Carroll Foley1, Hunter Groninger2, Anirudh Rao1. 1. Section of Palliative Care, Medstar Washington Hospital Center, 110 Irving Street NW, Room 2A68, District of Columbia, Washington, 20010, USA. 2. Section of Palliative Care, Medstar Washington Hospital Center, 110 Irving Street NW, Room 2A68, District of Columbia, Washington, 20010, USA. hunter.groninger@medstar.net.
To the Editor:In the January 2022 edition of Heart Failure Reviews, the article “Challenges and the innovations in the care of advanced heart failure patients during COVID-19” by Yehya and colleagues highlights the important, collaborative efforts in response to the unprecedented disruptions that the COVID-19 pandemic has had on the treatment of patients with heart failure and on the clinical teams caring for them [1]. Overlooked, we believe, is the critical role palliative care has had in supporting patients, families, and clinical teams navigate the uncertainty brought on by this pandemic.The American College of Cardiology endorses palliative care as an integral part of the care provided to heart failure patients as they progress along the disease course, and the pandemic has amplified these benefits [2]. Throughout the pandemic, palliative care teams have been well-positioned in both inpatient and follow-up care settings to address the increasingly complex needs of heart failure patients and their families. The authors identify several ways that the pandemic has disrupted routine heart failure care, highlighting some challenges and innovations. Among these, weighing the risks and benefits of the timing of heart transplantation listing and ameliorating burnout are spaces that palliative care specialists often work in. Palliative care specialists are adept at navigating the complex risk–benefit calculus that patients and families must face, employing expert communication strategies and shared decision making. Our “care for the whole person” philosophy stretches beyond considering what the patient in front of us needs; we consider the climate and culture of the clinical environment and can provide support to staff members who are struggling with the burdens that come with working during these challenging times.We commend the work of the authors to recognize the remarkable response of healthcare providers to the unprecedented challenges posed by COVID-19 in the care of heart failure patients. Palliative care should be seen as an integral partner to heart failure teams as we all adapt to the challenges brought on by the pandemic. Our healthcare system will surely benefit from codifying many of the adaptations made in response to the pandemic. A silver lining, indeed.Carroll Foley LMSWHunter Groninger MDAnirudh Rao MD