Upon the recommendation of his cardiologist, Gary Paulson began palliative care for heart failure with Paradigm Health in September 2022. In 2017, Paulson had an LVAD – a left ventricular assist device placed. These devices are implanted directly in the heart and are unusual and rare devices so caring for a patient with an LVAD requires training, expertise and a knowledgeable and trained team like Paradigm Health.
“Gary wanted to keep living which is why he had the LVAD placed,” shares Gary’s wife Linda. “But in fall 2022 through blood work, heart catheters and other testing, it was discovered that the right part of Gary’s heart wasn’t functioning, and his overall health was declining rapidly. We began palliative care right away.”
The Mayo Clinic describes a left ventricular assist device as a pump used for patients who have reached end-stage heart failure. The LVAD, a battery-operated, mechanical pump, is surgically implanted which then helps the left ventricle (main pumping chamber of the heart) pump blood to the rest of the body. These devices are called mechanical circulatory supports and are considered life-sustaining therapies for patients with advanced heart failure. The LVAD is a sustaining treatment replacing left ventricle function. Stopping it would mean hastening the process of death.
“At some point after just a couple of months, it became obvious that our dad would need to transition from palliative care to hospice care,” says Paulson’s daughter Andrea. “Dad’s cardiology team was very involved in his care but because Paradigm Health had taken care of him for palliative care, transitioning to hospice care was a relief as they already knew his goals of care and needs.”
As Paradigm Health’s hospice care team collaborated with Paulson’s doctors to understand how they would need to discontinue the LVAD near the end-of-life journey for Paulson. There are few teams with the expertise to allow a patient to wean off the LVAD comfortably and safely at home – this is a rare occurrence. Paulson’s stay on hospice care was extremely short lasting only a few days, but the team was able to disconnect the LVAD so that Paulson could pass at home peacefully and surrounded by his family.
“On the day that Gary passed, the Paradigm Health nurse stayed with us all day,” shares Linda. “She was wonderful and helped with the medications, but I mostly remember her being there to support us but giving us our space as well. Besides the hospice and death process, we had to deal with turning the LVAD off and their team made it is seamless as possible. If you can say that passing is a beautiful moment – for us – it was.”