Older Adults

73 year old woman presents as a new patient in a primary care setting, registered to NP. She has been taking lorazepam for anxiety/poor sleep since husband’s death 10 years ago. Normally on 1mg hs, but increased poor sleep x 2-3 months, self-increased dose to 2mg. sometimes takes during the day for anxiety with glass of scotch. Other drugs – candesartan and paroxetine (depression).

She reveals a recent ED visit after a motor vehicle accident – crashed car into tree driving home.  Fall at home 3 weeks ago which she tripped on scatter mat taking out garbage – sprained wrist, taking ibuprofen, wants Tylenol with codene (T3).  NP attempts to open discussion of benzo use and falls/accidents.  She is surprised and says “this has never been an issue, no one discussed this before”.