The use of complementary and alternative medicine (CAM) appears to be on the rise in all adult age groups, including the elderly population. Many herbal and biologic preparations offer promise, but they are largely of unproven benefit. The content(s) are unregulated by government agencies, such as the Food and Drug Administration, making their use problematic to recommend and guide. Use of CAM modalities in assisted living communities (ALCs) is by and large a hidden practice, but it is estimated that 5%-9% of residents ingest some kind of herbal remedy. Belief systems among residents and their families-for example, that a certain kind of tea is a cure for dementia-can be persuasive. Responsible for resident well-being, assisted living nurses are caught in the middle. Nurse licensure considers herbals as medications, yet physicians refuse to prescribe them, and nurses (or certified med techs) cannot administer them. In some states, "alternative practitioners" are not viewed as legal prescribers. Undaunted, residents (or their families) purchase alternative "medicines" that are contraindicated by their traditional medical regimen. Secreted in their room, nurses are unaware of the stash and the self-administrating practice. This article describes the state of the science regarding the efficacy and safety of CAM modalities and actions that ALC nurses might undertake to collaborate with residents to address their CAM interest and use respectfully.