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91-Year-Old Dies Weighing 35 Pounds, Caregiver Held For Over A Year In Prison

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Photo by zappowbang via Flickr
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Too fragile to receive CPR, 91-year-old Maria "Concha" Lopez, who suffered from dementia and "shied away from doctors," was given mouth-to-mouth by her 26-year-old caregiver niece, Stephanie Hernandez. Despite resuscitation efforts by Hernandez, Lopez died in their home in Madera County weighing only 35 pounds and covered in bedsores. According to the LA Times some of the wounds were "so deep they bared bone. A metal rod from hip surgery was visible."

[W]hen firefighters and paramedics opened the door to the little house on South A Street that December morning, they were immediately overwhelmed. By the stench — urine, feces, rotting flesh. By the mess — soiled diapers, used bandages, a stained mattress. Hernandez was arrested and then charged with murdering the woman she had bathed, fed and changed for three years. She would be put on trial, accused not of any overt violence against the woman who had raised her but of failure as a caregiver.

Last spring, as the prosecution tried to prove criminal negligence, Hernandez's defense portrayed the caregiver as "a loving niece whose meticulous efforts kept an old woman alive even as she lost 65% of her body weight," notes the LA Times.

In the end, the trial showcased the difficult questions facing doctors, courts and families today, when the "old old," 85 and up, are the fastest-growing segment of the population, when more than 43 million Americans care for aging relatives or friends and when neither science nor the law has kept pace. What is elder abuse? When does inadequate care become criminal? Can the elderly be forced to seek help? And what exactly does a "normal" death look like?
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Hernandez, as and infant, was left in the care of her four great-aunts who raised her. Over time, Lopez watched her sisters die in nearby Madera Community Hospital and reportedly made her family promise "to spare her such an end," notes the LA Times.

When Lopez broke her hip, Hernandez, who had left school after becoming pregnant, was pressured by family to care for her great aunt who, after returning home, reportedly refused outsiders, nursing aides, and would not go see a doctor. Where the prosecution saw "utter neglect," experts for the defense saw an elderly person with mental illness in "terminal skin failure."

Private, independent and stubborn, the 4-foot, 10-inch woman weighed a scant 100 pounds in 2001. Five years later, when she fractured her hip, her weight had dropped to 88 pounds. By the time she was hospitalized in 2008 with an ulcer on her left shin, she was down to 64 pounds.

Jurors, not seeing enough evidence of intention to harm the elderly woman, found Hernandez not guilty of murder, not guilty of involuntary manslaughter and not guilty of felony elder abuse. The lesser charge of misdemeanor elder abuse was deadlocked. Hernandez is now free, looking for work in a city with over 20% unemployment, and attempting to regain custody of her daughter as she cares for her elderly grandfather.

Questions exist about the definition of "elder abuse," and the data is unclear on how prevalent it is in our society. Advocates for "improved end-of-life care" view this case as a warning to all as baby boomers reach 65 and the 85 and older set continues to grow. "We live in a society that's in a place where no culture has ever been...We'll have to come to a better way of dealing with this than arresting a young caregiver," said Dr. Brad Stuart, chief medical officer for Sutter Care at Home, notes the LA Times.