Globally, chronic heart failure is a common, complex syndrome characterized by high levels of healthcare utilization, reduced quality of life and premature mortality. Self-care is a complex decision-making process involving symptom recognition, action and evaluation. The purpose of this article is to define self-care, discuss barriers and facilitators in promoting adherence and summarize the methods available for assessing the individual's capacity to be an active partner in care. The appraisal to undertake self-care will require not only assessment of the individuals' clinical, psychological, social and cultural circumstances, but also the capacity of healthcare providers and healthcare systems to accommodate patients as partners in care.