Table 1: Recommendations to Optimise Hospice Care for Heart Failure.

Increase flexibility in hospice enrollment by prognosis and need: given the difficulty in assessing prognosis, we recommend additional factors to determine hospice eligibility

Early introduction of palliative care for HF patients: efforts to introduce palliative care earlier in the natural course of the disease should be made and tested

Improved advance care planning: advance care planning for people with HF should incorporate features specific to them, such as ICD and LVAD status and iotropes in use

Development of new care and payment models for hospice care: given limitations of current models for HF, new care and payment models should be tested and implemented

Improve training of hospice staff in HF care: to increase comfort and competency, nursing staff should receive HF-specific training

Additional intensive social and medical support at home: people with HF are at high risk of hospital admission, which should be addressed with additional support services at home

Increase research in palliative care in HF: more funding from federal ad other sources should be directed towards testing and implementing HF-specific palliative care

HF = heart failure; LVAD = left ventricular assist device.