The purpose of this review is to evaluate research regarding whether women with heart failure (HF) need a special approach for improving their adherence to self-care. Prior research has sampled mostly white, male populations and these results have been generalized to the population of all HF patients. After age 65, women are at a higher risk than men for developing HF. Once women develop HF they are more likely than men with HF to experience greater symptom burden, re-hospitalizations, social isolation, and higher mortality rates. In this review we will explore barriers and facilitators that women experience when performing self-care, and whether they need individualized interventions or approaches to care that are different from those for male patients with HF. Special approaches such as assessment of social support and self-care counseling when treating women with HF will be discussed, as this may improve women's adherence, thereby slowing the symptom burden and disease progression.