Palliative Care in Older Adults with Cardiovascular Disease: Addressing Misconceptions to Advance Care

Purpose of Review: The prevalence of cardiovascular disease (CVD) increases with increasing age, and most patients with CVD are older. Death is more common in older than that in younger patients with CVD.CVD is responsible for significant disability, particularly in older patients. Findings: Older persons have many comorbidities that complicate palliative care. We summarize available information about palliative care in CVD and specifically in heart failure. We address many misconceptions about palliative care in patients with CVD, including the notion that palliative care and hospice are synonymous, that palliative care should be reserved for the end of life, and that it can only be delivered by dedicated palliative care providers. Palliative care for older persons with CVD includes therapies addressing the neurohormonal disarray and cytokine activation that accompany CVD, and other therapies that provide symptom relief. Summary: Palliative care should be delivered throughout the course of illness, by all clinicians involved in care. Communication should incorporate patient values into goals of care which should be revisited throughout the course of cardiovascular care.