Advance Care PlanningUsing Videos to Facilitate Advance Care Planning for Patients With Heart Failure

Inclusion Criteria:

1. A diagnosis of advanced heart failure as defined by ALL THREE of the following:

• New York Heart Association Class III or IV (NYHA III or IV) (III: marked limitation in activity due to symptoms, even during less-than-ordinary activity; IV: severe limitations, experiences symptoms while at rest).

AND

• Hospitalization for heart failure within the last six months. AND
• Age greater than or equal to 65.

2. Additionally ONE of the following must be met:

• According to the attending physician's best judgment the patient's survival is limited to 2 years but may very well be less than 1 year (i.e. the physician would not be surprised if the patient died within one year from any cause) OR
• Three heart failure hospitalizations in the last year OR
• One of the following:

• Two Systolic Blood Pressures < 90 within the last 6 months in the ambulatory setting
• Na < 130 within the last 6 months
• NTproBNP > 3,000
• EGFR < 35
• High diuretic use (160 mg po Lasix or 100 mg po torsemide or equivalent total daily dose)

Exclusion Criteria:

• New patient
• A transplant or mechanical circulatory support candidate
• Major psychiatric illness as determined by the attending that would make this study inappropriate.
• Any patient that has been excluded for transplant or mechanical circulatory support due to psychological or psychiatric co-morbidities.