A bag I wasn’t expecting to receive.
Author: Sofia Duque,
Afilliations: 1. Hospital CUF Descobertas, 2. NOVA Medical School
A few days after returning from holiday, something happened in clinic that was both unusual and surprisingly meaningful.
A few months earlier, an older woman had come to my Geriatrics clinic with a very clear goal: She wanted to age better. As always, we reviewed her medication. Among her prescriptions was a benzodiazepine she had been taking for many years. Benzodiazepines have an important role in selected clinical situations. But in older adults, prolonged use is generally discouraged, as the potential harms —including falls, cognitive impairment, reduced mobility and dependence— often outweigh the benefits. We discussed this, and agreed on a slow, gradual taper.
A few months later, she returned. When I reviewed her medication, the benzodiazepine was no longer there. She had gradually reduced it and successfully stopped. A deprescribing success.
But the story didn’t end there. At the end of the appointment, I noticed a white bag left behind in my office. I quickly went after her, assuming she had forgotten it. She hadn’t. She had left it there for me. Inside were all the boxes she still had at home — many of them, in several different doses. I wasn’t quite prepared for that “return”. For me, knowing that she had stopped the medication was enough. But that bag became a powerful symbol of something I deeply believe in: Deprescribing is also a form of care. It does not mean demonising medications. It means revisiting treatments and asking: Does this medication, for this person, at this point in their life, still offer more benefit than harm?
Sometimes prescriptions become habits that last for years or decades. And it can be tempting to think: “They’ve been taking it for so long. There’s no point changing it now.” There is. Not every journey is this simple, and benzodiazepine tapering should always be individualised, gradual and supervised. But this patient reminded me of something important: We should never underestimate older people’s ability to change. When we explain why, involve them in decisions and support them through the process, longstanding habits can change. The time we spend explaining is not wasted time. It is time invested in autonomy, safety and quality of life.
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