Medications are one of the most common sources of worry for families of older adults, and for good reason. A parent may see a primary doctor, a cardiologist, and a specialist or two, fill prescriptions at more than one pharmacy, and add over-the-counter pills and supplements on top. This guide covers the practical side: building a medication list, setting up a routine, and getting a professional review. It does not tell you what any medicine should be. Those decisions belong to your parent and their prescribers.
When to get help right away
Call 911 for trouble breathing, chest pain, sudden confusion, fainting, or a suspected overdose. For a possible poisoning or double dose, call Poison Control at 1-800-222-1222. Call the doctor or pharmacist promptly about new dizziness, falls, unusual sleepiness, or a rash after starting a medicine.
Why medication management matters
Adults 65 and older take more medicines than any other age group. The National Institute on Aging cites CDC data showing that about one-third of adults in their 60s and 70s used five or more prescription drugs in the previous 30 days. Taking many medicines is sometimes exactly right. But unnecessary or poorly coordinated medicines raise the risk of falls, confusion, and harmful drug interactions.
The CDC lists a medication review as one of the first steps in fall prevention, because some medicines can cause dizziness or sleepiness. See our fall prevention guide for more.
Step one: build one complete medication list
A single, current list is the most useful tool you can create. Bring it to every appointment, every pharmacy visit, and every trip to the emergency room. Medicare also recommends carrying a medication list to provider visits and hospital stays.
For each item, record:
- Name (brand and generic, if you know both)
- Strength and dose (for example, 10 mg, one tablet)
- When it is taken, and whether with food
- What it is for, in plain words
- Who prescribed it, and the date started
- Any notes, such as "makes her dizzy if taken at night"
Also include over-the-counter pain relievers, sleep aids, antacids, eye drops, inhalers, creams, vitamins, and herbal supplements. These are easy to forget and can interact with prescriptions. Add allergies and past bad reactions, the pharmacy's name and number, and the date the list was last updated.
The brown bag check
Put every bottle, tube, and box in the house into a bag, including what is in the bathroom, kitchen, purse, and nightstand. Bring it to the pharmacist or doctor and compare it to the list. You may find duplicates, expired items, or medicines that were supposed to stop.
Step two: set up a simple routine
The best system is the one your parent will actually use. Options include:
- Weekly pill organizers with compartments for morning, noon, evening, and bedtime. Fill them on the same day each week, ideally with a second person double-checking.
- Locking or automatic dispensers that open at set times and sound an alert. These can help when memory is a concern. Our technology guide covers how they work.
- Pharmacy blister packs or multi-dose packaging, where the pharmacy sorts doses by date and time. Ask your pharmacy whether it offers this.
- Synchronized refills, so all prescriptions are refilled on the same day each month. Many pharmacies offer this on request.
- A written chart by the coffee maker or on the fridge, checked off each day.
Use one pharmacy if possible. A single pharmacy can screen all prescriptions together for interactions.
Keep medicines in a cool, dry place, away from grandchildren and pets. If a person with dementia is getting into medicines, a locked box may be safer.
Step three: ask for a pharmacist review
Pharmacists are medication experts and are often easier to reach than doctors. Ask for a sit-down review of the full list.
If your parent has a Medicare drug plan, check whether they qualify for Medication Therapy Management (MTM). Medicare drug plans must offer MTM to members who meet certain requirements, often people taking drugs for more than one chronic condition. If your parent qualifies, it is free and includes:
- A comprehensive medication review with a pharmacist or other health professional
- A written summary of the review
- A personal medication list and a recommended to-do list
Call the number on your parent's drug plan card and ask, "Am I eligible for Medication Therapy Management?"
Useful questions for the pharmacist:
- Are any of these medicines duplicates or likely to interact?
- Could any of them cause dizziness, confusion, or falls?
- Are there lower-cost options we could ask the doctor about?
- Which ones are most important not to miss?
- What should we do if a dose is missed?
Step four: talk with the doctor about deprescribing
Deprescribing means reducing or stopping medicines that may no longer be needed or may cause more harm than good, with a clinician guiding the process. It is a normal, planned part of good care for older adults, not "giving up."
According to AHRQ, deprescribing should be supervised and done through shared decision-making. Some medicines need to be tapered slowly rather than stopped abruptly. Clinicians may use tools such as the American Geriatrics Society Beers Criteria, which lists medicines that are often inappropriate for older adults.
Ways to start the conversation:
- "Is each of these medicines still needed?"
- "Are any of these on the list of medicines older adults should usually avoid?"
- "Mom's main goal is to stay steady on her feet and clear-headed. Does her medicine list fit that goal?"
- "If we stopped or lowered something, what would we watch for?"
AHRQ also notes that stopping a medicine in the electronic record does not always notify the pharmacy. After any change, confirm with the pharmacy so the old prescription is not refilled automatically.
Watch closely during transitions
Medication errors are especially common after a hospital stay or rehab. New prescriptions may duplicate old ones, or a medicine stopped in the hospital may still be at home. Before discharge, ask for a reconciled list and go through it with the nurse. Our guide to the first days after a hospital stay has a full checklist.
When memory loss or distance complicates things
A parent with memory loss may forget whether they already took a pill and take it again, or may hide or refuse medicines. Signs that the current system is not working include leftover pills in the organizer, empty bottles before refill dates, or new confusion. Talk with the doctor and pharmacist about simplifying the schedule, such as fewer daily doses, and consider a locking dispenser or a person who supervises doses.
If you live far away, you can still help:
- Ask your parent to sign a release so the pharmacy and doctors can talk with you
- Keep a copy of the medication list on your phone and update it after every appointment
- Set up refill reminders or automatic refills
- Arrange for a local relative, neighbor, or aide to check the organizer weekly
Dispose of old medicines safely
The FDA recommends take-back options first: National Prescription Drug Take Back events, year-round drop boxes at many pharmacies and police stations, or mail-back envelopes. Scratch out personal information on labels before throwing away empty bottles. For other cases, see the FDA's disposal guidance.
Managing medications is one of those jobs that is invisible when it goes well. A current list, a routine, and an annual review can make it go well far more often.
Check before you decide
Benefit rules, dollar amounts, and state programs change, and every family's situation is different. This guide is general information, not medical, legal, or financial advice.
- Confirm eligibility and current amounts with the agency itself: Medicare, your state Medicaid office, or the VA.
- For legal documents and Medicaid planning, talk with a licensed elder law attorney in your state.
- For health questions, talk with the person's doctor. In an emergency, call 911.
Common questions
Can we stop a medicine that seems unnecessary?
Not on your own. Some medicines must be tapered slowly, and stopping suddenly can be dangerous. Bring your questions to the prescriber or pharmacist and decide together.
Does Medicare offer a free medication review?
Medicare drug plans must offer Medication Therapy Management to members who meet certain criteria, often people with several chronic conditions and many medicines. It is free if your parent qualifies. Call the plan to ask.
What should a medication list include?
Every prescription, over-the-counter medicine, vitamin, and supplement, with dose, schedule, purpose, and prescriber, plus allergies and the pharmacy's phone number.
How should we get rid of old medicines?
The FDA recommends drug take-back options first: take-back events, pharmacy or police drop boxes, or mail-back envelopes. Scratch out personal information on bottles.
Sources
- Safety checks, drug management programs, and Medication Therapy Management — Medicare.gov. medicare.gov/health-drug-plans/part-d/what-plans-cover/plan-rules/safety-management-programs
- The dangers of polypharmacy and the case for deprescribing in older adults — National Institute on Aging. nia.nih.gov/news/dangers-polypharmacy-and-case-deprescribing-older-adults
- Deprescribing as a Patient Safety Strategy — AHRQ PSNet. psnet.ahrq.gov/primer/deprescribing-patient-safety-strategy
- Drug Disposal: Drug Take Back Locations — U.S. Food and Drug Administration. fda.gov/drugs/disposal-unused-medicines-what-you-should-know/drug-disposal-drug-take-back-locations
- Preventing Falls and Hip Fractures — CDC. cdc.gov/falls/prevention/index.html
Last reviewed October 19, 2026. General information only, not medical, legal, or financial advice. Benefit rules and amounts change, so confirm with the agency before you decide. See our disclaimer.