Blood pressure & cholesterol medicine for a 97-year-old man?

It is really popular to bad mouth cholesterol lowering medications and I see a lot of that on this forum, however the advice to discontinue statins in older adults is directed to people who are taking it prophylactically and have never had heart problems or stroke. I was amazed when the advanced ultrasound given to my mother showed a marked decrease in carotic plaques after her neurologist moved to aggressively treat her TIAs with statins, diet and different BP medications, I would never have believed it possible in a 90 year old woman. Unfortunately by then the damage had already been done, my chief regret is that something wasn't done 20 years sooner.
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It's important to ask questions of the doctors and other medical staff. I worked in a field in which I provided technical advice to doctors as well as educational presentations. Some of them are brilliant and keenly interested in giving their patients the best care, others less so, and a few others who made me wonder how they made it through high school.

When my mother's BP dropped to frighteningly low levels multiple people in the healthcare system assured me that she was end of life. Sorry but no, she was on multiple medications that needed to be tweaked, several of which lowered BP. I'm convinced that this period of excessively low BP contributed to her vascular dementia because her brain was starved of oxygen. BTW, she lived a decade after I was initially told she was EOL, and several years after discontinuing almost all her blood thinners, BP and cholesterol meds.

I did read your earlier response. 140/70 is not bad for an older person. Too low means they have a hard time functioning. Usually B/P meds are given when pain makes ur b/p shoot up. With my husband its when he has an Afib problem, once in a blue moon. With Mom her B/P med was upped for pain. DH got it during an AFib incident. I questioned both at discharge. Answer, because of pain and bp went up. I told them Mom was no longer in pain and DH bp was normal. My Mom couldn't get up off the couch and the PCP couldn't believe my husband could walk because their bp was too low. I no longer go with hospital recommendations. I have both see their PCPs right after a hospital stay. I have even asked hospital doctors to consult with PCP, they won't.

There is no reason for a cholesterol med if ur under 200. A statin will effect them cognitively.

NO! AND, no one is supposed to be on Cholesterol meds at 90, let alone 97.
If his BP is that low - stop the BP medicine too.

The reason you cannot get a clear answer is the CMS Shared Savings Program which involves as much as a 60% payback for either denying treatment or the end of an elder's life. 34 years working at a major university in medicine, and our docs flying to D.C. to set up death panels was very educational and terrifying, as my parents were aging at that time. Now I am living the horrors of these programs where a 90+ y.o. is always in the crosshairs. My Dad was murdered by an LTAC, after inserting an unnecessary trach (they used no ventilator, and routinely knocked off the t-bar with his sats staying at 98 to 100% and heart rate at 69). My favorite Uncle was sent down the same grist mill and we could not prevent it. He had a simple uneventful ERCP for a blocked biliary duct with "no blood loss" except that after his death of an infection we got the bill including 6 units of blood. At the same time, my Mom had a UTI and collapsed breaking her leg. Both these fit elders were kept in the ER (different hospitals, but both feeding into the same long term acute care facility) for over 7 hours with no hydration of nourishment. Even after being assigned an inpatient room, the dehydration continued. Both had long q-tips inserted unto their nostrils with regular taking of their temperatures. This nasal q-tip issue is done under circumstances when a patient has come from another recent hospital stay to prevent transmission of MRSA. But in my Uncle and Mom's case neither had been in hospital in years. Within 6 hours, both of them spiked a very high fever with a terrible cough. At that time, a nurse came in and inserted betadine into their nostrils. I think this was to destroy the evidence of seeding them with type A enfluenza. After my Uncle was taken home, he died. My Mom was still in hospital, and we were told she had congestive heart failure. I have taken care of her for over 20 years, worked in medicine and as a consultant for athletes, so I know what congestive heart failure is. They used that excuse to deny her hydration, gave her hydrochlorothiazide and lasix at the same time. They never took tests to assess her electrolyte washout and continued on a saltless diet. I asked for a doppler which showed her ejection fraction was excellent (took four days to get the result as they continued their dehydration program), and destroyed their game. Her hospitalist actually threw the copy of her result at me and grunted "she doesn't have congestive heart failure, in fact her ejection fraction is excellent," turned and stomped out of Mom's room, and I never saw him again. They tried to transfer her out to Kindred Hospital, the same hospital responsible for Dad's death. We took her home, and are still dealing with the damage the hospital inflicted on my recently very fit and active Mom. Many years ago, my parents excellent doctor who did not have priveleges at these hospitals took them both off statins and due to their fitness gave them blood pressure meds to be taken as needed. Beetroot and magnesium were really quite effective. He said, and my research at my hospital, showed that elders do better with slightly elevated blood pressure, because perfusion is better. I thank God we found this doc, because their prior high class concierge doc was destroying them. Modern medicine is very dangerous for elders, and my experience in medicine and my age of 72 is keeping me away from allopathic medicine. We are living through the actualization of 1984 (nothing is as it seems). Everything a doctor tells you must be researched, so don't get lazy, if you value your loved one's life. God bless all of you and may He give you the energy, insight and intellectual curiosity to fight this new holocaust of elder abuse!

No 97 yr old needs to be started off on cholesterol meds. My Ma needed BP meds until she turned 92 now off them as she drops too much. A very common problem in the aged and needs that geriatrician needed to assess his need and response. Seek a second opinion

I could go on all day. My life became centered around providing therapy and healing! What a beautiful, cherished time!

Play...
Checkers, and any games he likes, I could literally see improvement with each game of Checkers. Make sure games are “easy” enough that he doesn’t get stressed out, and just sees this as fun. Rummicub is great since he likes cards- and working with the “tiles” is good for fine motor skills. Go to the movies (discuss afterward). Take him to beautiful places where he can watch birds. Play music from his era (easy through Amazon). The music will take ten years off!

Do things that Improve hand-eye coordination (table tennis?)

Try to help him get some exercise every day. We would go to the shopping mall. In the beginning, we would walk and sit on every bench. He was holding onto me like a walker. That meant we would walk 20 feet, sit down for 10 minutes get up walk 20 feet. He started saying, “let’s keep going” and we would skip a bench. In about a month we worked up to two miles without stopping. Walking at the mall was nice because the temperature was constant, the floor surface was perfectly smooth and safe. He got Vans (skateboarding shoes). Their smooth, flat, solid, large sole promotes balance. He loved all the “cool shoes” comments and he looked sharp! If your dad is a veteran, get him one of those nice caps - he’ll get friendly interactions and “thank yous” from strangers that will lift his spirits and make him feel valuable and appreciated.

My dad also liked using a stationary bike, and that was nice because he didn’t have to focus on balancing, like he did when when walking

I’m so happy for you that you have this time together! You are so lucky.

Enjoy!

Mmm. Tricky one.

Was that cholesterol reading before or after the meds? As I'm sure you know, it certainly doesn't seem to need intervention. The blood pressure is a teensy bit higher than ideal, I believe? - but in a 97 year old, surely any tinkering with it needs to be done with extreme caution.

The thing is, the px seems standard, what you would expect; but your father is not a standard patient. All I can say is if it were me, I would go to his established GP (if he has one you're happy with) or back to his cardiologist/attending physician, and say the equivalent of "not happy, what are we doing, could we go back to the drawing board please." With as much polite jumping up and down and snarling as necessary.

Changes have to be clinically justified in each individual patient, not just made for their own sake. Make them concentrate on *him*.

Probably not. What they're trying to do is prolong quantity of life instead of quality of life. Talk with his doctors and see what you can do to get him off these meds. Then get hospice involved as it sounds like he's done. Living all those years without medication and then having a stroke is nature's way of moving things along. I'm so sorry to hear that he's lost so much of his independence. But at least he has you. Hugs, hang in there. We're here for you.