Friends and family are an important part of the support system for a woman living with heart disease.  If illness requires you to become her caregiver, the strains on you can be enormous. Plus, you have to live with the uncertainty of her health, especially if she has suffered a heart attack or undergone bypass or transplantation surgery.

As her spouse, friend, or family member, you may be asking yourself:

• Will she (and our family) ever be "normal" again?
• Will she die?
• Will she be permanently disabled?
• Will she have another heart attack?
• Can she return to work?
• Will we ever have sex again?
• How are we going to pay the medical bills?
• How can we afford all these prescription medicines? 

Unfortunatley, there are no simple answers to these questions.  You will probably need to adjust your lifestyle and expectations of intimate and family life for a while. With good medical care and time for emotional healing, she will eventually get back to something approaching "normal" although your fears and uncertainties will probably linger for much longer.

She's Changing

Be prepared, however, for her to evolve into a new, healthier person, someone who is more focused on her own health and well-being. Her former lifestyle may have contributed to her heart disease, so she will need to change what she eats and how much she exercises. She may also, gradually and over time, become introspective and sort through her life's priorities. Her spirituality may deepen as her need for emotional and psychological healing emerges. She is on a very personal journey to re-shape her life and take better care of herself. While some of these changes may be subtle and mysterious to you, she will need your support and encouragement. All change is intimidating but if you can walk this path with her, you will both arrive at a more meaningful and healthy life.

Try to keep lines of communication open or confide your feelings to her or a close friend, as she may be pre-occupied with her own feelings and recovery. You do not need to "walk on eggshells" around her, but understand that you both have suffered a very real crisis and both will need time to recover. If handled well, this time can lead to a deeper and richer relationship, as well as a renewed appreciation for the fragility of life.

Caregiving Tips 

Some friends and family members get anxious, upset, and frightened when a woman their own age has a heart attack or major heart surgery. They wonder if they'll be next, and if they might die. If this sounds like you, it is important that you get a handle on your own fears and emotions before you speak with or visit your friend or family member. That way, she will not have to pay attention to your emotional needs when she needs her strength for her own recovery.

Make an effort to call before visiting the woman in the hospital or at home. Visitors from friends and family, while showing your concern and support, can be stressful and exhausting for a new cardiac patient. Send a card or flowers. If you do visit, make an effort to keep it brief and never visit without calling first.

Every woman is unique and heart disease will affect her differently, depending upon how serious it is, her age, overall physical condition, and emotional health. It can also be confusing because she may not be sure what she wants or needs from you. Sometimes she wants you close by her side, other times she wants to be alone. The best advice is to listen and take your cues from her. Mainly, she needs to know that you are there, you care, and that you love her.

If she's has just had a surgical procedure or heart attack, her physical needs will be obvious: adequate rest and time to recuperate. She'll also need someone to go grocery shopping and cook her healthy low-fat meals, wash her clothes and clean house, answer her phone and fend off visitors, take her to her doctor's appointments and/or to cardio rehab, and get her prescription medicines filled.

For a woman in the workforce who has suffered a heart attack or major heart surgery, the situation may be more complex because she may not want people to know about her heart disease for fear of job discrimination or problems getting health insurance. And she often does not want people continually asking her how she's doing because it makes her feel old and disabled.

Emotional Support

If your friend or family member has just been diagnosed with heart disease, given some bad news about her condition, or is recovering from a heart attack or major surgery, she will need special emotional nurturing as well. This includes:

• Support.  Chances are she will need to make significant changes in her lifestyle, diet, and exercise. Encourage, participate in, and praise these changes, however small. And don't hassle or scold her if she falls into old behavior patterns. Change is always difficult and takes time. She will change when she is ready and at a pace that is comfortable for her.
• Sympathy.  Show her understanding and compassion for how difficult and painful it can be to live with heart disease. Tell her that you know from your own experience how hard it is to make behavior changes.
• Warmth.  Be open and available to her conversation and silences alike. Hugs are always appreciated, but ask first if she wants one.
• Empathy.  Try to walk a mile in her shoes to understand her mood swings, tears, and confusion. Educate yourself about heart disease and consult our website for in-depth information about heart disease and treatment options. Read some of the books about women and heart disease available on our online store.
• Kindness.
 She'll most appreciate little remembrances that show you are thinking of her. Send her a funny card or flowers. Drop off some fresh fruit or teas. Call and ask if she'd like to go out to lunch or take a walk.
• Attention.  Listen to what she is saying and to any underlying emotions -- guilt, sadness, fear, or remorse. Give her feedback to let her know that you are paying attention both to what she is saying and how she is behaving.
• Interest.
 Show concern for her recovery. Ask her how she's feeling, about her cholesterol and blood pressure levels, her latest doctor's appointment, and the medicines she's taking. Mention any heart disease-related news items that you come across in newspapers or magazines.
• Acceptance.
 Just as she may struggle to accept the reality of her heart disease, she needs to be told that you accept her just as she is and will not judge, ridicule, blame, or scorn her past or present behavior.
• Respect.
 Let her have her own feelings and experiences concerning her heart disease, and allow her to recover in a manner and a pace that are most comfortable for her. Applaud her growing ability to nurture and care for herself.
• Encouragement.  As she progresses towards changing her lifestyle, she will appreciate encouragement and recognition of her achievements. Life becomes definitively "one day at a time" after a trauma such as a heart attack or major surgery. Being able to cut down on eating fried foods, or walking a little more each day can be important steps towards improvement. 

 As a friend or family member, you are an important part of each woman's support and recovery, and a valued member of our community. It is vital that you take care of yourself while you care for your friend or family member with heart disease. Use these tips and resources to help you develop your own self-care plan.

• Take care of yourself. Caregivers are prone to burnout, stress, and clinical depression. Monitor your mental and emotional health and watch out for days or weeks of prolonged sadness, anger, resentment, sleeplessness, alcohol or drug abuse, and anxiety. See a therapist if need be. Also, make sure you get enough "down time" to be with your friends and enjoy your hobbies. Call on relatives and friends to relieve you or, if you can afford it, hire someone to come in several mornings or afternoons a week. Don't be a martyr. If you don't take good care of yourself, you won't be able to take care of anyone else.
• Keep your perspective.  Don't become overly responsible for her health and recovery, or bug her to eat better or get more exercise. This is something she will need to do on her own schedule and no amount of nagging from you will make it any easier for her. Encourage her, yes, but keep a healthy distance between yourself and her disease. Urge her to join WomenHeart where she will find many women just like herself. Also, check out available WomenHeart Support Networks or support groups at cardiac rehabilitation programs at your local hospitals. However, if you believe she is suffering from clinical depression, which is very common among women with heart disease, and unable to take good care of herself, talk with her and her doctor about it. Treatment is available!
• Get support.  Your role is the most difficult, as no healthcare professional is specifically assigned to your well being. It will help you get through the tough times if you can reach out for help and connect with people who are going through similar experiences. Contact Heartmates, which provides information and support for "cardiac spouse, friend, or family members." (It is very much geared toward wives of men with heart disease but an increasing number of husbands of women with heart disease are involved). Heartmates also publishes a very helpful book, Heartmates: A Guide for the Spouse and Family of the Heart Patient.

• Learn CPR and how to use an AED.  Call your local fire and rescue department, local American Heart Association, or Red Cross chapter for a schedule of classes. 
• Read.  Visit our online store where you can order books about heart disease in women. 
• Join us.  Become a  MEMBER of WomenHeart and make a  donation to support our work. You may also make donations to WomenHeart In Honor of or In Memory of a loved one.