Illuminate
The Role of the Long-Term Care (LTC) Pharmacist in Senior Living
July 22, 2025
Most adults aged 65 and older take prescription medications regularly. In 2021-2022, 88.6% of older adults took prescription medications, and polypharmacy, defined as using five or more prescription medications, is not uncommon in this population. Medication management for these individuals is much more than putting pills in a container. Instead, it starts with the prescription and involves a number of safety and cost-effectiveness measures to ensure residents get the greatest benefits from their medications without experiencing preventable side effects or medication-related problems. That is where the senior care pharmacist’s expertise comes in.
Minimizing Complications, Maximizing Positive Outcomes
The senior care pharmacist has specialized knowledge and training about geriatrics, geriatric pharmacotherapy, and the medication-related
needs of the older adult population. Many senior care pharmacists practice in senior living and post-acute/long-term care settings, but these professionals can provide geriatric pharmacotherapy services in all settings. They provide person-centered care, viewing residents holistically with the best possible outcome and quality of life as top priorities. The senior care pharmacist has many roles, including:
- Conducting medication regimen reviews
- Identifying and helping to address medication side effects and the potential for adverse events
- Making treatment or medication recommendations that enhance safety, save costs, and improve adherence
- Identifying untreated or undertreated health issues or complaints
- Educating residents, families, and care team members about medication management
- Working with residents, families, and care team members on chronic disease state management
The Consultant Pharmacist: Senior Care in Long-Term Care Settings
Senior care pharmacists who work in post-acute and long-term care settings are referred to as consultant pharmacists. These professionals participate in quality assurance programs, conduct clinician training sessions, and ensure appropriate clinical practice guidelines are followed by staff and others. In the community, these pharmacists also:
- Help develop policies and procedures for medication administration, management, and disposal
- Conduct in-service training programs for clinicians and other staff on medication administration and management, and other medication-related issues
- Make recommendations for changes to medication regimens, including suggesting therapeutic alternatives or dose reductions
- Work with the community on issues including fall prevention, behavioral management, and chronic disease state management
- Assist the community with legal and regulatory requirements
- Help develop and oversee antibiotic stewardship programs
- Assist with formulary management
- Provide immunizations and vaccine education
Whatever setting they practice in, pharmacists contribute to better outcomes and fewer medication-related issues and problems for seniors. Several studies have documented the positive impact of pharmacists on care for older adults. For instance, one review found that pharmacists contributed positively to managing cardiovascular disease risk factors, as well as helping to reduce blood pressure, cholesterol, and smoking. Another review showed an association between pharmacists’ interventions and reductions in systolic blood pressure. Other studies documenting the value of the pharmacist have shown:
- Consultant pharmacists’ recommendations, as part of an immunization needs assessment on community admission, contributed significantly to increased pneumococcal immunization rates.
- Consultant pharmacist involvement in opioid stewardship resulted in significant reductions in resident pain scores and PRN opioid medication use.
- Home care providers indicated that consultant pharmacist services have proven beneficial in areas such as pain management and addressing drug side effects and interactions.
- Pharmacist-conducted medication regimen reviews identified key threats to resident safety that can contribute to positive outcomes and cost-effective care.
- Pharmacists can play a key role in screening for and addressing mental illnesses in a variety of settings.
These are just a few of the studies documenting the value of the pharmacist’s services for seniors, wherever they reside. The senior care pharmacist not only contributes to quality of care but also helps individuals enjoy the best possible quality of life. For instance, they can identify individuals taking medications that increase the risk of falls and recommend changes to reduce or eliminate that risk. Preventing falls helps keep seniors more active, engaged, and independent for as long as possible.
In any setting where a resident is taking some type of medication, the pharmacist has a key role on the care team. As Matthew Palmer, PharmD, BCGP, senior director of clinical operations at PharMerica said, “When a pharmacist is actively involved in medication management, interdisciplinary collaboration is enhanced, and resident care is improved.” There are no federal senior living regulations that mandate pharmacist involvement or review like there are at skilled nursing communities, he noted. As a result, he observed, “This valuable resource is not always utilized in senior living, despite the increasing acuity of residents these communities are caring for. When pharmacists are involved in care planning, medication related goal setting, and routine medication reviews, residents feel better, and costs are reduced.”