Heart Disease Care at Home

Heart Conditions Explained

The term "heart disease" covers a range of conditions:

• Coronary Heart Disease (CHD) — narrowing of the arteries supplying the heart, leading to angina or heart attack. The most common form of heart disease.
• Heart Failure — the heart doesn't pump blood as effectively as it should. Causes fatigue, breathlessness and fluid retention. A chronic condition requiring ongoing management.
• Atrial Fibrillation (AF) — an irregular heart rhythm. Associated with increased stroke risk, often managed with anticoagulant medications (blood thinners).
• Heart Valve Disease — valves don't open or close properly, affecting blood flow through the heart.
• Peripheral Arterial Disease (PAD) — narrowed arteries in the legs, causing pain on walking and poor circulation.

Daily Life with Heart Disease

Heart conditions can cause fatigue, breathlessness, pain and reduced tolerance for activity — all of which can make daily tasks challenging:

• Breathlessness may limit cooking, cleaning and climbing stairs
• Fatigue can be severe — particularly with heart failure
• Multiple medications need to be taken precisely
• Fluid and salt restrictions may apply (especially with heart failure)
• Activity must be balanced — too little is harmful but overexertion is also risky
• Emotional impact — anxiety and depression are common alongside heart disease

How Home Care Helps

A home carer can provide practical support that significantly reduces the burden of daily living with heart disease:

1. 1

   Reducing Physical Exertion

   Taking over physically demanding tasks — cleaning, cooking, laundry, shopping — to reduce the strain on the heart and conserve the person's energy for the activities they value most.

2. 2

   Heart-Healthy Meal Preparation

   Preparing low-salt, heart-healthy meals. Monitoring fluid intake where restrictions are in place. Ensuring adequate nutrition when appetite is reduced due to medication or fatigue.

3. 3

   Medication Prompts

   Heart medications — including anticoagulants, beta-blockers and diuretics — must be taken consistently and at the right times. Missed doses or incorrect timing can have serious consequences.

4. 4

   Monitoring and Observation

   Noting and reporting any changes — increased breathlessness, ankle swelling, significant fatigue, or changes in urine output (relevant in heart failure) — to family or healthcare professionals promptly.

5. 5

   Companionship

   Emotional support and social connection. Anxiety about health is extremely common in heart disease — consistent, positive company makes a real difference.

Heart Failure — Special Considerations

Heart failure requires particularly careful monitoring. Key points for carers and families:

• Daily weighing — many heart failure patients are asked to weigh themselves daily. Sudden weight gain of 2+ kg in 2 days may indicate fluid retention and should be reported to the care team
• Fluid restrictions — some patients are restricted to 1.5–2 litres of fluid per day, including fluid in food
• Salt restriction — low-sodium diet is typically advised
• Diuretics — "water tablets" must be taken at consistent times. They can cause urgent need to pass urine — ensure bathroom access is safe and timely
• Breathlessness — worsening breathlessness, particularly at rest or when lying flat, should be reported promptly

Medication Management

People with heart conditions often take multiple medications. Common types and what to know:

• Anticoagulants (warfarin, rivaroxaban, apixaban) — blood thinners for AF or blood clot prevention. Consistency is critical. Warfarin also requires regular INR blood tests.
• Beta-blockers (bisoprolol, atenolol) — should not be stopped suddenly. Should be taken at the same time each day.
• ACE inhibitors / ARBs — can cause dizziness, especially on standing. Ensure safe movement after taking.
• Diuretics (furosemide, spironolactone) — usually taken in the morning to avoid disrupted sleep from night-time urination.
• Statins — typically taken at night. Consistency matters more than exact timing.

Diet and Lifestyle

A carer can support heart-healthy living by preparing appropriate meals:

• Low in saturated fat — avoid butter, fatty meat, full-fat dairy, processed foods
• Low in sodium/salt — no added salt, avoid processed and tinned foods with high salt content
• High in fibre — oats, wholegrains, vegetables, fruits, legumes
• Omega-3 rich — oily fish twice a week (mackerel, salmon, sardines)
• Limited alcohol — no more than 14 units per week spread over at least 3 days, or as advised by the clinical team