John Lithgow plays an elderly care home tyrant out to drive an arrogant and partially paralyzed judge, played by Geoffrey Rush, insane in the official trailer for The Rule of Jenny Pen, which dropped Monday.

The psychological thriller from director James Ashcroft, set to hit theaters March 7, has Lithgow playing Dave Crealy, a retirement home resident out to terrorize fellow residents with a sadistic game called “The Rule of Jenny Pen,” which includes a dementia doll wielded as an instrument of cruelty.

“Who rules?” a creepy Crealy, doll in hand, at one point in the trailer asks a tormented Judge Stefan Mortensen (Rush), who is bed ridden after suffering a near-fatal stroke. But the teaser foreshadows Mortensen soon engaged in a deadly struggle with the care home bully after his pleas for help to staff go unheeded and he looks to end Crealy’s reign of terror.

The Rule of Jenny Pen,...