What to Do When You Suspect Overmedication

Protect your loved one if you are worried they are taking too many drugs

Paul Wynn,

AARP

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En español

Published July 17, 2025

Susie Singer Carter (both images)

When filmmaker Susie Singer Carter placed her mom in one of Los Angeles’ top-rated assisted living facilities, she believed she was doing everything right. Her mother had Alzheimer’s disease but remained physically strong and socially engaged. But within a few months, her mom, who once held court at the facility every Friday singing songs with a piano player, became unrecognizable: silent, immobile and incontinent. “I thought it was the disease progressing,” Carter recalls. “But it wasn’t. It was actually the drugs.”

That revelation launched Carter on a quest to uncover the hidden epidemic of overmedication that is quietly robbing individuals of alertness, independence and vitality. Her mom had been given the sedating medication Depakote without her knowledge or consent. She found out only when she received a call from her mother’s primary care doctor. They stopped the drug immediately, but the damage persisted. “Once we got her off it, some of her spark came back, but she never walked again. It was like, ‘Oh, hello again, there you are, I was wondering where you went.’ ”

The story is at the heart of No Country for Old People, Carter’s documentary that uncovers the systemic neglect and abuse of older adults, which includes overmedication, especially in long-term care environments. What she discovered, after interviewing many other families, was how common the problem is, whether at long-term care facilities or even at home under a doctor’s care.

Before starting treatment with Depakote, Norma Pecora sang every Friday (Left: March 2012) at her assisted living facility. After starting therapy, however, she became uncharacteristically quiet, lost mobility and experienced incontinence (Right: August 2012).

Courtesy Susie Singer Carter

Hidden dangers of overmedication

Many older Americans find themselves managing an ever-growing list of prescriptions, over-the-counter remedies and dietary supplements. While medications are essential for treating and preventing a wide range of health conditions, some may do more harm than good. Interactions between medicines, called drug-drug interactions, can pose serious health risks, particularly when it comes to mental health treatments.

A comprehensive 2018 review of 248 studies found that certain drugs commonly prescribed to older adults — including antidepressants, antipsychotics and benzodiazepines to treat anxiety, seizures and sleeplessness — are consistently linked to a higher risk of falls and other adverse effects.

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As people age, their bodies metabolize medications differently, making them more susceptible to side effects such as dizziness, confusion, constipation and impaired balance. “Even small changes in hydration, nutrition or kidney function can turn a routine dose into a serious risk,” says Sean Jeffery, professor of pharmacy practice at the UConn School of Pharmacy in Storrs, Connecticut. “Any new change in condition should first be considered a drug side effect until other causes are ruled out.”

How do you know if your loved one is being overmedicated or experiencing a drug side effect? Jeffery notes several red flags to keep an eye out for, especially when starting a new product or changing the dose:

Confusion
Digestive changes
Drowsiness or fatigue
Frequent falls or changes in balance
Increased irritability
Loss of appetite
Memory problems
Nausea
Sudden mood shifts

Tamara Goulden encourages families to stay vigilant about any medication changes. When her 86-year-old father, Les, was discharged from a hospital and entered a skilled nursing facility in Scottsdale, Arizona, in January 2025, she had hoped it would be a short, restorative stay. Within hours of arrival, Les discovered a serious medication error by scrolling through his patient portal on his mobile phone. The dosage of metoprolol, used to manage his atrial fibrillation (A-fib), was dangerously low. The facility’s staff acknowledged that they couldn’t verify the hospital's discharge instructions from Les’s phone, so Tamara had to retrieve the correct documents from the hospital and deliver them to the facility herself.

What followed was three weeks of near-daily crises: missed updates, staff miscommunication, unnecessary IVs and Goulden battling the system, every turn just to keep her father safe. It left Goulden with the realization that if her father hadn’t been alert enough to catch the mistake, the consequences could have been fatal.

Drugs to watch out for

Certain types of drugs pose higher risks for older adults, particularly those with cognitive decline, frailty and multiple chronic conditions. Commonly prescribed medications can cause unexpected side effects, alter behavior or mobility and interact dangerously with one another.

About 7 out of 10 adults ages 40 to 79 in the United States take at least one prescription medication, and around 1 in 5 take five or more medications, according to a report by the Centers for Disease Control and Prevention.

AARP research found that taking five or more prescription medications — a level known as polypharmacy — is linked to increased social isolation, lower life satisfaction, and poorer mental well-being among adults age 40 and older. Nearly half of those surveyed (49%) reported having limited social connections. Polypharmacy rates continue to rise, more than doubling among those 65 and up over the past two decades.

“Some medications can do more harm than good in older adults by causing confusion, falls or personality changes. That’s why it’s so important for families to ask questions, stay informed and speak up if something feels off,” says Mike Sevilla, M.D., a family physician in Salem, Ohio.

Sevilla urges caregivers to be especially cautious if their loved one is taking the following types of medications.

Anticholinergics (e.g., benztropine, oxybutynin) block acetylcholine, a neurotransmitter that carries signals throughout the nervous system, and are often used to treat allergies, overactive bladder and gastrointestinal issues, but they can cause confusion, drowsiness, dry mouth and other side effects, especially in older adults.
Antihistamines (e.g., Benadryl) that are over-the-counter (OTC) may seem safe, but their sedating qualities cause drowsiness that may lead to falls or injuries. Keep in mind, products like Tylenol PM include Benadryl’s active ingredient, diphenhydramine.
Depakote and similar sedatives are given to residents in long-term care settings to control their agitation, but families sometimes notice loved ones become quiet and withdrawn, appearing flat or disengaged.
Benzodiazepines (e.g., Ativan, Valium), commonly prescribed to treat anxiety and insomnia, may cause side effects, including drowsiness, dizziness, cognitive impairment and muscle weakness. Discontinuing benzodiazepines can be challenging, as long-term use often leads to physical dependence and withdrawal symptoms when it’s stopped suddenly.
Blood thinners (e.g., warfarin, Lovenox, Eliquis) require close monitoring because of the chance of increased falls, confusion, bleeding risks and serious bruising.
Opioids (e.g., oxycodone, morphine) are sometimes necessary to manage severe pain but can cause serious constipation. Avoid combining opioids with other sedatives.

For a comprehensive list of medications to use with caution in older adults, Sevilla recommends that families consult the Beers Criteria for Potentially Inappropriate Medication Use in Older Adults, a resource developed by the American Geriatrics Society.

How caregivers can take charge

Managing medications for an older loved one can feel overwhelming, but it’s one of the most important ways to protect their safety and well-being.

Jeffery and Sevilla want to remind caregivers that they can make a real difference by staying organized, asking questions and building a support team that includes health care providers and pharmacists. Here are several practical steps to consider:

Request a complete medication list.

Gather a full, updated list of all medications your loved one takes, including prescriptions, OTC drugs, vitamins and supplements. Bring the list to every appointment. Keep in mind that seniors may fill prescriptions at multiple pharmacies or pay cash using coupons like GoodRx, leading to incomplete medication records — and making it harder for doctors and pharmacists to catch dangerous interactions. Ask their doctor for a full medication review, or ask a local pharmacist if they offer medication consultations.

Request discharge papers from the hospital.

Before your loved one leaves the hospital, ask for a printed discharge summary. Make sure it includes lab results, baseline vitals and a current list of medications. Don’t wait for the facility to track it down later. Taking this one step can help prevent dangerous delays, confusion and medication errors once they’re admitted to a skilled nursing facility or rehab center.

Ask about bringing medications to facilities.

Check the facility’s policy before bringing in medications from home, even vitamins, supplements and OTC products like Advil, aspirin, antacids and decongestants. Each care facility, whether it’s a nursing home, assisted living or rehab center, has its own rules about accepting medications from outside sources. Some facilities require all medications to be provided through their in-house pharmacy for safety, inventory control and regulatory reasons.

Watch for open-ended use of drugs.

Medications prescribed as PRN (from the Latin pro re nata, meaning “as needed”) could lead to long-term problems because some medications — especially sedatives, painkillers or psychiatric drugs — can be given too frequently by well-meaning staff trying to calm agitation, manage behavior or ease discomfort. This could lead to oversedation or harmful side effects. Ask your provider why PRN needs to be included on the prescription.

Take advantage of the Medicare annual review.

Use your loved one’s Medicare yearly wellness visit as an opportunity to review medications and discuss what might no longer be necessary. Pharmacists can be a valuable resource too. “Bring them your medication list and ask them to flag any concerns about interactions or side effects.”

Ask questions of health care providers.

If a new medication is being added, find out what it’s for. Are there alternatives? Are there common drug-drug interactions? Families have the right to ask for explanations and a medication review.

Don’t be afraid to speak up. Even if your loved one is on only three medications, don’t assume everything is fine, says Jeffery. “If something seems off, like changes in alertness, balance or mood, it’s worth taking it seriously.”

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Paul Wynn, a veteran health care writer, has spent over a decade immersed in the caregiving community, both as a family caregiver and as a journalist covering caregiving issues for national publications.