People 65 and older visit emergency departments 450,000 times per year for adverse drug events. That’s more than twice as often as younger people.

While this group represents 14 percent of the population, they consume more than one-third of the total number of prescription medications. In addition, approximately 90 percent of seniors use herbal remedies and/or vitamins.

Because many seniors take a wide variety of medicines, keeping track of them, particularly when cognitive impairment is present, is a challenge.

Given the scope and complexity represented by these facts, how can caregivers and seniors do a better job of managing medications?

Common Medication Challenges

Incorrect dosage.

Tracking multiple medications each day can be overwhelming. Vision loss can also contribute by making medication labels difficult to read and result in dosage errors.

Drug reactions.

As we age, our bodies react to medications differently. Sometimes a change in dosage is needed, which requires consulting a physician.

Swallowing difficulties.

Some seniors may reduce their dosage or mash them into food out of fear of choking. This may reduce the effectiveness of the medications.

OTC medication.

Common over-the-counter (OTC) medications can cause serious drug interactions and complications. A pharmacist and the senior’s physician need a complete list of all medications being taken by the senior.

Multiple prescribers and pharmacies.

Obtaining multiple prescriptions and filling them at several pharmacies can cause unnecessary confusion.

Food and drug interactions.

Some foods alter the effectiveness of certain medications. For example, caffeine and grapefruit juice can change the way the body absorbs and interacts with medications. Vitamin K (found in broccoli) can affect blood-thinning medications.


Alcohol intensifies the effect of some medications, and some medications can increase the dizzying effects of alcohol. Not only does alcohol diminish balance, but it can also adversely affect the body’s ability to metabolize medications. Aging slows the body’s ability to break down alcohol, so it remains in a seniors system for a longer period of time.

Herbal remedies and OTC medications.

Both can be dangerous when mixed with alcohol. Be aware that some cough syrups and laxatives have high alcohol content. Mixing alcohol with anxiety/anti-depression medicine can prove deadly.

Medication Safety Tips

Monitor your senior’s reaction to medications, recording should include:

  • When the medication was given
  • When the reaction occurred
  • What the reaction was

Stay informed.

Read the information that comes with the medications about side effects. Be sure to look out for any signs of these effects. It’s important to consult the senior’s physician if side effects occur.

Know the dosage.

Not only the time of day and amount to be taken, but also if the drug should be taken with food, milk, other fluids, or on an empty stomach. Take the dosage as directed and don’t skip a dose to make the medications stretch further.

Follow the storage instructions.

Moisture and heat can affect medications. The bathroom medicine cabinet may not be the best place to store drugs.

Find out if heat, cold, or sunlight affect the medications.

Some medications should not be taken during extreme heat, cold or sun exposure. This may result in sensitivity to the sun’s rays.

Find out what foods to avoid.

Some foods, like grapefruit juice, can render medications ineffective.

Learn about OTC medication interactions.

Find out what OTC medications to avoid with prescribed drugs. For example, some antacids have the potential to minimize the effectiveness of drugs. Likewise, learn about potential interactions with herbal supplements.

Do not discontinue medications on your own.

Do not discontinue use of a drug without consulting a physician.

Use one pharmacy.

Shopping at several pharmacies to obtain the cheapest price may sound like a good idea, but it has the potential of creating confusion, which can lead to hazardous drug interactions.

Dispose of outdated medications.

You may feel as though you are saving money, but you could also be taking a drug that has degraded over time. If you keep taking out-of-date prescription medications.

Don’t ‘borrow’ someone else’s medications.

This is extremely dangerous. Don’t’ take another person’s medications, and never give your medications away to someone else.

Caregivers, be on the lookout.

Seniors tend to lose feeling in their fingertips. Periodically check at the counter or on the floor where seniors take their medications. You may find they are missing doses because pills have been dropped.

Will larger print bottles help?

If a senior has vision problems, larger-print prescription bottles may decrease the chance for a medication error.

Helping seniors understand their medications.

Though this may be a challenge for seniors taking multiple medications, help them understand the purpose behind the medications.

Stay in contact with the senior’s physician.

With a senior adult, health conditions can change rapidly. Constant monitoring of the senior and consultation with his or her physician is vital.

Organizers can help with medication management.

Electronic pill organizers that dispense medications on a set schedule and notify caregivers if doses have been skipped, can be a valuable tool in medication management. Organizing medications on a shelf according to frequency of use can simplify taking drugs. Also a dry erase board can list the medications to be taken, the quantity and how frequently they should be taken.

Keep a current list of all medications.

This includes dosage, purpose of the medication, and the prescribing doctor’s name and phone number.

Understanding your own or your senior loved one’s medications can go a long way for overall health. If you need a helping hand when it comes to medication management, after a conversation with your physician, contact a Bethesda Care Manager. We can help make sense of the challenges of aging, while helping you manage the day to day. Learn more about our Care Management services here.