Resident centred care is a core principle of residential aged care policy, yet pharmacy services have historically focused on medication review, compliance, and risk management rather than residents’ everyday experience of medicines. The introduction of onsite pharmacists in Australian residential aged care presents an opportunity to reorient pharmacy practice toward resident centred medication management, but what this means in practice remains poorly defined. This study draws on interviews with residents conducted as part of the national OPTIMISER3 evaluation to examine how older people experience medication management in aged care homes implementing an onsite pharmacist. Residents’ accounts are used to specify what resident centred pharmacy practice requires in everyday care. Residents evaluated medication management mainly through its impact on daily life, dignity, and reassurance rather than medication changes alone. Resident centred pharmacy was characterised by predictable medication routines, clear and timely explanations, respectful and discreet practices, and access to a visible and approachable pharmacist embedded in daily care. Residents reported meaningful benefits even when no medication changes occurred, highlighting understanding and reassurance as outcomes that are largely invisible in conventional clinical evaluations. Where pharmacist presence was limited or poorly integrated, residents described ongoing fragmentation, uncertainty, and difficulty navigating multiple layers of staff to resolve medication issues. These findings demonstrate that the onsite pharmacist model creates a structural opportunity to embed resident centred medication management, but only when pharmacy practice aligns with residents’ everyday priorities. By articulating resident defined criteria for resident centred pharmacy, this study offers a practical framework for evaluating and enacting medication management consistent with resident centred care standards.