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Living with Congestive Heart Failure (CHF)

Jorge Ramirez lives alone in a low-income senior housing facility in Oakland. His daughter, Eva, and two grandchildren live in San Leandro, and are able to make regular weekend visits to help with his chores and shopping, to take him to church and to a family dinner. Two years ago Mr. Ramirez was diagnosed with congestive heart failure. "I thought that meant I was a goner," He laughs. "I told my daughter to buy a burial plot."

Jorge had reasons to feel so gloomy: his legs were uncomfortably swollen, he became short of breath just sitting in his chair, and he felt tired all the time. In reality, Jorge's condition was moderate and treatable. His doctor prescribed a modified diet and an array of medications to improve the function of his heart and eliminate excess salt and water. His condition should have stabilized. Instead, it took a nose dive.

"On the weekends he would eat right and take all his pills, because I was there," says Eva. "But during the week it just all fell apart. He took some pills but not at the right times, and didn't take other pills at all. I was going crazy trying to call him from work to get him to follow the doctor's orders." Jorge was not being non-compliant on purpose, it was simply that maintaining a regimen of diet and medication was foreign to him. He was surprised that taking his medications incorrectly could be worse than not taking them at all. He was hospitalized three times in as many months.

The third time, a hospital social worker referred him to an Adult Day Service program which was near his apartment. At first, Jorge didn't think he wanted to go. "He walked in the door and was ready to walk out," Eva recounts. "But they didn't give up on him, they treated him like royalty and that started to change his thinking." He agreed to try it out. What finally sold him on the program was the improvement in his physical state. After enjoying regular (and healthy) meals and taking the right medication at the right times, Jorge felt tremendously better. "I didn't know I could feel so good," he says. "At this place they take care of you."

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