Heart failure (HF) patients are a rapidly emerging hospice population. Although cancer patients still comprise the largest disease group in hospices, they account for less than 50% of patients, whereas a rapidly growing population is the group with heart disease. Cardiac disease is the second most prevalent medical diagnosis, accounting for 14% of hospice admissions nationwide, with HF being the most common designation. Patients with HF endure numerous physical and emotional symptoms. Research indicates that patients experience sustained symptoms of shortness of breath, edema, dry mouth, fatigue, pain, anxiety, sadness and depression that adversely impact quality of life. Importantly, depression is a common comorbidity among HF patients that is frequently overlooked.