Difficult decisions must be made when heart failure (HF) progresses to an advanced stage, which requires teamwork. Shared decision-making is what is important which enables patients and doctors consider all the options and the patient’s preferences before drafting a treatment course. About ten percent of the more than 6 million Americans living with HF have advanced heart failure which is indicative of the fact that conventional heart therapies and symptom management strategies aren’t working well. An individual with advanced HF feels shortness of breath and other symptoms (persistent coughing or wheezing, buildup of excess fluid in the body, lack of appetite, nausea, tiredness and fatigue, confusion and impaired thinking, increased heart rate) at rest. Medication and a healthy lifestyle can help manage HF in its early stages but treatment gets more complex as the disease progresses and the ticker becomes weaker. This is the time that you must have conversations with your family ...