Abstract
The primary remit of terminal care in heart failure is to relieve suffering, which begins with a routine and standardized assessment of symptoms using validated instruments. The scope of this review is to explore symptom burden and control, and to examine some instruments used to assess and monitor heart failure patients' distress. Elderly heart failure patients have many complaints and poor global health status. Symptoms are both of cardiac and noncardiac origin, attributable to the high frequency of comorbidities, side effects of medication and the psychosocial consequences of a chronic progressive illness. Continuity of care, familiarity with the patient and the quality of inter-personal relationships between patients, relatives, nurses and physicians are essential to obtain high-quality end-of-life care. Validated instruments to measure symptom burden may be useful tools to quantify patients' distress and to evaluate the efficacy of care.
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