<unk>  of<unk>  care in the patient with<unk><unk><unk>  is focused on making the patient comfortable.  Invasive procedures should be minimized, and patients may elect to have their defibrillators inactivated.  The growing number of patients with Stage IV<unk><unk>  (intractable symptoms of fatigue, shortness of breath or chest pain at rest despite optimal medical therapy) should be considered for palliative care or hospice, according to American College of Cardiology/American<unk>  Association guidelines listed below.
Some have argued that any patient with NYHA class III CHF should have a palliative care referral.  Palliative care can not only provide symptom management, but also assist with advanced care planning, goals of care in the case of a significant decline, and making sure the patient has a medical power of attorney and discussed his or her wishes with this individual.
Congestive heart failure end-of-life considerations
Sudden cardiac death post arrest care and prevention
Community-acquired pneumonia hospital admission decision
MICU Intern's survival guide sepsis
Suicide physical examination
Resident survival guide topics
Delirium cost-effectiveness of therapy
Traumatic brain injury future or investigational therapies