Upstreaming palliative care for patients with heart failure.

Upstreaming palliative care, practicing and advocating for palliative care earlier in the heart failure (HF) trajectory, is an idea whose time has come. In this article, we explore the meaning of palliative care for HF and then discuss its relationships with both chronic care and end-of-life care. A case study is used to envision the practical implementation of palliative care into existing systems of care. We conclude by discussing the clinician's role in implementing palliative care earlier for individuals with HF by practice and advocacy.