Linda, honey, she's 81.
She's already exceeded the average life span of an American woman and the way you write about her, she's got a pretty good life (people care about her if something would happen).
I agree with the other poster, that it would help me to know if she's got a good LDL:HDL ratio and some other data but the first line of cholesterol control is exercise and diet NOT necessarily meds. Now, she has got a pretty high cholesterol and some folks would treat that with meds immediately--all things being equal--but what does SHE have to say about this?
Does she want a second opinion? Does she want to be on meds? Does she want to change her diet and lifestyle? At 81, these things are a _choice_. You may think her doc is a little cold (and he certainly wins no awards for finesse) by saying, "The damage is already done," but her coronary and carotid and cerebral arteries likely do look like an 81 year old American woman's and starting cholesterol lowering meds tomorrow (like one poster said, expensive and not without risk) won't change that quickly.
Read a little further on this BB and you will see that the one thing that wears nurses out the fastest is the number of interventional deaths* in which they get to participate in the ICU. Your dear, lovely, and loved great aunt is going to die some time. That's a fact. Starting cholesterol meds at this point won't change that immutable fact. It's not going to magically undo 9 decades of diet and exercise behavior. And it may change how much money she has in her pocket to go to bingo, how good she feels daily and it signals the doctor that "this family wants a lot done to preserve the life and not necessarily the quality of life of this person." (bingo money counts as quality of life in my book).
Now, all things done, you and your family might well decide to go ahead and take great auntie to the internist that will aggressively treat her high cholesterol. and that will be fine with me. I am not against the medical treatment of 81 year olds. My parents are that age. _But do her the dignity of asking her what she wants and listen closely to the answers._
Entertain that she just wanted to ventilate her worries. "The doctor said my cholesterol is high and he said that he's not sure there's a beneift to treating it." She knows daily she's going to die; she's lost a lot of her family, friends and peers at this age. But the doctor just underlined that fact with her. Listen to her and hold her hand and help her look at her options but realize that _sometimes_ the RIGHT thing to do is this: "Don't DO something, Just sit there."
I am hoping some other experienced nurses might post some thoughts here. Do what your auntie wants to do and don't rush her into acting.
*In America, the highest medicare expenditure for elderly statistically occurs in the last 1 to 3 months of their lives as American medicine heroically pours resources into the lives of elderly people who are mostly tormented by their efforts. For many seniors, this is is a *horrible* interventional death that includes IV lines, feeding tubes and ventilation. Don't get me wrong. I am a former ICU nurse and I "worship" at the altar of technology, but there is a time and a place when those interventions are not called for and they are cruel. The efforts prolongs lives that have NO expectation of survival OR more importantly, returning to their mostly satisfying, pre-illness level of functioning.