• Judith E Hupcey, Janice Penrod, and Kimberly Fenstermacher.
• College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania 17033, USA. jxh37@psu.edu
• Am J Hosp Palliat Care. 2009 Oct 1; 26 (5): 399-404.

AbstractThe heart failure illness trajectory is both complex and unpredictable, which makes providing palliative care services to patients with heart failure a challenge. As a result, although services are needed, few tend to be offered beyond basic medical management. The traditional model of palliative care is typically based on palliative care being considered a system of care delivery most appropriate for patients with a predictable illness/death trajectory, such as terminal cancer. This type of model, which is based on the ability to predict the course of a terminal disease, does not fit the heart failure trajectory. In this article, we propose a new model of palliative care that conceptualizes palliative care as a philosophy of care that encompasses the unpredictable nature of heart failure.

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