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Heart failure and family caregiver burden: an update.

The estimated prevalence of heart failure in the United States for adults over 20 years of age is 5,700,000. Heart failure is the most frequent cause of adult admissions and readmissions to the hospital. It is the only cardiac-related diagnosis still rising in prevalence. Paradoxically, heart failure treatment advances are the major cause of this increase in prevalence. Better control of hypertension, newer pharmacological agents, heart transplant, and the addition of technological devices such single and double chambered pacemakers, ICDs, and ventricular assist devices allow patients to live longer after the onset of heart failure. The epidemiology and economics of heart failure exert immense demands on families with the transfer of responsibility for ongoing acute care as it moves from the hospital to the home. It is important to understand family caregiver experiences of burden as they have a direct influence on heart failure self-care and outcomes. Research in caregiver burden and heart failure is relatively new. To date, there are no population-based, longitudinal studies, nor are there large scale prospective, randomized, controlled studies pertaining to caregiver burden and heart failure. What we do have is a beginning understanding derived from small qualitative and a few larger descriptive studies of family caregivers of heart failure patients. The purpose of this paper is to provide an update on what is known regarding family caregiver burden as it pertains to heart failure, taking into account the changing nature of family caregiving and the impact of newer heart failure treatments and technologies.