Ask A Geriatrician- by Dr. Susan Nelson

Ask a Geriatrician- by Dr. Susan Nelson

I know that February is National Heart Awareness Month, so how does cardiovascular illness affect older adults?

Great question! In fact, the leading cause of death in men and women over the age of 65 is heart disease while stroke is in 4th place. The important thing is to be screened and treated for cardiovascular risk factors and to recognize the warning signs of heart attack and stroke.

The risk factors for heart disease and stroke are similar. They include advancing age (we can’t turn back the clock!), being a man (women catch up by age 72), high blood pressure, elevated cholesterol, diabetes, smoking, obesity and sedentary lifestyles. Please talk to your doctor or other health care professionals about what you can do to decrease your risk!

The early warning signs of a heart attack (Signs of a Heart Attack)  are:

  1. Uncomfortable pressure, squeezing, fullness or pain in the center of your chest. It lasts more than a few minutes or goes away and comes back.
  2. Pain or discomfort in one or both arms, the back, neck, jaw or stomach.
  1. Shortness of breath with or without chest discomfort.
  2. Other signs such as breaking out in a cold sweat, nausea or lightheadedness.

The early warning signs of stroke use the acronym FAST.

Facial drooping, Arm weakness, Slurred Speech and Time to call 911. Other symptoms include sudden numbness, confusion, trouble seeing, trouble walking or severe headache. (AHA Stroke Symptoms).

The American Heart Association has a great fact sheet about older Americans and cardiovascular disease which can be found here. There is a lot of great statistical information showing how different cardiovascular conditions affect older adults in general, and differences between men and women.

Be kind to your heart!


Ask A Geriatrician- by Dr. Susan Nelson

Ask a Geriatrican- by Dr. Susan Nelson

What information do I need to take to the doctor with me concerning my 91 year old mother who can no longer drive? – K. Martin


Check out this great checklist from Dr. Nelson that lists the information you should have at hand if you are involved in the care of an elderly parent/relative. Feel free to print the checklist out and use it  whenever you need to !

Caring for your parent Checklist-1


Ask A Geriatrician- by Dr. Susan Nelson

Ask A Geriatrician- By Dr. Susan Nelson

Are advanced directives made to encourage people not to seek aggressive care?

Not at all! The purpose of advance care planning is to have your voice heard and your wishes respected as you go through the health care system. We want you to receive the best care possible based on what you want and what the medical possibilities might be. We all know of someone who had a sudden illness or a chronic illness which grew worse rapidly that did not make any plans–leaving their family and friends to make tough decisions without any direction. Those watching the scenario unfold are often heard saying “I hope that never happens to me” or “I hope MY children act differently towards each other” but then never put those thoughts in writing or tell others what they would want in such a situation. Advance care planning is not just the completion of a form (living will or health care power of attorney). It should be conversations with those we love and trust about the many things that are important to us as we age. These discussions may be the BEST GIFT you can leave your family.


Ask A Geriatrician- by Dr. Susan Nelson

Ask A Geriatrician- By Dr. Susan Nelson

Do I need a lawyer to create an advance directive (living will, health care power of attorney, etc)?  

You do not need an attorney to complete either an advance directive (living will) or Health Care Power of Attorney. The advance directive also known as a living will is a legal document that states what kinds of treatment should be given to you when you can no longer make decisions or speak for yourself. It only goes into effect if you are terminally ill and have lost decision-making capacity, and it is usually completed in advance of any known illness. You complete it yourself, and unless there are other known facts, it must be honored. To become valid, it must include the signatures of two witnesses not related to you by blood or marriage. The health care power of attorney document authorizes someone else to make decisions about your health care when you are no longer able to make those decisions or speak for yourself. In Louisiana, there is a very specific order of who can make these decisions for you if you have no written instructions available. It must be witnessed by two people to become valid. Neither document requires that they be notarized.


Ask A Geriatrician- by Dr. Susan Nelson

Ask A Geriatrician- by Dr.Susan Nelson

Is it difficult to engage in advance care planning?

Not at all! The key thing to do is have a conversation with your friends and family about what is most important to you with regard to your health care if you suddenly become very ill. The conversations that we have change as events occur in our lives and the lives of those we care about. The discussions are about whether you would or would not want life support but also how we want to live out our life if our health and function decline. For instance, if you are a robust 80 year old who cares for your great grandchildren every day, you might want a treatment which may allow you to keep your same level of function a few months or years longer. That same person might not want a treatment that is difficult-painful or lots of side effects-if it won’t change how much longer you live. You might also want to have a treatment for an easily fixable problem but would not want life support if you would not be able to stay in your own home. Most of us talk about wanting to die at home in our sleep “when the time comes” yet that is difficult to do without careful discussions with our health care team and those we love.