The first sign is rarely a missing bottle. It is a refill that never gets picked up. The pharmacy texts that a prescription is ready, the reminder goes to his phone, and the bag stays on the shelf. Nothing dramatic has to happen for this to occur. It only takes a man who has stopped answering the phone and a pharmacy that can no longer reach him.
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What to look at before you call anyone
Look at what is on the counter and in the cabinet, without moving anything into a new order. Two bottles with the same name but different fill dates mean a refill is being made but not taken, or a new prescription was started while the old one kept coming. Either one is worth a question to the pharmacist. A bottle that is still full well past its usual use date tells you something too, though it does not tell you why. Write down what you see, with the date, and ask instead of assuming.
Ask the pharmacy what is on file
Call the pharmacy during regular hours and ask three things: which prescriptions are active under his name, when each was last picked up, and whether any are on automatic refill or have been put on hold. Pharmacists can share what they are permitted to share with the person on the account. If you are not on the account, you may hear only that they cannot discuss it. That answer is still useful, because it tells you the next step is his signature, not your guess. Ask what form they need so he can name you. Also ask whether the prescription can be delivered or moved to a pharmacy closer to the house if the trip is the problem.
Ask the prescriber's office for the list
Call his doctor's office and ask for the medication list on file, the date of his last visit, and whether any prescription was due for a renewal visit that did not happen. A renewal that lapsed for want of an appointment is one of the most common quiet failures, and the office can tell you what it is without you having to guess. Compare their list with what is in the cabinet, and do that comparison yourself or with him present. A hired non-medical caregiver can remind him of a pickup time and run to the pharmacy as an errand. Sorting, checking, or managing what he takes stays with the family, the doctor, and the pharmacist.
The legal line
Be exact about what you can start on your own. Looking at what is in the house, calling the pharmacy to ask what is on file, and calling the doctor's office as a family member are all things you can do now. Getting into his pharmacy account or patient portal under his name, or making decisions about his medicine without a signed document that gives you that authority, is a different matter. If he has already signed a release or named you on a power of attorney, bring that paper to the pharmacy and the doctor. If he has not, do not guess at what a document would cover. Ask a lawyer who works on elder matters in Missouri, and use Local Help in St. Louis to find where to start.
The next move is one phone call. Call the pharmacy before they close and ask only three things: what is active under his name, when each prescription was last picked up, and what form he has to sign so you can ask again. Write the answers, the name of the person you spoke to, and the time on a single sheet. That note is your starting record, and it is the first thing you will need when the conversation with him gets harder.