Live-in Care for Heart Failure and Heart Disease

What is heart disease care at home?

Heart and circulatory diseases, including coronary heart disease, heart failure and atrial fibrillation, affect more than seven million people in the UK, according to the British Heart Foundation. Heart failure in particular means the heart is not pumping as well as it should, which can cause breathlessness, tiredness and swollen ankles and legs. It usually needs careful, daily self-management.

Heart disease care at home supports someone to manage those routines and live well in their own home. With live-in care, one carer is there day and night, which is especially reassuring for people who become breathless at night or have been in and out of hospital.

How a live-in carer helps with heart failure

• Daily weights — weighing at the same time each morning and recording it; a quick gain can be a sign of fluid building up.
• Fluid and salt — helping follow any fluid limit and low-salt diet advised by the heart failure team.
• Medication — making sure diuretics, beta blockers and other medicines are taken correctly and on time.
• Breathlessness — helping with positioning, pacing activities, and sleeping propped up if advised.
• Swelling and skin — noticing ankle and leg swelling and looking after fragile skin.
• Cardiac rehabilitation — encouraging the exercises and walks recommended by the rehab team.
• Everyday life — shopping, cooking healthy meals, cleaning and company, so energy is saved for the things that matter.

Spotting the signs of worsening heart failure

Heart failure can get worse gradually. Signs such as a weight gain of a couple of kilograms over a few days, more swelling, needing more pillows to breathe at night, or new breathlessness at rest should be reported to the heart failure nurse or GP promptly, and chest pain or severe breathlessness always needs 999. A carer who sees the person every day notices these changes early, which can prevent a hospital admission.

Care after a heart attack or heart surgery

After a heart attack, bypass surgery or valve replacement, the first weeks at home can feel frightening. Short-term live-in care helps with personal care, meals and mobility while strength returns, supports attendance at cardiac rehabilitation, and gives the whole family confidence. See short-term live-in care.

Paying for heart disease care

Live-in heart disease care starts from £1,200 a week, or £1,300 for more complex needs. Attendance Allowance or PIP, council support after a needs assessment, and NHS Continuing Healthcare for advanced heart failure with complex needs are all worth exploring. See our funding guide.

Living with heart failure: a daily routine that works

Heart failure is usually managed with a combination of medicines and daily self-care. A good routine, supported by a carer, might include:

• weighing at the same time every morning, after the toilet and before breakfast, and writing it down;
• taking medicines at the prescribed times, including diuretics timed so trips to the toilet do not disturb the night;
• checking ankles and legs for swelling;
• following any fluid limit, using a measured jug or a record sheet;
• eating low-salt meals, cooked fresh where possible;
• some gentle activity, such as a short walk, paced around breathlessness;
• resting with legs raised when swollen, and sleeping propped up if advised.

Following this routine consistently can help keep symptoms stable and reduce hospital admissions.

Atrial fibrillation and blood thinners

Atrial fibrillation (AF), an irregular heart rhythm, is common in older people and increases the risk of stroke. Many people with AF take anticoagulant (blood-thinning) medicines. Carers help by making sure doses are taken exactly as prescribed, noticing signs of unusual bleeding or bruising, and reporting them to the GP. Anyone on blood thinners who has a fall and hits their head should be checked by a doctor promptly, even if they seem fine.

Cardiac rehabilitation at home

After a heart attack, heart surgery or a diagnosis of heart failure, many people are offered cardiac rehabilitation: a programme of exercise, education and support. Attending makes a real difference to recovery, but getting there can be hard for older people or those who no longer drive. A live-in carer can help with transport, encourage the exercises between sessions, and support the lifestyle changes the programme recommends, from healthier cooking to stopping smoking.

When heart failure is advanced

In advanced heart failure, symptoms such as breathlessness and fatigue may be present even at rest, and hospital admissions may become more frequent. At this stage, the focus often shifts towards comfort and quality of life, with support from the heart failure nurses and palliative care team. Live-in care helps people with advanced heart failure stay at home, comfortable and supported, rather than moving between home and hospital. See palliative care.

Recognising a heart attack

Everyone in a household where someone has heart disease should know the signs of a heart attack. They include chest pain or pressure that may spread to the arms, neck, jaw, back or stomach; shortness of breath; sweating; feeling sick; and a sense of dread. In older people and women, symptoms can be less typical, such as breathlessness or sudden unusual tiredness. Call 999 straight away. Carers are briefed on what to do, including any prescribed GTN spray, while waiting for help.

Staying active safely with heart disease

Regular activity is good for the heart, even for people with heart failure, but it needs to be at the right level. Cardiac rehabilitation teams can advise on how much and what kind. Generally, gentle activity such as walking, built up gradually, is encouraged, with rest when breathless and stopping if there is chest pain, dizziness or unusual breathlessness. A carer can walk with the person, help them pace themselves and build up activity safely, which also helps confidence and mood.

Working with the heart failure nurse

Many people with heart failure are supported by a specialist heart failure nurse, who adjusts medicines, monitors symptoms and advises on self-care. Sharing a carer's daily records of weight, swelling and breathlessness with the nurse helps them spot changes early and adjust treatment before a problem becomes an admission.

Written by the Live-in Care Direct care team. Last reviewed 24 September 2026.

Further reading and sources

• NHS: Heart failure
• British Heart Foundation
• NHS: Cardiac rehabilitation