Medication intake monitoring is pivotal for healthcare management. While several medication management technologies have been developed, limitations include cost, adoption and adherence, and learning how to use a new system, which is particularly challenging for older adults with cognitive impairment. In this work, we present PA-Pill, a vibration-based sensing system for medication intake monitoring. PA-Pill leverages a physical structure with a unique vibration signature for medication intake event detection and recognition. We implement a prototype and depict preliminary results to verify the feasibility.