Frailty, end-of-life care and heart failure

This session looks at how to tailor approaches in patients who have heart failure (HF) with coexisting frailty and for those who may be in the last year of life, in order to better improve their outcomes and experience of care. It is structured into 2 main sub-module component parts:

• Part A: Understanding frailty and its relevance in the management of HF
• Part B: End-of-life care for people with HF

The session describes up-to-date best practice evidence-based management principles for frailty, plus palliative and end-of-life care (PEOLC), through a series of 7 high impact (HI) actions to help improve outcomes, reduce avoidable harms, reduce premature mortality risks and reduce inequalities that people may commonly face.

Due to the amount of content, completing the full session will take 45-60 minutes.

Introduction

This session describes how and why we need to identify those with HF, who have coexisting frailty, and those who may be entering their last year of life. It emphasises the importance of identifying frailty, plus those with emergent EOL prognostic indicators in the most timely way and the risks of not identifying them.

Figure 1 shows that adults of any age with HF may commonly follow a continuum from not having frailty, to developing frailty and then when they are likely to be entering their last year of life.

Patients may enter this continuum at any point, sometimes even skipping the severe and very severe frailty stages and yet still have terminal illness (also referred to as Clinical Frailty Score (CFS) 9 in persons aged over 65 years old).

This session takes the learner on a journey, describing key learning objectives.

• Part A explains what frailty is, how to diagnose it and how best to manage HF in persons with frailty.
• Part B explains how to identify and manage people with HF who may be in their last year of life.

The session describes up-to-date best practice evidence-based management principles for frailty, plus palliative and end-of-life care (PEOLC), through a series of 7 high impact (HI) actions to help improve outcomes, reduce avoidable harms, reduce premature mortality risks and reduce inequalities that people may commonly face.