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For families of residents

For families of residents

You are allowed to ask why your mother is on eleven medications. You are allowed to ask what each one is for, whether it is still needed, and whether anyone has looked at the whole list at once. Asking is not being difficult. It is often the only way the question gets asked at all.

Before you read on

Never stop or change a prescribed medication without speaking to your own prescriber. Several of the classes described on this site rebound, or cause a withdrawal syndrome, when they are stopped abruptly, and some have to be reduced gradually over weeks or months under supervision. Nothing here is advice about your own medication, and nothing here is a reason to change anything on your own.

What is true, and worth knowing before you ask

  • Nobody chose the whole list. A person arriving at a facility from a hospital, from home and from another facility carries three prescribers’ decisions, and usually none of them saw all of it. How a list gets long.
  • Reviewing it is safe. Across 118 randomized trials covering 417,412 people aged 65 and over, careful medication review showed no increase in adverse drug reactions, falls, emergency visits, hospitalizations or deaths.
  • Most people agree to changes when they are asked. In one trial, patients or their family agreed with 63% of the clinician’s deprescribing recommendations across 883 medications. The obstacle is usually that nobody asked.
  • What you know is not in the chart. That she worked nights for thirty years, that he was a teacher and settles when given something to organize, that she has never in her life liked being touched from behind. None of that is recoverable from a record, and all of it changes a care plan.

What to be careful about

Important

Never stop or change a medication yourself, and never ask a relative to. Several of the drugs discussed on this site rebound or cause a withdrawal syndrome when stopped suddenly, and some can be dangerous to stop abruptly. The FDA warns that stopping a benzodiazepine too quickly can cause withdrawal reactions including seizures. What this site is asking for is a conversation with the prescriber, not a decision.

What the evidence does and does not show

Sedating medications impair gait, balance and reaction time, and their labels say so. That part is not in doubt. What has not been shown is that a deprescribing program reduces fall rates — the trials that tested it were small, short, and mostly measured a medication count rather than a fracture. Those are two different questions, and absence of evidence from underpowered trials is not evidence that the drugs do not cause falls. What the evidence actually shows about deprescribing and falls.

That last point matters for families in particular, because “we are reducing her medications so she will stop falling” is a promise you may be given and it is not one the evidence supports. There are good reasons to review the list. That is not one of them, and a review is still worth doing.

The pages

Why is my parent on nine medications?

Nobody decided on nine. Here is how a list gets long, one reasonable decision at a time.

Questions you are entitled to ask

Specific questions, in words that work, and what a good answer sounds like.

What a medication review looks like

What actually happens, how long it takes, what you should be told, and what you should expect afterward.

When behavior is communication

What a change in behavior usually means, and why “agitated” is a description rather than a diagnosis.

Common questions

Am I allowed to question my parent’s medication?

Yes. You are frequently the only person who sees change across time — a shift sees a day, and you see a year. What you should not do is change anything yourself. Bring what you have noticed to the prescriber, with dates if you have them. Questions you are entitled to ask.

My mother seems more confused since she moved in. Is that the dementia?

It might be, and it might be a medication started around the same time, an infection, constipation, dehydration, pain she cannot report, or an unfamiliar environment. Confusion that came on over days rather than months, or that comes and goes through the day, is particularly worth asking about — that pattern suggests something reversible. When behavior is communication.

If you are wondering whether a medication is affecting her memory

That question has a specific answer for some drugs and an honest “we do not know” for others, and they should not be run together.

If your relative takes a benzodiazepine — and temazepam, triazolam, flurazepam, estazolam and quazepam are benzodiazepines even when they are described simply as sleeping tablets — then the drug is impairing the formation of new memories while it is being taken. That is how the drug works, not a rare reaction. Removing it removes that ongoing effect. How much of the longer-term difference recovers after years of use is genuinely uncertain, and the gains measured in older adults were real but described by the researchers themselves as “subtle,” at six to twelve months rather than weeks.

What nobody can promise you is that reducing medications generally will improve memory. The trials do not show that. The three claims, and how well each is supported · Benzodiazepines.

References

  1. Persaud N, Workentin A, Rizvi A, et al. Interventions to Address Potentially Inappropriate Prescribing for Older Primary Care Patients: A Systematic Review and Meta-Analysis. JAMA Network Open. 2025;8(6):e2517965. PMID 40577011 · DOI 10.1001/jamanetworkopen.2025.17965.
  2. Kim JL, Lewallen KM, Hollingsworth EK, Shah AS, Simmons SF, Vasilevskis EE. Patient-Reported Barriers and Enablers to Deprescribing Recommendations During a Clinical Trial (Shed-MEDS). The Gerontologist. 2023;63(3):523–533. PMID 35881109 · DOI 10.1093/geront/gnac100.
  3. Lee J, Negm A, Peters R, Wong EKC, Holbrook A. Deprescribing fall-risk increasing drugs (FRIDs) for the prevention of falls and fall-related complications: a systematic review and meta-analysis. BMJ Open. 2021;11(2):e035978. PMID 33568364 · DOI 10.1136/bmjopen-2019-035978.
  4. U.S. Food and Drug Administration. FDA requiring Boxed Warning updated to improve safe use of benzodiazepine drug class. Drug Safety Communication, September 23, 2020. fda.gov. 2020. https://www.fda.gov/drugs/drug-safety-and-availability/fda-requiring-boxed-warning-updated-improve-safe-use-benzodiazepine-drug-class.
  5. Savić MM, Obradović DI, Ugrešić ND, Bokonjić DR. Memory effects of benzodiazepines: memory stages and types versus binding-site subtypes. Neural Plasticity. 2005;12(4):289–298. PMID 16444900 · DOI 10.1155/NP.2005.289.
  6. Curran HV, Collins R, Fletcher S, Kee SCY, Woods B, Iliffe S. Older adults and withdrawal from benzodiazepine hypnotics in general practice: effects on cognitive function, sleep, mood and quality of life. Psychological Medicine. 2003;33(7):1223–1237. PMID 14580077 · DOI 10.1017/s0033291703008213.

Bibliographic records on this page were retrieved from PubMed. Every reference links to its DOI or PubMed record.

Written and medically reviewed by Dr. Gurpreet Singh Padda, MD, MBA, MHP, founder and medical director of DWARAA. Last reviewed . This page is educational. DWARAA does not prescribe, deprescribe, diagnose or treat.