The purpose of the study was to explore the family caregiver’s perceptions of need associated with caring for a mostly homebound family member with moderate to severe heart failure (HF) and hospitalized at least once in the prior three months. The specific aims were to explore: (a) areas of HF caregivers’ lives that have been altered (positively and negatively) by the caregiving experience, and (b) what family caregivers perceived their greatest needs to be. Of the11 patients and their family caregivers, all dyads were receiving home nursing care. Four of the patients were receiving an additional patient monitoring system (telehealth). The patient sample consisted of seven male and four female patients. All participants were white except for one Asian patient/FC dyad. The family caregivers were spouses (n = 8) or adult daughters (n = 3). Caregiver interviews were tape-recorded, transcribed and analyzed to include a line-by-line method to code, categorize and analyze the data. A second reviewer was used to validate findings. The results suggest that caring for family members with HF who are high risk for readmission appears to consume the life of the family caregiver. It is a job they want to fill but lack the skills to handle it emotionally and are at risk for health problems of their own. It was apparent in all the family caregivers that hospitalizations were not respite but more burdensome. The constant worry expressed by family caregivers suggests the unstableness and unpredictable nature of their situation. However, the family caregivers using the additional support of telehealth felt better about managing the patient’s care at home and confident that when things went wrong, it could be remedied at home to prevent an emergency room visit or hospitalization. These findings support the need for more nursing support and perhaps more use of patient monitoring systems (telehealth) among HF families in the community setting.