Many older adults take five or more medications, and mix-ups are a leading cause of avoidable hospital trips. Here is how Puget Sound families can review, organize and safely manage a parent's prescriptions.
By Patricia Nguyen, CDP · October 07, 2026
Many older adults see a primary care doctor, a cardiologist, a specialist at a health system such as UW Medicine, Swedish or MultiCare, and a pharmacist at a separate drugstore, and each may add a prescription without seeing the full list. Taking five or more medications is commonly called polypharmacy, and it raises the odds of side effects, drug interactions, falls and confusion. A new symptom in a parent is sometimes a medication effect rather than a new disease, which is worth asking about before assuming the worst.
Gather every bottle, including over-the-counter products, vitamins and supplements, and sit down with your parent. Write down each name, the dose, the reason it was prescribed, who prescribed it, and when it is taken. Keep one copy in your parent's wallet or on the refrigerator and one on your phone, and bring it to every appointment and hospital visit.
Then book a medication review. Many pharmacists will do a brown-bag review, and primary care clinics can schedule a visit for the purpose. Ask the clinician whether anything can be stopped or reduced. Geriatric guidance such as the American Geriatrics Society Beers Criteria flags medications that carry higher risk in older adults, such as some sleep aids and anticholinergic drugs, and doctors can use it as a reference. Never stop a prescription on your own, since some drugs need to be tapered.
If your parent has Medicare Part D or a Medicare Advantage plan with drug coverage, ask whether the plan offers Medication Therapy Management. Eligible members with multiple conditions and medications can get a free comprehensive review from a pharmacist or the plan.
A weekly pill organizer is a good first step. Many pharmacies in the region also offer blister packaging or multi-dose packets sorted by time of day, sometimes with home delivery. Automatic dispensers with alarms can help someone who is still living alone, and a phone alert or a daily check-in call can add a safety net. Keep medications in one place away from the kitchen heat and out of reach of grandchildren.
Warning signs that it is time for more help include duplicate bottles, missed or doubled doses, pills found on the floor, refill gaps, or confusion about what each pill is for. These are also common early signals that a person with memory loss needs more support at home or in a care setting.
In Washington, who may handle medications depends on the setting. In assisted living (RCW 18.20), staff can provide medication assistance and, depending on the community and the resident's service plan, medication administration, with nurse oversight. In adult family homes (RCW 70.128), caregivers who are not nurses generally rely on nurse delegation for tasks such as giving certain medications, as set out in state rules, and the home has to have this arranged. Ask each provider exactly who gives medications, who checks for side effects, and how a change ordered by a doctor is carried out.
For in-home care, note that non-medical caregivers from an agency can usually remind a client to take medicine but may be limited in what they can do. Ask the agency what its policy is. If medication needs are complex, a visiting nurse through Medicare-covered home health after a qualifying illness, or a geriatric care manager, can set up a system.
Lock up opioids, sedatives and other controlled drugs if anyone else lives in or visits the home. Do not keep expired or discontinued medication around, because it is easy to take the wrong bottle. Washington's Safe Medication Return Program provides free drop-off kiosks at many pharmacies and law enforcement offices across King, Pierce and Snohomish counties, and the state Department of Health lists locations. If a mistake happens, call Poison Help at 1-800-222-1222.
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