Medication List Template: Easy and Nurse Approved

Here’s a simple, easy-to-use medication organization template you can fill out for your loved one. It is recommended to perform a medication reconciliation a few times a year – meaning “Are these medications still required?” Included are questions to ask your primary care provider. You can also keep a running medication list as an computer document.

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Personal Information – Medication List

• Name: ______________________________________
• Date of Birth: _______________________________
• Current Date: _______________________________
• Current Weight: ___________________________ lbs. or kg
• Allergies: ___________________________________
• Primary Doctor: _____________________________
• Pharmacy: __________________________________

Emergency Contact

• Name: ______________________________________
• Relationship: _______________________________
• Phone Number: _____________________________

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Current Medications

Medication Name	Dosage	Frequency (How often?)	Reason for Taking	Prescribing Doctor	Notes (Side Effects, etc.)

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Over-the-Counter Medications and Supplements

Name	Dosage	Frequency	Reason for Taking	Notes

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Questions to Ask the Doctor or Pharmacist

1. Are all these medications still necessary?
2. Are there any interactions to be aware of?
3. Can any medications be combined or simplified?
4. What side effects should we monitor?
5. Is this medication safe with [specific supplement/condition]?
6. Any temporary medications that have been completed (a round of antibiotics/cream)?

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You can print and update this medication list template regularly. Bring it to every medical appointment to ensure everyone is on the same page about your loved one’s medications.

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Resources to Support Your Caregiving Journey

1. Educational Materials:
   • National Institute on Aging (NIA): Provides guides on managing medications for older adults. Visit their website for free resources: www.nia.nih.gov.
   • AARP Caregiver Resources: Offers practical advice, checklists, and tools for caregivers, including medication management tips.
2. Mobile Apps:
   • MediSafe: Tracks medications, sends reminders, and provides helpful education on prescriptions.
   • CareZone: Allows you to store a digital medication list and organize health records securely.
3. Pharmacist Consultations:
   • Most pharmacies offer free medication reviews. Schedule an appointment for a pharmacist to go over your loved one’s regimen in detail.
4. Contact a Geriatric Care Manager:
   • These professionals specialize in managing healthcare for older adults and can provide personalized support.

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Would you like additional details on any of these resources or help customizing the template further?