exercise
• education
• relaxation and emotional support

They're usually run in hospitals or community clinics by cardiac rehabilitation teams, which include various healthcare professionals, such as nurses, physiotherapists, occupational therapists and exercise specialists.

Before you start, you will have an assessment to find out how much exercise you can safely do.A programme of exercise can then be tailored specificallyfor you. You will be encouraged to start slowly and gently, and gradually increase the amount of exercise you do.

The education part of the programmewill give you information on healthy eatingand practical ways to reducethe risk of further damage to your heart.

Want to know more?

• British Heart Foundation:cardiac rehabilitation
• British Heart Foundation:cardiac rehabilitation in your area

Regular reviews and monitoring

You'llhave regular contact with your care team to monitor your condition.

These appointments may involve:

• talkingabout your symptoms such as whether they're affecting your normal activities or are getting worse
• a discussion about your medication including whether you think you might be experiencing any side effects
• tests to monitor your health

It'salso agood opportunity to ask any questions you have or raise any other issues you'd like to discuss with your care team.

You may be asked to help monitor your condition between appointments. For example, your care team may suggest weighing yourself regularly so any changes in your weight, which could be a sign of a problem, are picked up quickly.

Contact your GP orcare team ifyour symptomsare gettingworse or you develop new symptoms.

Your care team will advise you about when and where toseek advice if there's a potential problem.

Travelling and driving

Travelling

Havingheart failure shouldn't prevent you travelling or going on holiday, as long as you feel well enough and your condition is well controlled. But check with your doctor before you travel.

It may be advisable to avoid travelling to high altitudesor hot, humid places because this may put extra strain on your heart.

Flying won't usually cause problems, but if your heart failure is severe, your legs and ankles may swell andbreathing may become more difficult.

If you're flying, inform the airline of your condition. They may provide a wheelchair or electric car so you can avoid having to walk long distancesat the airport.

If you're travelling and sitting still for a long time, either in a car, coach or on a plane, you should do simple exercises to reduce the risk ofblood clots. Wearing flight socks or compression stockings while flying should also help.

It may be a good idea to take two sets of medication with you when you travel. Carry them in different places in case you lose one, and make a list of the medication you take and what it's for.

Having heart failure should not stop you getting travel insurance, but you may have to find a specialist company that will insure you.

Driving

You can usually continue to drive if you have heart failure, as long as you don't have any symptoms that could affect your ability to drive, such as a history of fainting.

You don't need to inform theDriver and Vehicle Licensing Agency (DVLA) if you have a group 1 licence for cars and motorbikes if your ability to drive is unaffected, although it's a good idea to tell your insurance company.

You should tell the DVLA about your condition if you have a group 2 licence for lorries and buses. If you have symptoms, you may be disqualified from driving these vehicles.

Want to know more?

• Travelling with a heart condition
• British Heart Foundation: holidays and travel
• GOV.UK:heart failure and driving

Emotions, relationships and sex

Being diagnosed with heart failure can be a shock. Some people feel scared, anxious, depressed or angry. These feelings are completely normal.

Some people also becomedepressed. Speak to your GP or care team if youfeelunable to enjoy the thingsyou used to, orcope with everyday life.

You may find your physical relationship withyour partner changes after your diagnosis because ofworries about having a heart attack, or because you lose interest in sexorare unable to get an erection, which can sometimes be caused by heart failure medication.

You candiscuss any worries or problems you have with your GP or care team if you feel unable to talk to your family or friends. They will be able to advise youand arrange support.

You may also find it helpful to join a heart support group, where you can talk to other people with heart conditions whose circumstances are similar to yours.

You can call the British Heart Foundation'sheart helpline on 0300 330 3311 to find out about support groups in your area.

Work and financial help

Can I continue working?

If you're well enough, you can keep working for as long as you feel able. With the right support, staying in work can make you feel better and give you financial security.

Talk to your employer as soon as you feel your heart failure is affecting your ability to do your job so you can find a solution that suits both of you. For example, it may be possible for you to work part-time.

TheDisability Discrimination Act1995 requires employers to make reasonable adjustments to working practices or premises to help a person with a disability.

Where possible, this mightinclude changing or modifying tasks, altering work patterns, installing special equipment, allowing time off to attend appointments, or helping with travel to work.

What happens if I can no longer work?

If you can't continue working as a result ofheart failure, you may be able to claim disability and incapacity benefits.

People over the age of 65 who are severely disabled may qualify for a type of disability benefit called Attendance Allowance.

Find out more aboutmoney issues on the British Heart Foundation website.

Help for carers

Carers may also be entitled to some benefits, depending on their involvement with the person with heart failure. You should find out whether you are getting all the benefits you are entitled to.

Heart failure can be disabling and distressing, and many people with the condition find it a huge relief to share their concerns and fears with someone.

As a carer, if youcanattend GP and hospital appointments with the person with heart failure, you can encourage them to ask the right questions while you note down the answers.

You could also provide the doctor with additional information or insights into the person's condition, which can be helpful for planning the right treatment.

Another way you can help is by watching for warning signs that the person's heart failure is getting worse, or if they are not responding to treatment.Contact the person's doctor if you notice a new symptom or their current symptoms are getting worse.

Signs to look out for include:

• shortness of breath that is not related to usual exercise or activity
• increased swelling of the legs or ankles
• significant weight gain over a few days
• swelling or pain in their tummy
• trouble sleeping or waking up short of breath
• a dry, hackingcough
• increasing tiredness or feeling tired all the time

See thecare and support guide for information about all aspects of caring for someone with a long-term condition.

What will happen towards the end?

Heart failure usually gets gradually worse over time. It may eventually reach a point where it becomes very severe and it's unlikely the person will live much longer.

Palliative carewill usuallybegin when heart failure reaches this stage. This involves treatment to help you feel as comfortable as possible,as well aspsychological, spiritual and social support for both you and your family.

You can choose whether you want palliative care and where you would like it to be provided. Itcan be provided:

• at home
• in a hospice
• in hospital

Plan in advance

It's a good idea to plan foryour carein advance, as you may not be able to make decisions about your treatment when you become severely ill.

Things you will need to consider include:

• making a will if you haven'tmade one already
• writing an advance statement this lets those close to you know about the type of care you would like and where you want itif you're not able to decide for yourself
• whether you want to make a living will (an advance decision) this allows you to refuse some or all forms of medical care in the future when you're unable to makeyour own decisions or tell doctors what they want
• whether you want to be resuscitated if your heart stops
• whether you would want your defibrillator turned off (if you have one)

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