Abstract
Heart failure, characterized by the inability of the ventricles to fill or eject blood, is a significant problem for patients and their families. This disease is characterized by periods of exacerbation and remission; patients must cope with the unpredictability and variability of symptoms. Classification systems for patients diagnosed with heart failure assist providers, patients, and families in understanding the chronic and progressive nature of heart disease. In the final stage, patients have refractory symptoms despite optimal medical therapy. At this stage, patients may benefit from hospice and palliative care. This article reviews essential points in the care of patients who are living with-and dying from-end-stage heart failure.