In December 2024, Marjorie Tingley’s adult sons received an urgent email from the dementia care unit at Vista Grande Villa, a Michigan senior living community. They were told that their 85-year-old mother was a major safety threat. On at least 10 days in the previous month, Tingley had hit, kicked, or elbowed aides when they were trying to help her change her briefs, get dressed, bathe, or go to the bathroom, according to Vista Grande behavior logs. Vista Grande wanted permission to sedate her. Into the new year, Tingley’s sons and Vista Grande fiercely wrangled over one of the most contentious topics in long-term care: the use of antipsychotic medications to pacify agitated people with dementia. The medications come with risks: The Food and Drug Administration requires pharmaceutical companies to warn that these potent drugs increase the chance of death in older people with Alzheimer’s and similar diseases. More than 5 million Medicare beneficiaries have a diagnosis of dementia. Despite a 14-year campaign by the federal government to reduce the use of psychotropics, 1 in 4 Medicare beneficiaries with dementia are potentially inappropriately prescribed antipsychotics and other brai...
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