In our work with individuals in crisis, we're often called when a parent, grandparent, or loved one starts to fail — which may be when the person can no longer perform one or more activities of daily living. Our clients require intervention when they exhibit behaviors that might result in them hurting themselves or others: failing to remember to take medications, forgetting to turn off the stove, or forgetting to eat.

After working in this field for nearly 20 years, we recently noticed an alarming trend. Behaviors like these, which used to be seen only in the very old, are now occurring in younger clients. It is not unusual for us to see individuals in their 50s and 60s confined to nursing facilities for the remainder of their lives. A recent event caused us to look at this situation in an entirely different light.

We worked with a bright, capable gentleman over several years. He was a former professional — highly functional, well organized, a good friend as well as a client. That is why it was shocking when his friend called to tell us he had acted out violently and had to be restrained and taken to a hospital. After months of continued hospitalizations and incidents, he was eventually confined to a nursing home. We all thought this was permanent — until the day he called us, completely coherent and at full capacity. He told us that a certain eye medication he was taking had caused an allergic reaction that resulted in signs of dementia.

It set us thinking: how many other clients might be in this same situation? How can you know if it is the drug — or a real disorder?

What the research shows about benzodiazepines (Valium, Xanax, Ativan):

Nearly 15% of people 65 and older — and nearly 20% of those over 75 — are currently taking them
Those over 65 who took the drug for several years were 50% more likely to develop dementia
When first approved by the FDA, these drugs were to be limited to short-term use of 2 weeks or less
Studies show the average time older people actually use them is 5 to 25 years
Research shows using these drugs for many years causes irreversible brain damage
Over the last 20 years, repeat prescriptions doubled every year — and 50% were given without a consultation

"They chalk up their feelings of illness and depression to 'old age' — not realizing that the very drugs they think are helping are hurting them and forcing many into nursing homes long before it's necessary."

Older people who take benzodiazepines suffer from more confusion, amnesia, night wandering, and pseudodementia. And they are far more likely to have serious falls. I cannot tell you how many people we have in nursing homes who fell down stairs, on their porch, or on the ice — suffering spinal and other injuries that result in long-term nursing confinement.

Benzodiazepines are also one of the most difficult drugs to stop taking. Withdrawal symptoms may include insomnia, anxiety, distress, weight loss, panic, depression, derealization, and paranoia — and it may take weeks to several years to completely discontinue them. Most older people simply accept that the drugs are beneficial since their doctors prescribed them, not realizing they are suffering from tolerance and interdose withdrawal.

What can a caregiver do? Make sure you know which drugs your loved one is taking. If they are taking a benzodiazepine, factor this into their treatment plan. Understand the side effects of each medication. Make sure they are not taking drugs that interact with each other — many websites offer cross-checking tools. Getting your loved ones off these medications might just make their lives — and yours — much better.

LS
Leonard L. Shober, J.D., LL.M.
Founding Attorney · Shober & Rock, P.C.

Len graduated with honors from Temple University School of Law in 1986 and holds an LL.M. in Taxation. Before law school, he worked as a social worker and family counselor — a background that shapes his deeply human approach to elder law. He has served Bucks County families for over 40 years.