The growing number of older adults with heart failure (HF) suggests the need for more information about how people with this condition experience their illness and strategies for coping with this condition. To address this need, the authors conducted a systematic review of the literature and an in-depth, thematic analysis of qualitative first-person accounts on the lived experience of HF. Results suggest that people with HF face many challenges, including those associated with the formal health care system, life disruption, social isolation, symptoms, and uncertainty about prognosis and symptoms. Coping strategies include HF management, dealing with the dying process, and social support. Social workers, who encounter people with HF in a variety of practice settings, can play a key role by focusing on the needs of people with HF, addressing and strengthening their ability to manage their condition, facilitating social support, and helping them to cope with the dying process. Greater attention to these issues in the social work literature is needed, with a particular focus on the role of racial and ethnic diversity as they pertain to people with HF facing end-of-life issues.