Many older adults take several medicines a day, and keeping track can be hard. Missed doses, double doses and mix-ups are common, and mistakes with medicines can cause serious health problems1.
Assisted living can help, but how much help depends on the community and the state. This guide explains the options and what to ask. For an overview of assisted living services, see assisted living services and amenities.
Levels of medication help
| Type | What it means | Good fit for |
|---|---|---|
| Self-administration | The resident manages their own medicines | People who manage well on their own |
| Reminders | Staff remind the resident when it's time | People who sometimes forget |
| Assistance | Staff open containers, hand over doses and watch the resident take them | People who need hands-on help |
| Administration | Trained staff give medicines and keep records | People who can't manage medicines |
Terms and what's allowed vary by state.
Who can help with medicines
States set the rules for medication help in assisted living, and they differ widely2. In some states, aides who've completed a training course can give most medicines. In others, certain tasks, like injections or adjusting doses, must be done by a licensed nurse. Some communities can't take on residents whose medicines need frequent nursing care.
Ask each community what its staff can and can't do, and what training they have.
How it usually works
- Assessment. At move-in, a nurse reviews your parent's medicines and abilities.
- Care plan. The plan records the help your parent needs.
- Pharmacy setup. Prescriptions are filled, often by a pharmacy that delivers packaged doses.
- Daily passes. Staff bring medicines at set times and record each dose.
- Reviews. Medicines are reviewed when prescriptions change or health changes.
Pharmacy options
Many communities work with a pharmacy that delivers medicines in blister packs or pouches labeled by date and time. This makes doses easier to give and track. Ask whether your parent can keep their current pharmacy, and how insurance and Medicare drug coverage are handled3.
Keeping medicines safe
- Give the community a complete list of medicines, including vitamins, supplements and over-the-counter products.
- Ask the doctor or pharmacist for a full medicine review once a year.
- Make sure the community knows about allergies.
- Ask how medicines are stored and how errors are reported to families.
- Ask what happens when a resident refuses a dose.
Some medicines raise the risk of falls, like those that cause dizziness or sleepiness4. A medicine review can catch these.
After a hospital stay or a new prescription
Medication mistakes are more likely when things change: a new diagnosis, a new doctor, or a trip to the hospital. Discharge papers often include new medicines, stopped medicines or changed doses, and these need to reach the community quickly.
- Get the discharge list. Ask the hospital for a written list of medicines, with any changes highlighted.
- Share it the same day. Give the community the list and new prescriptions before your parent returns, if you can.
- Ask for a reconciliation. The community nurse should compare old and new lists and check with the doctor about anything unclear.
- Remove old supplies. Make sure stopped medicines are taken out of the apartment and the pharmacy order.
How families can stay involved
Even with staff handling medicines, families play an important part:
- Keep a copy of the current medicine list and ask for updates after changes.
- Ask to see the medication record if you have questions.
- Tell staff about side effects you notice, like sleepiness, confusion or upset stomach.
- Go to care plan meetings and ask how medicines are working.
- Make sure the right person has legal authority to talk with doctors if your parent can't5.
Ask your parent's doctor or pharmacist whether every medicine is still needed. Older adults are often more sensitive to medicines, and needs change over time1.
Medicines and dementia
People with dementia often need full medication help, and may resist taking pills. Staff trained in dementia care can use calm, patient approaches. If your parent needs more supervision than assisted living provides, look at memory care. Medicines for behavior changes should be used carefully and reviewed often6.
Questions to ask
- What level of medication help can you provide?
- Who gives medicines here, and what training do they have?
- Is there a nurse on site, and when?
- How do you handle as-needed medicines, like pain relievers?
- Which pharmacy do you use, and can we keep ours?
- How do you track and report errors?
- Does medication help raise the monthly price?
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