Congestive heart failure (CHF) is a chronic heart condition in which the heart pumps ineffectively and fluid builds up throughout the body. CHF might be referred to as "heart failure,” but that doesn’t mean the heart stops; it just means that the heart is underperforming. CHF is a specific type of heart failure that includes severe fluid retention (also known as edema). But why exactly does the body retain fluid? And what does that mean for a senior with CHF?
Closer Look at CHF
To understand why fluid retention happens in CHF and how it affects the body, we first need to dive into a healthy heart compared to one affected by CHF.
Within the heart, there are four (4) chambers: two (2) upper chambers (atria) and two (2) lower chambers (ventricles). The lower chambers pump blood throughout the body, and the upper chambers collect blood as it returns to the heart. During efficient pumping, the chambers work in tandem and pump enough oxygen and nutrients to the rest of the body. During heart failure, however, it is unable to meet the body's needs.
To meet the demand for oxygenated blood, the chambers in the heart might stretch to increase their blood capacity or become stiffer. But ultimately these efforts cause heart muscles to weaken and become unable to pump efficiently.
As efficiency falls, the kidneys receive less blood. They sense the drop in blood supply and filter less fluid (primarily water) out of blood circulation to help increase circulatory volume. The extra fluid in circulation can leak into tissue and organs throughout the body — in the arms, legs, lungs, and other organs. This could initially result in mild swelling. But over time, the fluid buildup becomes serious enough to require medical attention and is referred to as "congestion." Congestive heart failure refers to this stage of heart failure.
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Effects of Fluid Retention
As fluid settles in different areas of the body, seniors may experience a range of symptoms.
- The fluids can settle in the lungs or chest cavity, resulting in shortness of breath or cough.
- If fluids settle in the extremities, individuals may experience swelling and weight gain due to fluid retention.
- Seniors may also experience bloating in their stomachs as fluid settles in the abdomen, reducing their appetite or causing nausea.
If a senior notices sudden swelling or changes in symptoms, they should seek medical attention immediately. The symptoms of CHF and fluid buildup as a result of the condition are gradual, so any sudden change is a sign that something else could be going on.
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Managing Fluid Levels
Because the body retains fluid because of CHF, a senior must manage their fluid levels through a combination of lifestyle changes and prescription medications. Here’s a look at some of the ways seniors can manage their fluid levels.
- Reduce sodium: Sodium, or salt, can cause the body to retain more fluid. So, seniors with CHF should reduce salt in their diet. Look for food items labeled “no sodium” or “low sodium,” and swap out salt as a seasoning with herbs and spices.
- Monitor water intake: Drinking too much fluid intake can put more strain on the heart. Fluid we ingest is absorbed into the bloodstream within the intestines. Because the kidneys do not filter out enough fluid, the heart has to pump it through the body, which can exacerbate CHF. In general, seniors with CHF should only drink about 2 liters of fluid per day. And don’t forget to include foods with high water content when considering fluid intake.
- Weigh regularly: Seniors with CHF may need to weight themselves regularly to measure the amount of fluid building up in the body. They may have a “dry weight,” which is a baseline weight when the body is not retaining fluid. Trying to stay as close to this dry weight as possible can help them manage fluid levels.
- Exercise: While it may seem counterintuitive for a senior with CHF to be active, these seniors should strive to stay moving. Mild exercise can help reduce swelling in the legs and feet by promoting circulation. Then, some of the retained fluid is pushed back up toward the center of the body and can be excreted in urine.
- Take medications as prescribed: A doctor may recommend that a senior with CHF take a diuretic, or a “water pill.” This type of medication helps the body get rid of excess fluid. A doctor may also prescribe other medications to help manage CHF, like ACE inhibitors, ARBs, or beta blockers.
- Keep limbs elevated: Gravity can naturally cause fluid to buildup in the lower extremities. You can combat this force through elevation. Seniors can position themselves so their affected extremities are elevated above the level of the heart to help manage fluid retention.
- Wear compression stockings: If a senior has fluid retention in their feet and legs, compression socks can help. Compression stockings are socks that fit tightly around the food, ankle, and lower leg. These socks put pressure on the area, which helps the blood vessels work more efficiently and reduces the leakage of fluid from the small capillaries to the surrounding tissue.
While some seniors with CHF are able to manage their condition on their own, some may need additional assistance. A professional caregiver can help a senior with CHF manage their condition at home. At Caring, we specifically train our caregivers on how to help seniors with CHF manage fluid retention along with their other symptoms. Reach out to a Caring location near you to learn more about how we can help.
