How can you tell if your parent can no longer manage their medication?

The signs that an older person needs help with their medicines and how to step in without taking away their independence.

Your father or mother probably needs help with their medication if you find untaken pills, duplicate boxes, expired packs, or if they are unsure what each medicine is for. It is rarely a sudden change: small details add up and are worth looking at calmly, without alarm and without blame.

Spotting it early matters because taking many medicines is common after 65, and every extra medicine increases the chance of missed doses, duplicates and interactions.

Which signs show that they need help?

The most reliable signs are the ones you can check at home: the number of pills does not match the days that have passed, two boxes of the same active ingredient appear under different names, or the person cannot explain their regimen. A single isolated sign is not conclusive, but several together justify acting.

Why is managing medication harder with age?

With age, long term conditions tend to add up and so do medicines. According to Spain's Ministry of Health, using 2023 primary care data, 29.7% of people over 65 in Spain take five or more different active ingredients on a long term basis within the same year.

• The figure rises with age: 20.5% at 65 to 74, 36.8% at 75 to 84 and 44.7% at 85 to 94.
• Eyesight, the dexterity needed to open blister packs and memory changes all play a part.
• Changes of packaging or brand at the pharmacy can cause confusion.

The World Health Organization identifies polypharmacy, transitions of care, such as discharge from hospital, and high risk situations as the three priority areas for reducing avoidable harm from medicines.

How can you check without undermining their independence?

The most respectful way is to do it together and present it as help, not control. You can suggest sorting the medicine cabinet and making a shared list of medicines, and ask them to explain how they organise things.

1. Gather all the medicines, including those bought without a prescription, vitamins and supplements.
2. Compare what you find with the doctor's active medication sheet.
3. Count the pills of two or three medicines and repeat a week later.
4. Ask about new symptoms: dizziness, sleepiness, forgetfulness or falls.
5. Take expired medicines, or ones they no longer take, to the SIGRE collection point at the pharmacy.

There are more ideas in how to tell whether your parents are taking their medication.

What should you do when you notice several signs?

The first step is to ask their GP or pharmacist for a medication review, without stopping or changing anything yourself. Reviewing the whole treatment makes it possible to detect duplicates, interactions or medicines that may no longer be needed (deprescribing).

• Take the updated list to the appointment and note down what you have observed.
• Ask whether the regimen can be simplified, for example by reducing the number of doses per day.
• Consider a system that prepares doses by day and time, and decide who will follow up.

If you also notice forgetfulness in other areas of daily life, mention that change to their doctor too. Our article on common mistakes when organising medication may help.

A practical example: Antonio and the duplicate boxes

Let us take the case of Antonio, 84, who lives alone and takes 8 medicines. His daughter Laura, visiting one Sunday, finds two boxes of the same blood pressure medicine in the kitchen, one branded and one generic, and a blister pack of another treatment that is almost full although it should be half empty.

• Laura does not scold him: she suggests sorting the medicine cabinet together and making a list.
• She books an appointment with the GP and takes the list and her observations.
• The doctor reviews the regimen and confirms that both boxes contain the same active ingredient.
• They decide that the medication will be prepared by day and time and that someone will check the doses every week.

How can IMA Health help?

When medication starts to become a problem, IMA Health coordinates with a specialised pharmacy that prepares each dose by day and time, delivers it to the home and provides personalised follow-up. That way your father or mother keeps their routine and you know every dose is properly organised.

Sources

• Spanish Ministry of Health: polypharmacy reaches 45% of people aged 85 to 94 (press release, January 2026)
• Spanish Ministry of Health: use of long term medicines in people aged 65 and over taking five or more medicines (BDCAP)
• World Health Organization: Medication Without Harm

This article is for information only and does not replace advice from your doctor or pharmacist.