Chronic diseases such as congestive heart failure require adaptation to a new lifestyle. Adaptation takes time and may be especially difficult for an older patient who may have to change life-long habits.

Maintaining quality of life takes precedence over compliance to a rigid regimen of treatment!

Counseling about congestive heart failure should address the following issues:

• Expected symptoms; when to call the doctor
• Self-monitoring; daily weights
• Role of family/caregivers in treatment plan
• Patient's prognosis

Counseling about care options should address the following issues:

• Advance directives
• Levels of care, including hospice care
• 911 calls

Counseling about medications should address the following issues:

• Medications and quality of life
• Medications and survival potential
• Importance of compliance
• Dosing and frequency
• Side effects
• Costs

Counseling about diet and related issues should address the following issues:

• Sodium restriction
• Avoidance of excessive fluid intake
• Avoidance of alcohol and tobacco

Counseling about activity should address the following issues:

• Recreation, leisure, work
• Exercise program
• Sexual activity