Aim: To establish what strategies and supports could feasibly improve engagement and support residents’ autonomy, dignity, and choice around medication administration in aged care facilities. Methods: Semi-structured interviews took place between November 2024-April 2025, followed by a 90-minute co-design workshop in April 2025. Residents, their family members, and aged care workers were recruited from two metropolitan aged care facilities in Melbourne, with additional recruitment through Dementia Australia. Interview and workshop transcripts inductively analysed using framework analysis. Key findings and recommendations were translated into five languages, and assessed for appropriateness by six independent community members and four experts including a speech pathologist, geriatrician, consumer advocate, and pharmacist. Results: Overall, 31 participants took part, representing residents (n=12), family members of residents (n=9), and aged care workers (n=10). Four themes were generated across the interviews and further explored in the co-design workshop: (1) residents’ preferences: when, where, and how to give medications; (2) barriers to enabling residents’ medication giving preferences; (3) methods for engagement and communication: looking, asking, listening, and documenting residents’ preferences; and (4) strategies to remember and action medication giving preferences: from initial admission to everyday medication giving rounds. Conclusions: This study identifies that it is entirely feasible to support residents’ autonomy, dignity, and choice around medication giving, through small actions that can be easily integrated into everyday practice, such as asking residents about how they like to take medication. This can turn a clinical task into an opportunity to provide relational care, building rapport with residents and reassuring family members.