Dr. Bryan Atkinson, with a background in Neurology, brings a wealth of experience and compassion to his role. Beyond his professional endeavors, he reveals the heart of a true physician by personally caring for 60 animals on his home ranch. Discover the unexpected insights and compassionate approach Dr. Atkinson brings to the delicate process of de-prescribing medications in the context of end-of-life care.

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Dr. Bryan Atkinson, former neurologist and hospice physician, led a thought-provoking class exploring the surprising benefits of stopping medications at the end of life. Drawing from his extensive experience in hospice care, Dr. Atkinson offered fresh perspectives that challenge conventional views on medication use—not just for those nearing the end of life, but for anyone taking multiple prescriptions.

The Paradox of Medication at Life's End

At the heart of Dr. Atkinson's discussion was a surprising fact: Stopping medications near the end of life can improve both life expectancy and quality of life. This paradox challenges the assumption that medications always extend life or improve comfort. In hospice care, it often becomes clear that the very drugs intended to help can actually diminish a patient’s remaining time and well-being.

Dr. Atkinson shared stories from his years working with hospice patients, where individuals often arrived near death while on 10 to 15 medications. Many of these drugs were prescribed for long-term conditions like high blood pressure or cholesterol—issues irrelevant in the final stages of life. When these medications were stopped, patients frequently experienced a dramatic improvement. Within days, some who seemed close to death would sit up, eat, and engage with their loved ones.

Why Stopping Medications Can Help

There are several reasons why discontinuing medications can lead to such remarkable improvements:

1. Diminished Organ Function: As the body weakens, organs like the liver and kidneys lose their ability to process and clear medications effectively. This can lead to toxic buildup, contributing to delirium, fatigue, and physical decline.
2. Polypharmacy Risks: Many elderly patients are on multiple medications, leading to harmful interactions and side effects. This issue, known as polypharmacy, can cause cognitive decline, increased fall risk, and hospitalization.
3. Inappropriate Protocols: Modern medicine often follows rigid, evidence-based protocols that fail to account for individual needs—particularly for older or terminally ill patients. Dr. Atkinson criticized the "one-size-fits-all" approach, highlighting cases where such protocols led to harmful outcomes, such as unnecessary antibiotic use for respiratory symptoms, which in some cases increased mortality rates.

The Flaws in Medication Approval and Protocols

Dr. Atkinson also questioned the relevance of the FDA’s approval process for medications. Clinical trials often involve relatively healthy participants, meaning the results may not apply to elderly or seriously ill patients. As a result, when medications are prescribed to those outside the study population, the risks can be significantly higher.

Additionally, medical protocols designed for the general population may inadvertently harm vulnerable patients. Dr. Atkinson shared an example from his time as a neurologist: hospitals were often required to prescribe statins to all stroke patients, regardless of individual risk factors or potential side effects. This blanket approach left little room for personalized care and often did more harm than good.

Reframing End-of-Life Care

One of the most emotional aspects of Dr. Atkinson's talk was the discussion of how families often misunderstand hospice care. Many believe that stopping medications means "giving up," but in reality, it is about shifting focus from treatment to comfort and meaningful closure. Ending unnecessary medications can allow patients to share valuable time with loved ones, free from the side effects and burdens of excessive treatments.

The Broader Message for Everyone

While Dr. Atkinson’s insights stem from hospice care, the lessons extend beyond end-of-life situations. He emphasized the importance of regularly reassessing all medications—especially for older adults. Every drug carries potential risks, and polypharmacy remains a significant concern even for those not facing terminal illness.

Dr. Atkinson urged individuals to:

• Review medications at least once a year with a healthcare professional.
• Discuss the real benefits and risks of each medication in the context of age and overall health.
• Explore non-pharmaceutical options like diet, exercise, and lifestyle changes to reduce reliance on medications.

Finding Like-Minded Physicians

A final concern raised during the class was how to find physicians who share Dr. Atkinson's patient-centered approach. While it can be challenging within the mainstream healthcare system, communities such as GoldCare offer access to healthcare professionals who prioritize individualized care and thoughtful medication management.

A New Perspective on Medication

Dr. Atkinson’s class highlighted the importance of questioning long-held assumptions about medication use. Whether navigating the complexities of end-of-life care or simply reviewing personal prescriptions, his message was clear: medications should serve the patient’s best interests—improving quality of life, not diminishing it. Regular evaluation and a thoughtful, individualized approach can help ensure that treatments truly support well-being at every stage of life.