Dementia care medication and management challenges

Discussions surrounding dementia care have centered on the controversial use of antipsychotic medications to manage patient agitation. In one instance in Michigan, a dispute between a family and a senior living facility over sedation requests led to a patient being evicted and subsequently passing away shortly after relocating.

While the FDA mandates warnings that such drugs can increase death risks in elderly patients with Alzheimer’s or similar diseases, research suggests that approximately 1 in 4 Medicare beneficiaries with dementia may be inappropriately prescribed antipsychotics, potentially leading to delirium, falls, and hospitalizations.

Clinical guidance increasingly emphasizes ‘deprescribing’—the process of tapering or stopping medications—when the harms of drugs like benzodiazepines, antipsychotics, and cholinesterase inhibitors outweigh their benefits. Beyond medical management, the situation highlights the significant emotional and logistical strain on caregivers, who often face internal family conflicts regarding residential care and the loss of patient independence.