Advanced heart failure is a typical example of non-oncologic palliative care. The main problem for management of progressive disease is communication about prognosis and questions: how large use farmacologic and invasive treatement? In countries such as England or United states have been giving number trials about needs of patients with progressive heart failure. Most of results talk about daily quality of personal life- first of all possibility to stay home (not in hospital), be without pain, dyspnea, anxiety (psychological-social support to both patient and family) and have good relationship with medical staff - based on empathy communication and reciprocal trust. But there is one question- how manage it best way in progressive and very dynamic symptoms of advanced cancer or non-cancer diseases? The response could we look for in the "community care model". This system of organization of medical care is based on home care nurses, specialized in pallitive care commonly and closely for example in patients with advanced heart failure. The second important part of the model are doctors - specialists or consultants in closer medical specialization (cardiologists) and very important are general practitioners. The regional network, based on cardiologic centre with consulting and educational role, should cooperate with regional services of specialize palliative care (for example hospice) in situations of too difficult symtomatic care or need of larger support of multidisciplinary team (hospice, palliative care service in hospital etc.). The model like this significantly improve quality of care and at the same time quality of patient´s and family´s life. Also can present conditioning for terminal and bereavement care. Hospice home care could be foundation of the model.
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