Advanced chronic heart failure in intensive and palliative care: A case-based analysis from the perspective of a non-physician healthcare professional

Abstract

Advanced chronic heart failure is a condition associated with high mortality and significant prognostic uncertainty, which complicates the timing of communication about goals of care. This article focuses on the analysis of the impact of such communication on the course of the end-of-life phase, based on two case reports of patients with comparable disease severity.

The presented cases show that delaying communication until the phase of acute decompensation may lead to limited patient participation in decision-making, increased burden on family members, and the use of intensive care without clear alignment with patient preferences. In contrast, early communication about prognosis and goals of care allows care planning in accordance with patient values and supports continuity of care.

The discussion further reflects on the role of non-physician healthcare professionals in the process of early identification of patient needs, facilitation of communication, and coordination of care. Experience from specialised palliative care suggests that this approach may also be beneficial in a broader context of care for patients with chronic, progressive diseases.

The article highlights the importance of early integration of palliative care into routine clinical practice and the need to support continuity of care throughout the course of the disease.