Around 8 million people in England take five or more prescription drugs each day, and another 2 million take ten or more. Most of these individuals are over the age of 65. While taking multiple medications is not inherently a problem, it can become concerning when prescriptions are no longer appropriate, fail to deliver benefits, or could be replaced with non-drug options. Overprescribing can lead to serious issues, including fatigue, dizziness, confusion, or unsteadiness, which can make daily tasks more difficult and increase the risk of falls and hospital visits. These effects can be especially harmful for older adults with frailty or dementia, who may already experience physical and cognitive challenges. As people age, their bodies process medications differently. The kidneys and liver may not remove medicines as effectively, leading to a buildup in the body and a higher risk of side effects. Medications that were once harmless can start to affect balance, concentration, appetite, and energy levels. This makes it harder to distinguish between normal aging and the effects of medications. One of the biggest challenges in managing multiple medications is that side effects can resemble the natural process of aging. Symptoms like tiredness, forgetfulness, dizziness, or unsteadiness are often attributed to growing older or to dementia itself. However, these symptoms can sometimes be caused or worsened by medications. This is especially important for people with dementia, who often take medications for other health conditions. For families, it can be difficult to determine whether changes in memory, mood, or behavior are due to the progression of dementia or the side effects of medications. Managing medications can become a daily task for people with dementia and their caregivers, requiring constant attention to prescriptions, organizing pills, remembering doses, and monitoring for side effects. Many caregivers feel responsible for identifying problems, attending appointments, and supporting treatment decisions—yet these efforts are often overlooked. A short film created with people living with dementia and their caregivers highlights how the burden of managing medications can impact daily life, independence, and well-being. It emphasizes the importance of involving people with dementia and their caregivers in decisions about prescriptions and understanding what matters most to them. It is important to note that people should not stop taking their medications without first consulting a doctor. Many prescriptions are essential and life-saving. However, medications prescribed years ago may no longer be needed as a person’s health, priorities, and circumstances change over time. As life expectancy increases, the focus is shifting from simply helping people live longer to helping them live well. For older adults with frailty, dementia, or multiple long-term conditions, the goal is to support independence, wellbeing, and personal priorities rather than just adding more treatments. Research has shown that it is possible to safely reduce the number of medications taken by older people without increasing the risk of hospitalization or death. This is true even for those living with frailty or dementia. If you or someone you care for is taking a large number of prescription drugs, it may be helpful to start a conversation with a doctor about a medication review. This can help determine which medications are still necessary, which may no longer be needed, and whether non-drug approaches such as exercise, social activities, or practical support could be beneficial. Medication reviews can help ensure that every prescription is still needed and doing more good than harm. By reducing unnecessary medications, people may experience fewer side effects, a simpler daily routine, and an improved quality of life. These reviews also provide an opportunity to ask questions, discuss personal priorities, and better understand the role of each medication. This can help people feel more involved in decisions about their care and more listened to.