Home Health Care for Adult Heart Transplant Recipients

After months waiting for a donor heart, patients and families feel a sense of relief when they get the call informing them a suitable heart is available and transplant surgery is scheduled. When the heart transplant recipient returns home, their new routine often overwhelms the patient and family members. Home health personal care assistants ease the transition to a new life with a healthy heart.

According to the National Heart Blood and Lung Institute at the National Institutes of Health, approximately 3,000 Americans are on the waiting list for a new heart. Doctors recommend heart transplants for people who are in the final stages of heart failure. While the primary cause of heart failure is cardiovascular disease, other causes include congenital heart defects and infections that damage the heart valves. The U.S. Department of Health and Human Services reports that 2,378 people in the United States received a heart transplant and the outcomes for these patients are promising. The one-year survival rate for people who have undergone transplant surgery is 88 percent and 75 percent of heart transplants recipients can expect to live for five years with their new heart.

After waiting months for the phone call from the doctor informing the heart transplant candidate that a donor heart is available, the patient and family have to arrive at the hospital. Once the transplant team preps the individual, the actual heart transplant surgery takes about four hours. On average, the patient spends about one to two weeks in the hospital, which is followed by three months outpatient transplant monitoring. While the patient and family anticipate heart transplant surgery for months, they are not guaranteed that a donor will be found. Given this uncertainty and the speed at which the surgery occurs, it is no wonder patients and their families are happy, but overwhelmed, when the patient comes home from the hospital. The services offered by a home health personal care assistant make this time of transition to a “new normal” much easier for both the patient and family.

Coming Home after a Heart Transplant: What to Expect

Most heart transplant doctors recommend heart transplant patients return home after they are discharged from the hospital as opposed to going into a skilled nursing facility. The primary reason for this preference is that patients are less likely to develop an infection at home as compared to a nursing facility because there is more control the people who are near the patient. Since the patient’s body views the new heart as a foreign object, the immune system attack it, so doctors prescribe drugs that suppress the immune system; however, this leave the patient vulnerable to infection. Family members and other caregivers need to monitor the patient closely for signs of rejection and infection.

Indications of Possible Heart Transplant Rejection

Heart transplant recipients, their families, and caregivers need to watch for the following signs that suggest the patient’s body might be rejecting the new heart:

  • Shortness of breath
  • Fever
  • Fatigue
  • Weight gain due to fluid retention
  • Reduced urine output

If the patient exhibits any of these signs, contact the heart transplant center immediately.

Another way heart transplant recipients catch the early signs of rejection is to record their weight, blood pressure, pulse, and temperature on a daily basis. These charts help the patient, caregivers, and medical team identify indications of rejection. When the patient goes to the outpatient heart transplant center, their doctor will order routine lab work that also provides insight into how well the person’s body is accepting the new heart.

Heart transplant patients need to take their medications at the same time each day and ensure they have the prescription refilled a few days before they are finished with their current supply of medication.

Watch for Signs of Infection

After transplant rejection, the biggest risk heart transplant recipients face is infection since the medications they take suppress the immune system. Some common warnings the patient has contracted an infection include the following:

  • Cold sores, fever, symptoms similar to the flu
  • Shortness of breath and coughing may indicate a chest infection
  • Inflammation, swelling, and draining from the incision site

Notify the doctor if the transplant recipient shows any symptoms that suggest an infection.

Simple hand washing goes a long way to reduce the risk of infection. Additionally, people who have colds, the flu, or other infectious diseases need to stay away from the patient. If the family owns a dog, make sure it is current with all vaccinations, that it is housebroken, does not have fleas or other parasites, and it is bathed and groomed regularly. The patient and caregiver need to be diligent after petting or playing with the dog.

The patient also needs to avoided unpasteurized milk and cheese, raw shellfish, and other foods that might harbor bacteria. Fresh fruits and vegetable need to be washed thoroughly.

Coping with Emotions after a Heart Transplant

While both heart transplant patients and their families are grateful for the promise of a better life after a heart transplant, they often are flood with emotions. Many heart transplant patients are anxious due to the possibility their bodies might reject their new heart. Others might fall into depression, which is common after heart surgery. Heart transplant recipients who engage in social activities and join support groups significantly reduce their risk of developing depression.

As with all caregivers, families of heart transplant recipients not only need to ensure their loved one has the attention and the care needed to recovery successfully from surgery, but they also need to take care of themselves. Since most families do not want to leave their loved one alone during the weeks after transplant surgery, they often have little to no time to attend to their own needs. Home health personal care assistants (PCA) can give the loved ones of the heart transplant recipient the respite the need to avoid falling into depression or becoming burnt out.

How PCA Help Heart Transplant Recipients and Their Families

PCAs are paraprofessionals who have specialized training to help heart transplant recipients and their families when the  patient returns home from the hospital. Some examples of the assistance provided by PCAs include:

  • Monitoring for signs of rejection and infection
  • Helping patient maintain health charts
  • Providing transportation to appointments at the transplant center
  • Assisting the heart transplant recipient with daily self-care
  • Reminding patients to take medications and check to see if any refills are needed.

To arrange for home health PCA services, contact Best Home Care at (651) 330-2550.