What is it?

The Heart Failure Zone Sheet and Daily Weight Log can be used to help monitor heart failure symptoms.

How it can help me?

The Heart Failure Zone Sheet and Daily Weight Log tool can be used to monitor heart failure symptoms and recognize when flare-ups or emergency occurs. These tools help identify flare-ups early so that the person with heart failure can get the necessary treatment to keep them healthy at home and avoid trips to the emergency department.

Watch the video below to follow Alaise and her daughter’s journey with Heart Failure.

  • Alaise is an 83-year old woman with early-stage dementia and heart failure. Alaise lives with her daughter.
  • Alaise’s daughter uses the Heart Failure Zone Sheet and Daily Weight Log to determine if her mother may be experiencing a heart failure flare-up. After noticing a change in symptoms, her daughter identifies that Alaise is in the “yellow zone” and calls their local community health center for medical assistance.
  • A community nurse comes to their home and treats Alaise. The community nurse updates Alaise’s nurse practitioner on her condition.

Heart Failure Zone Sheet

Use questions on the Zone Sheet to know when the person with heart failure is doing well (green zone), when they need to call a doctor (yellow zone), and when they need to go to the hospital (red zone) based on their symptoms.
Asking the questions below daily can help determine which zone your loved one is in:
  • What is their daily weight?

  • Is there any change in their breathing?

  • Do you notice any difficulty participating in usual daily activities?

  • Do you notice any swelling in the feet, ankles, legs or stomach? Is this more than usual (e.g., have difficulty getting shoes on, or pants are tight around the stomach)?

  • How many pillows are they sleeping with at night? Have they needed to sleep on a 'lazy boy' chair?

  • How is their appetite? Is there a change?


All clear

Continue activities as usual
  • No changes in weight

  • Can perform daily activities as usual

  • No new swelling of feet, ankles, legs or stomach

All clear

Continue activities as usual

Warning Zone

Call physician
  • 2 pounds (1kg) weight gain/loss in one day

  • 5 pounds (2-3 kg) weight gain/loss in one week

  • Increased or new shortness of breath

  • Shortness of breath that worsens when lying down or causes them to wake up from sleep

  • New swelling of feet, ankles, legs or stomach

  • Feeling weak and tired

Warning Zone

Call physician


Call 911
  • Struggling to breathe or can't catch their breath

  • Heart is 'racing'

  • Can't think clearly or feeling confused

  • Feeling dizzy or lightheaded

  • Have sudden chest pain that won't go away


Call 911


Heart Failure Zone Sheet & Daily Weight Log