Elderly person surrounded by floating pills, guardian angel watching over them.

Medication Safety for Seniors: Are They Getting the Right Care?

Soraya Malik in Health & Wellness December 2025 • 4 min read.

"A Deep Dive into Prescription Practices and Potential Risks in Long-Term Care Facilities"

As our population ages, ensuring the health and well-being of our senior citizens becomes increasingly important. One critical aspect of elderly care is medication management, especially for those residing in long-term care facilities. Polypharmacy, the use of multiple medications, is common among older adults due to the complex health conditions that often accompany aging. However, this practice can lead to potentially inappropriate medications (PIMs) and hazardous drug interactions (PHDI), posing significant risks to their health.

A recent study published in the Brazilian Journal of Pharmaceutical Sciences sheds light on this pressing issue. The research assesses the pharmacotherapeutic safety of medical prescriptions for elderly residents in a long-term care facility, aiming to quantify the prevalence of PIMs and PHDIs, identify risk factors, and evaluate the impact of pharmaceutical interventions. This article dives into the study's findings, offering insights and practical advice to help families, caregivers, and healthcare professionals ensure the safest and most effective medication practices for our seniors.

We'll explore the common pitfalls in prescribing medications to the elderly, discuss strategies to mitigate these risks, and highlight the importance of a collaborative approach involving pharmacists, physicians, and other healthcare providers. By understanding the potential dangers and implementing proactive measures, we can significantly improve the quality of life for our aging population.

What are Potentially Inappropriate Medications (PIMs)?

Elderly person surrounded by floating pills, guardian angel watching over them.

Potentially inappropriate medications (PIMs) are drugs for which the risks of use outweigh the benefits, especially when safer alternatives are available. These medications carry a high risk of adverse drug reactions (ADRs) without sufficient evidence of benefits. Several factors contribute to the increased risk of PIMs in the elderly:

Physiological Changes: Aging naturally brings changes in the body, such as reduced liver and kidney function, decreased muscle mass, and altered homeostasis. These changes affect how drugs are processed and can increase the risk of adverse effects.

Polypharmacy: The use of multiple medications increases the likelihood of drug interactions and adverse reactions.
Comorbidities: Older adults often have multiple chronic conditions, requiring numerous medications that can interact negatively.
Lack of Awareness: Some healthcare providers may not be fully aware of the specific risks associated with certain medications in the elderly.

According to the Beers criteria, a widely used tool for identifying PIMs, certain medications should be avoided in older adults due to their high risk of adverse effects. These include drugs that act on the central nervous system, such as benzodiazepines and antidepressants, as well as certain cardiovascular medications and antibiotics.

Taking Action for Medication Safety

Ensuring medication safety for the elderly requires a multifaceted approach involving healthcare professionals, caregivers, and family members. By staying informed, advocating for safer alternatives, and promoting collaborative care, we can protect our seniors from the risks associated with potentially inappropriate medications. Together, we can create a healthcare environment that prioritizes the well-being and safety of our aging population.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

Everything You Need To Know

What are Potentially Inappropriate Medications (PIMs) and why are they a concern for seniors in long-term care?

Potentially Inappropriate Medications (PIMs) are drugs where the risks of use outweigh the benefits, particularly when safer alternatives exist. These medications pose a high risk of adverse drug reactions (ADRs). For seniors in long-term care, PIMs are a major concern because of the physiological changes associated with aging, such as reduced liver and kidney function, which affect how drugs are processed. Polypharmacy, the use of multiple medications, and the presence of multiple chronic conditions (comorbidities) also increase the likelihood of PIMs. Healthcare providers' lack of awareness about risks associated with certain medications in the elderly further compounds the issue. The Beers criteria is a widely used tool that helps identify PIMs.

How does Polypharmacy contribute to medication risks in elderly patients?

Polypharmacy, the use of multiple medications, significantly increases the risk of adverse drug reactions and drug interactions in elderly patients. As older adults often have multiple chronic conditions, they require a larger number of medications. This increased medication load elevates the chances of negative interactions between the drugs. Furthermore, the complex interplay of various drugs can lead to unexpected side effects and reduce the effectiveness of treatments. This risk is further increased by age-related physiological changes, such as reduced liver and kidney function, which affect how the body processes and eliminates drugs.

Can you give specific examples of Potentially Inappropriate Medications (PIMs) that older adults should avoid?

According to the Beers criteria, several types of medications should be avoided in older adults due to their potential for harm. These include drugs that act on the central nervous system, such as benzodiazepines (often used for anxiety and insomnia) and some antidepressants. Certain cardiovascular medications and antibiotics are also frequently listed as PIMs. The specific risks associated with each of these classes of drugs can vary, but generally, they carry a higher likelihood of adverse effects in the elderly compared to younger adults. It's essential for healthcare providers to be aware of and utilize tools like the Beers criteria to reduce the likelihood of prescribing these types of medications.

What are the physiological changes in aging that impact medication safety?

Aging brings several physiological changes that significantly affect medication safety. These changes include reduced liver and kidney function, which impairs the body's ability to metabolize and eliminate drugs, leading to a higher risk of drug accumulation and toxicity. Decreased muscle mass and altered body composition influence how drugs distribute throughout the body. Changes in homeostasis, the body's ability to maintain a stable internal environment, also play a crucial role. These age-related changes can increase the risk of adverse drug reactions and necessitate careful consideration when prescribing and monitoring medications for older adults.

What steps can be taken to improve medication safety for seniors in long-term care facilities?

Improving medication safety for seniors requires a multifaceted approach involving healthcare professionals, caregivers, and family members. Healthcare providers must stay informed about the risks associated with medications in the elderly and use tools like the Beers criteria to identify and avoid Potentially Inappropriate Medications (PIMs). They should promote safer alternatives when possible. Caregivers and family members play a crucial role by being informed and advocating for the safest medication practices. A collaborative approach involving pharmacists, physicians, and other healthcare providers is essential to ensure comprehensive medication management, including regular medication reviews, and monitoring for adverse effects. This helps create a healthcare environment that prioritizes the well-being and safety of the aging population.