Managing Heart Failure at Home
Heart failure means the heart is not pumping as well as the body needs, so fluid backs up into the lungs, legs and belly. It is one of the most common reasons older adults go back to the hospital within a month of leaving it, and most of those readmissions start with a few days of slowly building fluid that nobody noticed.
The single most useful habit is a daily weight: same scale, every morning, after using the bathroom and before breakfast, written on the same sheet. A gain of two to three pounds overnight, or five pounds in a week, is usually fluid rather than food, and it is the earliest warning you will get. Our nurses leave a weight log on the refrigerator at the first visit for exactly this reason.
Most people with heart failure are asked to keep sodium under about 2,000 milligrams a day, and some are given a fluid limit too. Canned soup, deli meat, frozen dinners and restaurant food are where most of the salt hides. It is not neccessary to give up every favorite food; reading labels for a week usually shows where the easy changes are.
Medications are the other half. Water pills work best taken in the morning so the bathroom trips happen during the day. If a dose makes you dizzy when you stand, tell your nurse rather than skipping it; there is usually a timing change that fixes it.
Call your nurse or doctor if
- You gain 2 to 3 pounds overnight or 5 pounds in a week
- You need more pillows than usual to breathe at night
- Your ankles, legs or belly are more swollen
- You feel short of breath doing things that were easy last week