Drugs are widely used to sedate dementia patients.
asserted
Drugs → use → patients
Her sons wanted to keep her off them
asserted
sons → want → them
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.
asserted
sons → receive → Villa
They were told that their 85-year-old mother was a major safety threat.
asserted
mother → tell → ?
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.
uncertain
they → hit → logs
Vista Grande wanted permission to sedate her.
asserted
Grande → want → 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.
asserted
sons → wrangle → 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.
asserted
drugs → come → Alzheimer
More than 5 million Medicare beneficiaries have a diagnosis of dementia.
asserted
beneficiaries → have → 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.
asserted
study → reduce → delirium
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.
asserted
those → agree → 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.
uncertain
administrators → acquiesce → records
Tingley was repeatedly taken to the emergency room for assessment, hospital records show.
asserted
records → take → assessment
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.
asserted
records → give → placement
"I want her out of here," a flustered administrator told an ambulance crew, one entry shows.
asserted
entry → want → crew
Tingley died at another facility in January 2025.
asserted
Tingley → die → January
"They just wanted to have her drugged up," David Tingley, one of her five sons, said about Vista Grande in an interview.
asserted
Tingley → want → interview
"It's a lot easier to take care of someone who's just out of it."
asserted
who → take → it
Her sons' lawsuit against Vista Grande and its director at the time accused the facility of negligence, causing emotional distress, and wrongful eviction.
asserted
lawsuit → accuse → distress
The suit also asserted Vista Grande initiated the ER trips in retaliation for the family's disagreements about Tingley's care.
asserted
Grande → assert → care
Vista Grande and its director have denied the allegations.
asserted
Grande → deny → allegations
Their attorneys and the director did not respond to requests for comment.
asserted
attorneys → respond → comment
In a legal filing, Vista Grande called the drugs recommended to the Tingleys "routine medication" and said it sent their mother to the hospital "because of her family's refusal to allow Ms. Tingley to be treated on site."
asserted
Tingley → call → site
A Michigan Circuit Court judge has dismissed the negligence claim on legal grounds.
uncertain
judge → dismiss → grounds
A trial is scheduled for early next year on the remainder of the lawsuit if mediation fails.
asserted
mediation → schedule → lawsuit
Earlier this year, Vista Grande, which was a nonprofit, became a wholly-owned subsidiary of Otterbein SeniorLife, which renamed it Otterbein Jackson SeniorLife Community.
asserted
which → become → it
Otterbein is not named in the lawsuit, and representatives did not respond to requests for comment.
asserted
representatives → name → comment
Dangers of aggression
Diseases that cause dementia damage the parts of the brain that regulate impulse control and perception.
asserted
that → cause → control
Impaired people can become aggressive because of fear — especially when they no longer recognize their caregivers — or because they have no other way to communicate that they are in pain, hungry, or have some other need.
asserted
they → become → need
Altercations between agitated people with dementia and other residents or workers charged with caring for them are disturbingly common in long-term care facilities and private homes.
asserted
Altercations → charge → facilities
KFF Health News previously found that federal inspectors have cited nursing homes more often for resident-to-resident abuse than for any other type of abuse, neglect or exploitation.
asserted
inspectors → find → abuse
Those dangers are particularly true in the more than 6,000 assisted living facilities that specialize in dementia care, usually in locked buildings or units populated by people with cognitive damage.
asserted
that → assist → damage
These memory care facilities promise specially trained staff and meaningful activities for residents and usually charge more than standard assisted living.
asserted
facilities → promise → living
The long-term care industry's reliance on tranquilizing medications has been a concern of Congress for half a century.
asserted
reliance → tranquilize → century
A 1975 Senate report stated that "an ugly pattern of prescription drug misuse, with harsh consequences to patients, exists in many nursing homes of the United States."
asserted
pattern → state → States
In 2012, the Centers for Medicare & Medicaid Services launched its Partnership to Improve Dementia Care to target overprescribing.
asserted
Centers → launch → overprescribing
It has shown some success with reducing the use of antipsychotics, which the FDA has approved primarily for people with schizophrenia.
asserted
FDA → show → schizophrenia
Excluding those patients, antipsychotics were given to 1 in 7 nursing home residents in 2025.
asserted
antipsychotics → exclude → 2025
An inspector general report released in March identified "alarming instances of inappropriate use of antipsychotic drugs."
asserted
report → release → drugs
Nationally, nearly half of the 1 million people in assisted living facilities have Alzheimer's or other diseases or conditions that cause dementia.
asserted
that → have → dementia
…and 74 more, not listed.
The Aporia
