Staying healthy as we age often involves more than just regular doctor visits. For many older adults, one of the most critical — and potentially challenging — instrumental activities of daily living (IADLs) is medication management. Taking medications correctly, consistently, and safely can mean the difference between stable health and preventable complications. Yet despite this, the importance of medication management is frequently underestimated until something goes wrong.
Proper medication adherence a must for healthier aging
Research shows that nearly half of adults over age 65 take five or more nonprescription and/or prescription medications weekly, and more than 12% take 10 or more drugs every week. While each medication may be necessary on its own, managing multiple prescriptions dramatically increases complexity … as well as potential risk.
Medication mismanagement among older adults (including missed doses or taking too much/too little of a drug) is linked to higher rates of falls, emergency department visits, hospitalizations, and other adverse drug effects. Studies show the issue is especially prevalent among older adults dealing with cognitive decline.
Medication adherence — taking medications exactly as prescribed and instructed — is therefore a cornerstone of healthy aging and remaining independent. When adherence breaks down, even slightly, poorer health outcomes often follow.
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Medication management often becomes challenging with age
Several common age-related factors can make medication management increasingly difficult.
Cognitive changes
Cognitive decline is one of the most prevalent issues that impacts proper medication management among older adults. Even mild memory impairment can interfere with remembering whether a medication was taken, understanding dosing instructions, or keeping track of refills.
Recent research puts a finer point on it: A 2025 study out of the University of Rochester indicates that older adults with cognitive impairment (particularly those with dementia) who struggle with medication management face significantly higher risks of hospitalization compared to those without memory issues. Specifically, the researchers found “the rate of medication management difficulty was 13.12% among participants with dementia, 5.8% among those with CIND [cognitive impairment, no dementia], and 1.96% among those with intact cognition.”
More medications = more problems
Beyond memory, the sheer number of medications many older adults take also is a factor since each additional prescription adds another layer of mental effort.
Research has shown that so-called “polypharmacy” — the simultaneous use of five or more medications — significantly increases the likelihood of nonadherence, particularly when medications are taken at different times of day or under varying conditions. This cognitive load can overwhelm even highly organized individuals.
Common age-related physical challenges
Physical changes as we age can further complicate the task of medication management. For instance, osteoarthritis can make child-resistant caps painful or impossible to open, while a decline in vision may interfere with reading labels or distinguishing pills that look similar. These physical barriers can contribute to skipped doses, accidental double-dosing, or incorrect administration, all of which can have serious health consequences.
Cost constraints
The ever-increasing cost of medicine also frequently plays a role in proper adherence for many Americans. Since older adults often live on fixed incomes, high pharmacy copays or coverage gaps may lead people to stretch medications by skipping doses or delaying refills.
In fact, research on medication adherence among older adults shows that “high medication cost” is a consistent predictor of intentional nonadherence, even when people understand the importance of their prescriptions.
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When medication management becomes a shared responsibility
Challenges with managing medications are not limited to those handling their own prescriptions. For many families of aging loved ones, the difficulty intensifies when one partner or spouse begins managing medications for the other. What starts as occasional reminders can evolve into full responsibility for sorting pills, overseeing administration, tracking refills, coordinating with physicians, and watching for any side effects or interactions.
It’s common for caregivers to experience significant emotional strain in this role. Managing a loved one’s medications requires constant vigilance, and mistakes can feel frightening or guilt-inducing.
Research has shown that caregiver involvement in medication management increases stress levels, particularly when medicine regimens are complex or when the care recipient resists help. Long-standing relationship dynamics can also complicate the situation, especially when independence and identity are deeply valued.
For adult children, the challenge can be even greater. They may live far away, lack real-time visibility into whether medications are taken correctly, or struggle to balance caregiving with work and family responsibilities.
>> Related: When Is It Time to Call in Care Reinforcements for an Aging Loved One?
Why medication management is a key indicator of care needs
Because medication management touches on cognitive, physical, and organizational abilities, it is often one of the earliest indicators that additional support may be needed as a person ages. Challenges with medication management and adherence are closely associated with declines in functional independence and are frequently used by clinicians as a marker for assessing care needs, particularly for people with cognitive decline.
This is one reason medication support is such a central feature of assisted living, memory care, and other senior living care options. Proper medication oversight reduces the risk of adverse drug events and provides peace of mind for residents and families alike.
Tailored solutions for medication management
The good news is that medication management challenges are solvable with the right combination of planning, tools, and support.
Simple ways to manage medications
One of the most effective first steps is medication simplification. Pharmacists and healthcare providers can review a person’s prescriptions to eliminate any unnecessary medications, align dosing schedules, and reduce complexity whenever possible. Research consistently shows that simpler regimens improve adherence and reduce errors.
There are other options to assist with medication management as well. Traditional tools like weekly pill organizers and clearly labeled medication trays help externalize memory demands. Alarms, watches, or phone reminders also provide consistent prompts. Such “low-tech” solutions are often sufficient for individuals with mild challenges and can significantly reduce missed doses.
Finally, maintaining an up-to-date medication list, which notes dosage amount and frequency, can be helpful for the patient, loved ones, caregivers, healthcare professionals, and pharmacists. The list should include prescription drugs as well as over-the-counter medications to ensure proper adherence and prevent dangerous interactions.
High-tech medication management tools
Higher-tech solutions have also expanded rapidly in recent years. A 2025 study found that older adults’ drug adherence improves when technology tools are easy to use, provide clear reminders, and align with personal preferences. This might include electronic medication dispensers, which release the correct dose at the correct time and often include visual or audio cues. Some models even notify caregivers if a dose is missed, adding an extra layer of safety.
Recent clinical trials show that such in-home electronic medication dispensing systems can significantly improve medication adherence among older adults with complex regimens, reducing both missed doses and caregiver stress. Mobile apps are another high-tech solution that have been shown to improve adherence during clinical trials and, in some cases, reduce hospital readmissions.
Additional technological innovations for medication management include smart pill bottles that track openings, wearable reminder devices, and connected dashboards that allow family members or clinicians to monitor adherence remotely. These tools help bridge the gap between independence and oversight, especially for families managing a loved one’s care from a distance.
It’s important to note that no single medication management solution fits everyone. Research emphasizes that adherence tools work best when they align with an individual’s comfort level, cognitive abilities, and daily routines. Some older adults prefer simple, familiar systems; others embrace higher-tech tools that offer automation and caregiver visibility.
>> Related: How Technology Is Reducing Long-Distance Caregiver Burden
Choose the right medication management solution for health and peace of mind
Medication management is much more than a routine task; it is a cornerstone of safe, healthier aging. Because it sits at the intersection of memory, mobility, finances, and emotional well-being, it is also one of the most revealing indicators of when additional support or care services may be beneficial.
The challenges are real, but they are not insurmountable. With thoughtful planning, appropriate tools, and the right level of assistance (whether through family support, technology, or senior living services), older adults can maintain better health and more independence, along with greater peace of mind.
For families, having open conversations and investing in effective medication management solutions for their aging loved one is not just about preventing mistakes. It’s about supporting dignity, independence, and quality of life for the long term.
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