The purpose of this study is to assess the relationship between cognitive impairment, patient self-management, health, and health service use in adults with heart failure (NYHA Class 2 and 3). The research questions are:

1. How is cognitive impairment (memory, attention, global and executive function) related to various aspects of impaired self-management (knowledge of adherence, adherence to sodium restriction and medications, symptom monitoring of weight changes, and decision and action to seek care)?
2. How are these relationships altered when adjusting for medical, demographic, and psychosocial factors?
3. What are the relationships among degree of cognitive impairment, quality self-management, health status, and health service use?

Inclusion Criteria:

• documented systolic heart failure
• NYHA class II, III of at least 6 months duration
• 50-85 years of age
• has a telephone (land line) or be willing to allow a telephone installed for duration of study

Exclusion Criteria:

• history of neurological disorder or injury
• moderate or severe head injury
• past or current history of severe psychiatric illness; specifically, psychotic disorders and bipolar disorder
• 5 year past or current history of alcohol or drug abuse
• history of learning disorder or developmental disability
• renal failure requiring dialysis
• history of sleep apnea
• current home telemonitoring program to assist w/ HF self-management
• cardiac surgery < 3 months

50-85 years of age, documented diagnosis of systolic heart failure (EF \