Helping a loved one with coronary artery disease

How can I help a loved one who has coronary artery disease?

If you have a family member or other loved one who has coronary artery disease (CAD) or has just returned home from the hospital due to a complication of CAD, you may want to know what you can do to help. Your loved one may be able to perform fewer normal activities and may also require a great deal of encouragement and emotional support. This article provides some guidelines on helping with daily activities and offering emotional support to loved ones who are recovering from CAD-related hospitalization.

What if CAD turns into end-stage heart failure?

Your loved one may need special assistance if CAD leads to heart failure. Heart failure typically results in a weakened heart, one that cannot pump blood in sufficient quantities to the body. Often, people with end-stage heart failure are not able to execute all the tasks and activities that they once performed with ease, and they may rely on you for both emotional support and physical assistance. As you read this article, you may want to consider how you may help a loved one in either situation: recovery from a CAD-related hospital stay or the later stages of heart failure.

How can I help with daily activities?

People who have CAD may experience considerable physical limitations because of chest pain or shortness of breath with exertion or because of severe weakness. These people may therefore rely on others for help with relatively simple but important tasks. If your loved one experiences trouble with daily activities, you and your family may choose to assume a large role in managing his or her day-to-day life. Some of the ways in which you can help are listed below.

• Shopping for and preparing food. Most people recovering from surgery cannot leave their house on their own to shop for food and therefore depend on others for what they eat. If you can, ask neighbors and friends to help with grocery shopping. Also, you may be closely involved in the preparation of all low-fat, low-cholesterol food for your loved one during recovery at home.
• Providing a clean environment. Cleaning the house may be too difficult during recovery. However, a clean environment can be important for both mood and health (to prevent infections). Caregivers should consider cleaning the house regularly or hiring a maid service. In addition, the temperature and humidity of the home should be controlled as precisely as possible. The physical discomforts of recovery from surgery often worsen during hot, humid days, and air conditioners should be used during the summer, if possible.
• Driving. For the first 3 to 6 weeks after surgery, or if your loved one can no longer drive because of chest pain, irregular heartbeats, fainting spells, or other complications of CAD-related heart failure, you may need to drive him or her to frequent doctor appointments.
• Medications. Most people with severe heart disease require multiple medications to control their symptoms. Having a family member organize medications into a special pillbox with one or more compartments for each day of the week can prevent the person from forgetting to take any medications or taking them incorrectly.

How can I provide emotional support?

Being a full-time caregiver may be an unfamiliar role for you and one in which you never imagined yourself. There are several things you can do to help provide the emotional support that your loved one needs at this time:

• Offer encouragement. Adopting lifestyle changes recommended for people with heart disease can be difficult. If the person you are caring for cannot comply with a strict diet or exercise regimen, encourage him or her to start slowly and build up to the ultimate goal over time. You may also offer to alter your own diet or lifestyle to encourage healthy behaviors. This is particularly true for smoking, since it can be nearly impossible for an individual to quit smoking if there is another smoker in the home.
• Help. Offer help, but encourage your loved one to remain active. Even though people who have just been hospitalized have physical limitations, they should still try to stay active as long as this does not cause undue strain. Getting moderate exercise and completing tasks around the house can often be done safely and will help the person you are looking after feel better both physically and mentally. If you are concerned about what level of activity is appropriate, speak with the doctor who has been the most involved in your loved one's care.
• Ask if you can participate in doctor visits. Offer support by sitting in on doctor visits and taking notes. Your loved one will be better able to remember important instructions if you help keep a record.
• Be realistic about the future. Your loved one may be facing a serious situation. You can help prepare for the future by helping review insurance policies, wills, and finances.
• Respect the wishes of the person you are caring for. Discuss living wills and other advance directives, and be clear about wishes concerning artificial life support in case you should be called upon later to make this important decision.

Why is it important to also look after myself?

Looking after a loved one who has CAD can be mentally and physically challenging, especially in the end stages of the disease. There are steps you can take to help make the situation more manageable for yourself. Remember that you will be an effective and loving caregiver only if your own physical health and mental outlook remain good.

• Enlist help when you need it. If possible, involve other family members or enlist the help of a visiting nurse. You may also hire a food delivery or housekeeping service to help with cooking and cleaning.
• Take time for yourself. Offering care can be stressful and time-consuming. To make sure that you do not burn out and that you can continue to provide love and care, it is very important to make time for activities you enjoy.
• Seek emotional support if you need to. Caring for a loved one who is recovering from a major procedure and who has a chronic disease can be emotionally difficult.

If you are having difficulty coping with your feelings, you should not feel ashamed or embarrassed about seeking advice and counseling from appropriate sources, such as other family members, trained mental health professionals, or religious advisors. Look for peer groups. You may be able to find support groups for people with caregiving responsibilities. Talking to other people who are in similar situations may be a valuable way for you to share your concerns and also to gather information.

When should I seek outside help?

Unfortunately, some families cannot assume care for a loved one with severe heart failure without enlisting outside help. Economic stresses may be overwhelming and, if all the family members are at work, adequate at-home supervision and care for the patient may not be possible. Additionally, some people with heart failure require more care than their family can be reasonably expected to provide. In these cases, you may consider placing your loved one in a long-term care facility.

The available long-term care options depend on an individual's level of independence and need for nursing supervision. Some people will still be able to perform basic activities on their own but may need assistance preparing meals and sorting medications. Such individuals may be well cared for in a supervised living facility where food is provided and staff is available to assist them if needed, but routine nursing care is not provided.

Other people with end-stage heart failure may have difficulty performing basic activities and may be better served in a nursing home where the staff can assist them with eating and bathing. In these more closely monitored settings, nurses can track your loved one's heart failure symptoms and ensure that he or she takes medications appropriately.

It is important for people in these facilities to feel that they are still a part of their family. Frequent visits by family members or day trips to the family home go a long way in improving their emotional health. At first, you may think that paying for elder care will be prohibitively expensive. However, there may be options available to make it more manageable.