Congestive Heart failure symptoms and quality of life

Dear Ask The Doctor: My mother-in-law was diagnosed with Congestive Heart Failure approx. 7-10 years ago. She does not take her medication as prescribed, and refuses to be seen by a doctor. She has trouble breathing, she has a deep hard cough. Often times she has a hard time going to the bathroom. She has to sleep sitting up, because of the fluid in her abdomen. She pants even without exerting herself. Her abdomen, legs, and feet are swollen. Her skin and eyes are yellos. Her legs from her knees to her feet are very red, tight, and dry. Her feet are extremely dry tight and over the past 3 or four days have turned a dark gray color. I understand that she needs to be taken to the emergency room immediately. We have done this in times past, and although the doctors reccommended her to stay and have tests run, she refused. Due to the sever state of panic that she goes into when the doctor or hospital is mentioned we adhere to her wishes because we are afraid tht to take her to the hospital could send her into such a panic that it causes her to have a heart attack. My question is from reading my information about her, can you tell me what stage this sounds like, and if there is anything that we as her family can do? I realize that you can't diagnose or speculate about her ondidtion without seeing her, but she WILL NOT seek medical attention, and we feel like our hands are tied. Thanks, Paige Staton

Dear Paige: From the history and symptoms you describe, your mother-in-law’s heart failure is progressing to involve other organs, and causing her significant discomfort and poor quality of life. If your mother-in-law continues to resist medical attention at the emergency room or hospital, this is her right to refuse treatment, if she has the capacity to make this decision. She may however benefit from a home visit from her family physician or a community heart failure specialist nurse, to reduce her symptoms of shortness of breath and leg discomfort, and improve her quality of life in her own home environment. I would advise discussing these options with your mother-in-law, but ultimately the decision is in her hands.