Talking to patients with heart failure about end of life

Patients with heart failure (HF), particularly those admitted to hospital, have a reduced life expectancy.1 When asked to consider their preferred place for end-of-life (EOL) care if recovery appears unlikely, many patients express a wish to spend their final days at home.2 Yet analysis of patients with HF in randomized controlled trials and in epidemiology studies suggests that most patients with HF die in hospital.3,4 Whether there is a discrepancy between preferred and actual place of EOL care has not been evaluated in a prospective cohort of patients with HF. We aimed to address this question, and assess the acceptability to patients with HF (and their caregivers) of discussing EOL care.