What are the stages of congestive heart failure?

my dad is being taken care of by my husband and myself and helped tremendously by hospice. He has copd, diabetes, a history of cabg, a quad. by pass, hyperlydemic, hyperthyroid, and severe, severe dementia. When we went to get him in Jan. they didn't think he could even survive the trip to NC, but he not only survived, he actually improved, with reg, medicene, good meals, and most of all love and caring he seemed the best he'd been in 5 yrs. Unfortunately, we are down to the last stages. No food, no fluid, can't swallow and is having a horrible time breathing. I promised him I would not let him die alone in a hospital., and I will keep true to my word. He's had last rights, and I sit and sing with him, I say prayers, and hold his hand. Listening to him breath is agonizing, but I know it is worse for him.His lungs are filling up and there is a foam in his mouth that seems to choke him. We suction this out, and he is burning up with 104 fever. I know that no one can put a time line on a life, I would just like to know how long a person can survive like this, The morphine drops and the atropine drops seem to control the pain, but my heart goes out to him. They say it is only a matter of time, but that can be anything, Please give me some kind of hope that his h*ll will be over soon, My heart is breaking.

Thank you everyone for your input. I appreciate your knowledge on the subject. It is just so hard seeing him struggle everyday just to breath. Last visit with Cardiologist his oxygen level was 97, since then he has been diagnoised with a kidney stone and an aneurysm (sp) in his stomach area, aorta?? Fluid in the lining of his lungs. All of that and he is still calling himself lazy because he can't get out to chop wood or do the yard work. So very sad to see him beat himself up because he can't be the strong worker he once was. Men like him don't come along very often. Thank you all so much!!!

unless you knew him well, you wouldnt even know he was sick. we go to the store normally, take a drive. but the thats all he can do. even then his oxy drops below 85. he refuse to get a portable oxy, cus he 'doesnt want to wear it out in public'..sheeesh.
today he was helping bring in the groceries and his oxy went to 69 and he had blue lips. i told him he needed to be in the hospital and he still refuses.

Hi prwhite55, hope all is going well for you today and you have some sunshine in your world. It sounds like you have your hands full and I am sure often a heavy heart.

Your situation is much different than ours so I can’t tell you much that may be of help to you and what you are dealing with or suggest viable options. When I said they wouldn't do further cardioversions on my FIL it was because they were not holding and he would just keep going back into atrialfib, so no point in doing it over and over. He is on 17 different pills every day, including Bumex, Amniodarone, Coumadin, and a ton more. His feet and ankles look like watermelons from fluid retention caused by poor circulation after using leg veins for by-pass surgeries. He is in mid-stage dementia and getting him to do what he is supposed to is an exercise in futility. We try to curtail his salt and fluid intake and get him to keep his feet elevated, but he drinks fluids all day and gets up in the middle of the night to get more ginger ale. We have salt substitute and he loads that on his food to the point of snow-covered mountaintops. We put his feet up and two seconds later, he has them down. This is our fourth series of wound clinic sessions because he won't do what he is told or wear the pressure stockings, so his legs split from the fluid pressure. We keep thinking he has CHF, but no official diagnosis and after all the angioplasties, by-pass surgeries and new heart valve, they tell us his heart is fine. Could have fooled me, but hey.

Your husband is young and it sounds like he is mentally acute, so his medical plan will be much different and more aggressive that that of my FIL. I take it your husband has other problems than just the diabetes. Is he also suffering from CHF and possibly COPD?

I wish I could be more help, but I don’t know the care plan or complete medical picture you are dealing with. I am sorry, but that is about all I have to offer relating to the cardioversion and why we aren’t having it done anymore. Seems like in the deep recesses of my mind, the doctor said he could do it 5 times, but I have heard there is no limit. However, after the second, they usually suggest and look to alternative treatments.

I wish you and your husband hope and health in all you are going through. This must be a lot for you to shoulder. I pray that the extra fluid they removed gave him relief and he feels much better. May the doctors find the answers so you will have a long and joyous life together.

Hugs!

@ manybelessings..do you mean just for you they wont do cardioversion more? or is there a limit? my husband is 61 and suffering from diabetes, has dialysis 3x a week, had afib twice in two weeks, both times cardioversion helped. was on warfarin but after 3 weeks refused it any longer. the cardiologist didnt complain. he is also on Amiodarone and 6 other drugs. currently we cant keep his oxygen level over 85% at resting. he uses oxygen all day, and cpap at night. he also cannot walk half a block with out being winded. today he managed to go to breakfast with a friend and has been up one hour of the last 8 hrs. he cants stay awake anymore.
the cardiologist suggested he try having the dialysis take off another kilo, which they did today. i dont know what to expect of his situation.

My uncle Ben is 89 and has CHF and renal insufficiency.His refraction rate is only 35%.He is also incontinent,and taking lasix four times a week doesn't help.There are four stages to CHF,and he is in stage 2B,which means he can walk several blocks before he gets out of breath and has to sit down.He went into vfib several years ago and was declared clinically dead.He has a midway aortic aneurysm,and his lad is 90% blocked.He has an implanted ICD which both shocks his heart and also paces.He is now on both Coreg and Amiodorone,but fluid build up is still a problem,because he likes his TV dinners.Last year,he received 19 shocks in a row and we had to rush him to the hospital.He was put on 400mg of amiodorone which lowered his blood pressure to 70/40,and he couldn't function.I fought to have it lowered to 200,and at least he can get out of bed and take walks.

Try WebMD for medical questions and answere.

My dad is 86 and was diagnosed with congestive heart failure in 1995 or so. He has had some ok years, some very, very bad years and some fair years. 4 years ago he had respiratory failure from the CHF and ended up on a ventilator for 2 weeks. Noone thought he would survive but did and ended up having his aortic valve replaced a year and a half ago in an effort to better control his failure with medications. He had about 3 fairly good months and then we were right back into the cycle of gradual decline into failure, hospitalization, medication adjustments, etc, etc, etc. This year he was in the hospital for his CHF in Feb, March, April and May. After the valve replacement his heart function improved some but we found in May that it has gotten worse and he is now classified as end stage heart failure. What does that mean as far as a timeline? Who knows. He may go for several months without having any problems or he may go into failure next week. He is always in a state of heart failure, it's just how acute are his symptoms at any given time. Anymore, he goes downhill very fast. He doesn't want to go to the hospital anymore so we admitted him to hospice, knowing that we WILL reach a point of no return with his failure without hospital intervention and this gives us the ability to maintain his comfort at that point. There are stages and you can find the description of them on various websites when you look up congestive heart failure. His stage is Class IV and is determined by his symptoms, his other health issues, etc. It's a long road and very difficult to witness when they are at their worst. Thankfully, there has been more research into this disease process and they are finding better methods to control the symptoms. Ask your doctor if there is a heart failure clinic nearby that you could go to. These are overseen by cardiologists who specialize in CHF and usually run by nurse practitioners. It gives another level of care and their primary focus is managing the failure in an outpatient setting with frequent adjustment of medications based on patient symptoms, lab testing, etc. Dad was in one for about a year and I really did feel it reduced the number of times he could have been hospitalized. Hope this helps.

My Mom is 88 with CHF. She was first diagnoised 8 years ago. She had a pace maker installed and lives on a ton of meds that sometimes have to be changed now and then to keep up with the problem. (and she is on coumadin, which I hate because of the constant monitoring) . After the implant of the pace maker, the hospital provided us a book to take home called, "Living with Heart Failure". My moms doctor just recently told me in one of her visits that she is worsening. If she lifts anything strenuous , which is not a lot, it causes bleeding out of the valve of the heart. They don't want to operate on her because of her age. Even though she has been told many times about how the condition, and how it can effect you, she continually will say she doesn't understand and continues to do chores around the house. She loves to do house cleaning and is her only hobby she enjoys doing. All I can say, is that I have read up on it on many websites. Never really found anything on a timeline. Its just that the heart is working hard all the time, and can be managed by different medications. However, no one can live forever, so I guess you can only imagine that the heart will keep beating the best it can, till it can no longer. I just keep up with the Doctor and always tell him what is going on as to how she feels. If you are a caregiver, you have to monitor alot of things to keep things on track to help the person with the bad heart. I feel it is only buying them time. I only know that someday it will give out, but the best advice is to always ask the Doctor. If you don't like the Doctor, keep searching to find one that you feel confident with.

Momsdaughter2,

My mother is a-fib and I know it is a hard thing to handle seeing a loved one suffer.

Wishing you the best.

Oh yea, atrial fib, cardioversion 4 times and because it no longer holds they won't do it anymore. Coumadin needs weekly monitoring. Dad was put on Amiodarone too but it is only for controlling fibrillation and since he was no longer a candidate we had him taken off. That was a while ago, but I do remember there were nasty side effects and that is why we asked to have him removed from that medication. Once you start Coumadin, you, more than likely, will be on it for life. And when there is fibrillation, especially atrial, you will be put on Coumadin to prevent clotting.

I am sorry you had such a terrible experience with Cleveland Clinic, Purple. The doctor we had was the top in the world and after extensive research, that is why we elected to go there for Dad’s mitral valve. We were extremely happy with the doctor and his team. However, I have to admit, the nursing care after the surgery was deplorable. I am a nurse and have never seen such shoddy quality of patient (lack of) care. When being transferred his chest tube separated because they were not watching and it wrapped around the wheel of the wheelchair. When he started complaining because it was pulling and hurt, I saw the problem and told them to STOP!! What really corked my cookies was they just reconnected it without cleaning the ends of the tubing that had been dragging on the floor and wrapped in the wheel. We were expected to bathe him as no one ever came in to help. And when they did, they were grumpy and never smiled. It was unreal! Those were just a few incidents, there were numerous others. But, he recovered and is doing fine, so I guess..... We had taken my sister-in-law to Mayo's for 13 surgeries battling ovarian cancer and they were FANTASTIC!! Truly cared about the patients and families comfort. Everyone smiled and had a kind word, not just a number like we were at Cleveland. Think I would choose Mayo over Cleveland. Sorry Cleveland.

I am not sticking to the “timeline” information, but it all is part of the care. IMHO. And interesting to hear what others have experienced as they travel down the road.

there is no cure for CHF, but if managed well patients can live a long time. My father is suffering from CHF and COPD. He has been living with CHF for awhile. The stages do involve progressive weakening of the body, fluid build up, circulatory problems, etc. Oxygen helps. My father gets tired easily and is weak. It is heart breaking because one day I know he may not wake up. From what I understand from my research, it is a peaceful way to go. However, my godmother's mother was gasping for air. I think with proper medication and oversight from your doctor you can live fairly comfortably.

My father died at 84,just this past March. He had just about every heart problem imagineable. He died of congestive heart failure. He suffered a severe heart attack at 62 and lost the back portion of his heart. At the time, he was put on several heart medications and monitored. As time went on , he had to have a mitral valve replacement.He was sent to Cleveland Clinic, but the doctor tried the new band-aid fix, and in so doing, my dad suffered a stroke. This led to 6 weeks at the Clinic and therapy once he came back home. He was put on Coumadin as well as lasix to his heart regimen. There were a few strokes after this and then a V-fib attack. More pills and more therapies along with an ICD implant. Dementia set in,but he still could feed himself and groom himself,etc with some assistence. He was mobile and my mom made sure he had good quality of life. And then, in Dec. of 2011, my Dad heart beat began racing and he was hospitalized and put on the last best type of medication to control it. The medicine gave him jerky tremors and he lost the ability to walk. He was no longer able to be cared for at home, and went to a nursing home, where he spent the next 21/2 months. He began filling up with fluid so much so that his heart and ICD began to be affected. His lungs filled up with fluid, his breathing became difficult and he literally drowned in a fluid around his heart and lungs. Doctor was wonderful and kept him comfortable and out of pain. I watched my Dad die. If you ask me what was the worst part of this ordeal, I would tell you that the last medication , amioderone, was the end for him. His life from that moment on had no quality. Make sure your doctor is honest with you about what to expect and what he will do for your loved one when the time comes. We learned only from this unbearable experienceIf there is no quality to your life, there is NO LIFE AT ALL!

That is a very good question. I too would like to hear what others have experienced.

My father-in-law has not been "officially" diagnosed with CHF. He has had four different by-pass surgeries and three angioplasties. When he was at Cleveland Clinic for a new heart valve, they asked if anyone had diagnosed him with CHF, but didn’t confirm it there either. That was over five years ago and he is still going. Other physicians have asked the same question, but none has said it definitively. If he doesn’t take a mountain of medications swells up like a balloon. Also has beginning stages of dementia. Due to incontinence issues created by the medications, he is often not too pleasant to be around. He can't smell it and gets testy if we tell him he needs to go change. Refuses to wear protection no matter how it is presented to him. We never refer to them as adult diapers, although, that is how everyone perceives them. What is it with old people? I would think they want to preserve some semblance of dignity, but maybe the mind just doesn’t care any longer. However, my mother was 95 with severe dementia when she died and through the fog she ALWAYS wanted to be clean. I deeply appreciated and respected that about her, even if it wasn’t always easy.

My father-in-law lives with us. He can't go too far without being out of breath. He basically does sitting activities and, sadly, since the death of his wife, they include drinking. Breaks your heart. Along with being very frustrating on numerous levels, especially when the doctors don’t back us when we try to discourage its use with the medications. I too have wondered how much longer he can keep going. He is 86 and out lived his wife who died from dementia three years ago and my mother died last December at 95.........all have lived with us. We are becoming very knowledgeable in areas we never wanted to experience.

I hope someone out there can shed light on the CHF timeline. I know each person is an individual, but am finding there is a pattern to most of the illnesses.

Thank you in advance for you input and thanks for reading. This is a fantastic site and deeply appreciated by all of us who go through the trials and love while caring for loved ones.

I really don't think congestive heart failure has stages. It is a condition that can be treated and if not well taken care of can get worse. Other medications for other problems can also make the chf worse like some diabetic meds. The dementia on the other hand dose have stages, this also can play on the chf. The best thing you can do is sit down with his doctor or your own and discuss this with them. This way you will get better answers to your question. I hope this helps a little, I know its hard when you care for someone.