Although research-based information concerning geriatric polypharmacy is lacking, available data suggest possible causes, health risks, and areas for intervention. Nursing home residents are more likely to be recipients of unnecessary and excessive drugs than community-dwelling elderly. Polypharmacy can lead to increased adverse drug reactions, drug interactions, and medication errors. In the future, there will be single drug therapy for conditions now requiring multiple drugs, but improved diagnosis of disease could lead to persons receiving additional, appropriate drugs for these health problems. Informed patients collaborating with knowledgeable prescribers and those dispensing and administering their medications may be able to reduce the number of drugs they are taking. More research is needed to identify methods that promote safe self-medication behavior and better drug use in nursing homes. Health risks associated with polypharmacy and the escalating costs of medications require that nurse participation in ensuring that the elderly receive only necessary and effective drug treatment.