How to Be a Caregiver for Someone with Coronary Artery Disease

Be a member of the care team

Heart patients who have an involved caregiver are more likely to take those medications and follow other instructions, and more likely to get to their appointments, says Lisa Kitko, dean of University of Rochester School of Nursing and coauthor of a 2022 heart association scientific statement on engaging families in cardiovascular care.

If possible, caregivers should go with patients to appointments or connect virtually, with a video call or speaker phone, the experts agree. 

“Two sets of ears are better than one,” Kitko says. And caregivers often have information to share, she says: “They are going to see changes that practitioners are not going to pick up on.”

It’s also ideal to be there or check in frequently during any hospitalization, the experts say.

“The more the patient and the family understand, the more likely they're going to be able to follow the treatment plan after they leave the hospital,” Martin says.

Having a loved one paying attention also adds a “layer of safety,” Kitko says.

Kay and Don Young say they’ve experienced that during multiple hospitalizations — like the time Kay prevented Don from getting one too many blood transfusions or the times she learned he wasn’t getting all his medications (he takes 18 pills a day, she says).

Kay says she pays close attention during regular doctors’ visits too, filling Word documents with notes after each appointment.

She says she’s often the first person to realize something isn’t right with Don — like when he complained of jaw pain two days before a planned trip to Alaska. Because he’d had that symptom when an artery needed stenting in the past, she called his cardiologist. A quick catheterization found an old stent 95 percent blocked, Kay says. She says it’s a good thing they didn’t ignore the pain and head to Alaska: “He was a dead man walking.”

Kay Young monitors Don's 18 daily pills for coronary artery disease.

Theo R. Welling

Encourage cardiac rehab

If your loved one has had a heart attack, a stent, coronary bypass surgery, heart valve replacement, or if they have regular chest pains (stable angina), they can qualify for an exercise and education program called cardiac rehabilitation. It’s covered by Medicare and many other insurers, Prasad says.

Over several weeks, he says, patients get counseling on diet and other lifestyle changes, along with supervised exercise.  “You have to gradually increase your activity, because having a heart attack or having a stent or surgery or some kind of cardiac event does put a lot of stress on the body,” he says.

Rehab participants “have a much better prognosis,” yet the programs are greatly underused, Martin says. Some health care systems, including his, are experimenting with apps, video visits, and other technology to make rehab more accessible, he notes.

Families can help by providing transportation and other practical support, but also by talking about how helpful rehab can be, Kitko says. One reason some people don’t want to go, she says, is that after heart treatment they feel better and don’t see the need.

One fact caregivers might share: A recent study in the Journal of Cardiopulmonary Rehabilitation and Prevention found that patients who attended any cardiac rehab sessions were 43 percent less likely to die or be readmitted to the hospital within six months.

Share in a heart-healthy lifestyle

Changing the habits that contribute to coronary artery disease can change the course of the disease, experts say.

“In the United States, the number one modifiable risk factor for coronary artery disease is smoking,” Prasad says — so helping your loved one quit can matter a lot. If you smoke or others in the household do, make quitting a shared goal, he suggests.

Eating a heart-healthier diet, one lower in sodium and sugar, with lots of fruits, vegetables, and whole grains can be a family affair, too, Kitko says: “It's easier to cook one meal,” she says, and a “win-win” for everyone’s health.

If you can manage daily walks with your loved one, do it, Prasad says: 30 to 60 minutes a day “can make a big difference,” he says and is safe, once people build up exercise tolerance.

Making such changes can be hard, Prasad says, and frustrating for families when patients aren’t on board. Try to encourage one small change at a time, he suggests: “You don't have to do everything all at once.”

Ed Frauenheim says wife Rowena Richie helps him dial down the stress after his mild heart attack.

Courtesy: Frauenheim/Richie

Attend to mental health — theirs and yours

Finding out you have coronary artery disease can be scary, especially if you find out by having a heart attack. It can be scary for families, too.

“Yesterday, you thought your family member was doing just fine,” and now they’re not, Martin says.  “It's just very disruptive to your life.”

People recovering from heart crises are at increased risk for depression, anxiety, and post-traumatic stress, according to the heart association. Their caregivers often report financial strain, sleep disturbances, and feeling overwhelmed, studies have shown.

Ed Frauenheim, 56, and his wife Rowena Richie, 54, of San Francisco can relate. Three years ago, Frauenheim was overcome with nausea, chest tightness, and fatigue while on a walk in his hilly neighborhood. He’d had a “mild heart attack,” he says, an unusual one caused by a spasm in one of his coronary arteries, not plaque build-up.

Such spasms can be caused by emotional stress, something Frauenheim knew was a problem for him. The author and speaker, who focuses on masculinity and workplace culture, has a history of anxiety and panic attacks and struggled even more in the days after the heart attack, he says: “I thought I was going to die.”

He’s seen mental health counselors, but Richie has also helped him dial down the stress. She says she regularly sits down with him, looks at his calendar, and helps him “de-bunch” and pare down his typically over-packed schedule. And most Friday nights, the two put lit candles and mats on their apartment floor and do yoga together for an hour or more. “It’s super sweet,” Richie says.

“She’s been a great care partner,” Frauenheim says.

Even great partners get tired, though. For many people, caregiving gets more intense over time, Kitko says. When that happens, she says, don’t hesitate to find help and take breaks. “Caregivers need to know that they have to take care of themselves,” she says.