At first glance, nothing about William Neff’s death seemed unusual. The 83-year-old WWII veteran had spent his final days in an assisted living facility in Bucks County, Pa. When the inevitable occurred, and Neff succumbed to advanced-Alzheimer’s disease in September of 2000, the nursing home doctor simply noted that Neff “failed to thrive.”
Case closed; documents sealed.
Until a local funeral home director got a glimpse of Neff’s body.
“I’m no CSI expert, but I’ve been doing this for 25 years, and I’ve seen a lot of dead people,” said Jeffrey Thompson, in a recent article by NPR and Propublica.org. “He was all bruised up and purple, and his ribs were broken.”
Thompson’s grim discovery let to an autopsy, which revealed that a violent impact had shattered five of Neff’s ribs. The results of the autopsy spurred an 18-month criminal investigation, in which nursing home employee Heidi Tenzer was convicted of stomping on Neff’s chest. In 2003, Tenzer was sentenced with third-degree murder.
While William Neff’s case may be somewhat extreme, it’s certainly not unusual for coroners to miss signs of elder abuse. In fact, as many as 80 percent of deceased seniors never even receive an autopsy.
“We’re where child abuse was 30 years ago,” said Dr. Kathryn Locatell, a California-based geriatrician who specializes in diagnosing elder abuse. “I think it’s ageism – I think it boils down to that one word. We don’t value old people. We don’t want to think about ourselves getting old.”
According to the NPR article, chronic understaffing in coroner’s offices and medical examiner’s offices across the country mean fewer autopsies are being performed. Compounding the lack of staffing are funding shortages, an increase in the number of elderly deaths, and systems in most states where physicians can sign off on an autopsy without ever seeing a body.
“I’ve had instances where the physician just doesn’t understand the importance of what they’re writing down,” said Robert Anderson, chief of mortality statistics for the Centers for Disease Control and Prevention. “I’m appalled when I hear that.”
Proponents of more stringent autopsy procedures are calling for independent agencies to help review death certificates.
“If we want to ensure that all death certificates are accurate, there has to be a professional, independent review process,” said Dr. Richard Harruff, chief medical examiner for King County, WA.
Harruff recommends that all coroners check:
- Eyeballs for signs of dehydration
- Stomachs for lack of food, which could indicate malnutrition
- Skin for decubitus ulcers, which often indicate abuse
“I take the attitude that these are potential homicides,” Harruff said.
According to NPR, nearly one-third of all Americans will be over sixty in the next ten years.
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