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Interview HF41  

Interview HF41

Sex: Male
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A doctor explains why doctors find it difficult to talk to patients about the end stages of heart failure.

 



I don't forewarn people about for instance the risk of 'sudden death' which is one of the ways that people with heart failure leave this world, because I think it's a very difficult thing to live with. I don't necessarily warn people about the inevitability of deterioration because not everybody deteriorates and I think you have to strike a balance between honesty and between working with people's coping mechanism and you've always really got to have an ear open for what the patient herself or himself needs to know, and wants to know and I don't think any of us always get that right.  

Its impossible because it is a natural instinct, but I think the patient who wants to become an informed patient is gradually getting the means to do so and is going to have much better means now that DIPEx is available, but I think there are patients who cope best by what one researcher in heart failure called 'disavowal' which means that you know you've got the condition but you decide that you're going to lead your life in the best way you can without thinking about it all the time. And I think that's probably one of the commonest coping mechanisms that people have - its not denial, they know they've got it, they need to be aware that they've got it so that if it deteriorates they can call for help, but they don't let it dominate every aspect of their life all the time, and I think its working with these coping mechanisms that's one of the biggest challenges of helping people with heart failure.
Heart failure
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