intermediategeriatricbenzodiazepine-deprescribingfallscognitive-impairmentphysiological-dependencetaper-protocol
An 81-year-old woman has been taking lorazepam 1 mg at bedtime nightly for 12 years, originally started by her previous primary care provider for insomnia. She was referred to the PMHNP by her new primary care provider for evaluation of recurrent falls and cognitive complaints. She reports that she 'cannot sleep at all' without the lorazepam and expresses significant anxiety about any dose changes, stating that a previous provider attempted to reduce her dose three years ago and she experienced severe insomnia, tremors, and anxiety that led to emergency department utilization. Her current MoCA score is 23/30 with deficits in delayed recall and executive function. She takes no other psychotropic medications. The PMHNP evaluates the approach to this clinical scenario. Which of the following most accurately reflects evidence-based assessment of benzodiazepine deprescribing in geriatric patients?