Drugs are widely used to sedate dementia patients. Her sons wanted to keep her off them

For stories on the science of healthy living, subscribe to NPR's Health newsletter. 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 the previous month, Tingley had hit, kicked, or elbowed aides when they were trying to help 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 brain-altering medications that can cause delirium, falls and hospitalizations, a JAMA study estimated.

While some families and guardians agree that the benefits of these drugs outweigh the risks, those with misgivings confront a wrenching choice: consent to drugging loved ones or risk eviction from a long-term care facility. As the Tingleys alternately acquiesced to and resisted Vista Grande's insistence on medication, administrators started calling 911 after altercations, according to ambulance and police dispatch records. Tingley was repeatedly taken to the emergency room for assessment, hospital records show.

After four trips, Vista Grande gave Tingley a 30-day eviction notice, and it sent her to the hospital four more times while the family was arranging a new placement, medical records show. "I want her out of here," a flustered administrator told an ambulance crew, one entry shows. Tingley died at another facility in January 2025.

The cause was plaque buildup in her brain, a hallmark of Alzheimer's, a degenerative brain disease and the most common type of dementia. "They just wanted to have her drugged up," David Tingley, one of her five sons, said about Vista Grande in an interview. "It's a lot easier to take care of someone who's just out of it." Her sons' lawsuit against Vista Grande and its director at the time accused the facility of negligence, causing emotional distress, and wrongful eviction.