Medication management is a concern for older adults because they are at risk for adverse side effects associated with many medications. Despite the risk of harmful side effects, antipsychotic medication is often prescribed to limit unwanted behavior problems associated with dementia or Alzheimer’s disease. The federal Omnibus Budget Reconciliation Act (OBRA) of 1987 established guidelines for limiting the use of antipsychotic medication in skilled nursing facilities. Similar guidelines have not been implemented in assisted living facilities or the community. This quantitative study examined the use of antipsychotic medication for older adults in different living environments using environmental, biological, and ecological theories as the theoretical frameworks. The medical records of 102 older adults were examined (52 from a skilled nursing facility and 50 from an assisted living facility). A chi-square analysis determined the degree of difference in antipsychotic medication use in the different living environments. The results of this study did not show antipsychotic medication use being higher in an assisted living facility than in a skilled nursing facility. However, studies such as this one are required in the careful consideration of policies and policy planning for best practice in the health care of older adults. Implications for positive social change encompass continuing consideration of medication guidelines and practices in the variety of settings in which older adults receive care. This study contributes to positive social change pertinent to the ongoing development of best practices in health care for older adults, through offering an additional examination of medication use for older adults.