Photos go to relatives and the knickknacks might go to a garage sale, but who wants to deal with the array of unused pills when grandma passes away?
Some politicians do.
In the last year, state legislators across the country have proposed bills aimed at curbing the disposal of unused medication. Colorado, Maine, Minnesota, Maryland and Washington have all proposed legislation that in one way or another tries to address the issue ofmedicines that end up in landfills and watersheds every year.
Bills in some states, such as Colorado, want nursing homes to be free to donate the unused medication to charities that help developing countries. Bills in other states attempt to divert unused medication back to manufacturer -- and are facing resistance from pharmaceutical companies.
But whoever is fighting over the unused medicine, all involved hope that no one flushes them down the toilet.
"Probably about 50 percent of the medications that are sent to my nursing home from the pharmacy end up having to be destroyed," said Maxine Roby, an administrator at Rowan Community -- a 66-bed nursing home facility in Denver, Colo.
Roby said the waste at her nursing home is not unusual. In fact, by regulation it's often unavoidable. When a doctor writes a prescription at a nursing home, the pills aren't dispensed as they would be from a local pharmacy.
The pills are shipped from the pharmaceutical company on 30-day supply cards -- each pill snugly in its own "bubble" so the nurse can pop it out. But, Roby explained, if a patient has a bad reaction to the medicine after one day and stops taking it, or even passes away, nurses are required to get rid of the whole card.
"They [pharmaceutical manufacturers] will not take the drugs back, I don't even know why. Once they give it to us, where stuck with them," said Roby.
"A lot of people would just flush them," said Roby. But "we were notified by the Denver Water board, that they have no way to filter medications out of the drinking water."
Since water treatment plants across the country have no way of filtering out pharmaceutical waste -- which can come from bodily fluids as well as unused medicine -- more and more environmental groups are encouraging people to dispense of the medication in the trash and hospitals to incinerate leftover medicine.
The home alternative to flushing is to follow the U.S. Environmental Protection Agency guidelines. Mixed unused medication with something unsavory -- like kitty litter -- to keep it away from animals and seal it in a container for the landfill so it does not dissolve and leach into groundwater.
"That's a big issue. That's why they're telling people put your medicine in kitty litter, or in coffee grounds and throw them away," said Colorado Democratic state Senator Lois Tochtrop who co-sponsored the bill, HB 10-1061, Colorado Medical Donation Program.
Tochtrop had no clear estimation of exactly how much medication could be saved through his bill. Few estimates of how much medical waste is generated have even been done. A 2009 investigation by The Associated Press estimated that at least 250 million pounds of pharmaceuticals and contaminated packaging is generated in medical facilities each year.