A nursing home resident died in October 2007 of acute sepsis and other complications from what her family's lawyer calls "a bedsore (pressure sore, pressure ulcer, decubitus ulcer) the size of a turkey platter," a Stage 4 pressure wound that had eaten deeply into her flesh.
It was discovered almost by chance two months earlier, when her son found her suffering unrelated shortness of breath. Paramedics rushed the 82-year-old woman to the hospital from a board-and-care home.
Now the home's owner and administrator and her husband are the focus of pending legal action on three fronts.
A felony elder abuse trial continues in mid-September, and the family's civil suit, claiming negligence and wrongful death, goes to court a month later. The Department of Social Services' Community Care Licensing division began license revocation proceedings in late July.
Long-term care for the elderly isn't cheap: the woman who died paid a monthly fee of $3,500, which rose to $4,500 in May 2007 after she suffered what the family said was a minor stroke.
State regulators monitor the industry, but patient advocates said enforcement can sometimes lag. Barring complaints, about one-third of this particular state's 7,800 residential care facilities for the elderly are randomly inspected each year, said the department of social services spokesperson.
When families visit care homes, they see facilities that look clean and neat, and they assume this means elderly loved ones are well-tended, said the family's attorney.
"If you went into a day care center and found a child dehydrated with diaper rash penetrating to the bone and physically restrained because they're crying, you'd have the district attorney and attorney general's office lining up to take those cases," she said.
Too often, she said, care providers tell families their loved one would have died anyway – and families, who don't know where to turn for help, believe them.
The deputy attorney general who is prosecuting the criminal case agrees.
"Working with law enforcement on elder abuse cases, we're where domestic violence was 20 years ago," he said. "We're still in the process of educating the public and the courts. The elderly are some of our most vulnerable people."
The woman who died was diagnosed with Alzheimer's disease and dementia in 2006, and it quickly became clear to her sons that she couldn't continue living alone. That fall, she moved into a private room in the facility, where, according to the facility's brochure, residents "can enjoy a lifestyle of Elegance!"
"I've been blaming myself for killing my mother for the past couple of years, because it was my decision for her to go to this facility," said her older son.
He went by the home regularly to visit his mother, take her out to lunch and bring her to his house, he said.
In July 2007, he took pictures of her with a huge black eye. She told him someone hit her, he said, while staff told him that she fell asleep sitting in her wheelchair at the dining table and hit her face on the table.
A month later, he found his mother suffering shortness of breath and called 911 because, he said, the on-site attendant – who has since returned to her native Romania – didn't speak enough English to make the call. For more, read the story.
Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.