When it comes to prescription drugs in nursing homes, medications given to elderly residents to manage chronic conditions like heart failure, diabetes, or dementia. Also known as long-term care pharmacy regimens, these drugs are meant to improve quality of life—but too often, they become a source of harm. Nearly 90% of residents in U.S. nursing homes take at least one prescription drug daily. More than half take five or more. This isn’t just common—it’s a systemic issue.
The problem isn’t the drugs themselves, but how they’re managed. polypharmacy, the use of multiple medications at once, often without clear purpose. Also known as medication overload, it’s one of the leading causes of falls, confusion, and hospitalizations in older adults. A resident might be on a blood thinner, a sleep aid, an antidepressant, a stomach acid reducer, and a painkiller—all prescribed by different doctors, with no one reviewing the full list. These drugs don’t just sit quietly. They interact. One can make another stronger, weaker, or toxic. Digoxin, for example, becomes dangerous if potassium levels drop. Carbamazepine can knock out the effect of birth control or blood thinners. And when staff are stretched thin, labels go unchecked. That’s how errors happen.
medication errors, mistakes in prescribing, dispensing, or giving a drug. Also known as drug administration errors, they’re not rare—they’re expected in many facilities. A nurse gives the wrong dose. A pill gets dropped and replaced with a similar-looking one. A family member brings in an herbal supplement, and no one asks about it. These aren’t accidents caused by bad people. They’re failures of systems. Hospitals use barcodes and double-checks. Nursing homes often don’t. And when they do, it’s inconsistent.
What makes this worse is that many of these drugs are prescribed for symptoms that don’t need pills at all. Agitation? Maybe it’s a full bladder or loneliness. Insomnia? Could be caffeine after noon or lack of daylight. Yet antipsychotics, benzodiazepines, and sleep aids get handed out like candy. The FDA has warned that these drugs increase the risk of stroke and death in dementia patients. Still, they’re used.
Families often don’t know what their loved one is taking—or why. You might think the doctor explained it all. But in a 10-minute visit, that’s unlikely. You need to ask: What is this for? Is it still needed? Are there safer options? Keep a written list. Bring it to every appointment. Ask if any drugs can be stopped. Many can. Studies show that when pharmacists review these lists, up to 40% of medications are safely discontinued without harm.
And then there’s the money. Some drugs are expensive. Others are cheap but risky. Medicare Extra Help can cut costs, but not everyone knows they qualify. Counterfeit drugs show up in online pharmacies that some families turn to for savings. And when a pill looks wrong, no one speaks up.
Below, you’ll find real stories and facts about what goes wrong—and what you can do to fix it. From checking labels before every dose to understanding how drugs like heparin or phenytoin behave in aging bodies, these articles give you the tools to speak up, ask better questions, and protect someone who can’t always protect themselves.
