End-of-Life Care: Stop Medications for Better Quality

June 12, 2024

In our latest GoldCare Masterclass, we explored a rather surprising yet crucial aspect of end-of-life care: the potential benefits of stopping medications. Led by Dr. Brian Atkinson, a retired neurologist and hospice physician, the session delved into his experiences and observations regarding the discontinuation of medications for terminally ill patients. The discussion also touched on the implications this might have for all of us, not just those near the end of life.

The Paradox of Medication at Life's End

Dr. Atkinson emphasized a compelling statement: "Stopping medications near the end of life improves life expectancy and quality of life." This paradoxical notion challenges the common belief that medications are always beneficial. In hospice care, it often becomes evident that many medications, intended to prolong life and enhance quality, may instead contribute to discomfort and hasten decline.

Real-Life Observations from a Hospice Doctor

During his tenure as a hospice physician, Dr. Atkinson encountered numerous cases where patients, previously close to death, showed remarkable improvement after discontinuing their medications. These patients, initially delirious and unresponsive, would often become alert, begin eating, and engage with their surroundings once their medication regimens were simplified. This transformation underscores the potential toxicity of polypharmacy—taking multiple medications simultaneously—especially in patients with compromised bodily functions.

Understanding the Broader Implications

The discussion also touched on broader issues within the medical field, such as the FDA approval process for medications and the implementation of evidence-based protocols. Dr. Atkinson critiqued these systems for not adequately considering the unique conditions of hospice patients or the cumulative effects of multiple medications. He shared examples of how rigid adherence to protocols, like the automatic administration of statins or antibiotics, can sometimes lead to more harm than good.

Reassessing Medication Use: A Call to Action

One of the key takeaways from our class is the importance of regularly reassessing the necessity and impact of medications. Dr. Atkinson advocates for annual reviews of all medications, ensuring that each prescription is still appropriate and beneficial for the patient's current health status. This proactive approach can help minimize the risks associated with polypharmacy and improve overall patient outcomes.

Smarter Medication Management

The insights shared by Dr. Atkinson illuminate a critical aspect of healthcare that often goes overlooked. By understanding the potential harms of unnecessary medications, especially at the end of life, we can strive to provide more compassionate and effective care. For those interested in exploring these concepts further and gaining access to a wealth of healthcare knowledge, consider joining GoldCare. Our community is dedicated to empowering individuals with the information and support needed to make informed health decisions.

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