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The Silver Standard





By David Holmberg


I’m from Minnesota, and you might call me a loyalist. All my life, I’ve taken pride in the state’s reputation as a citadel of progressivism. It’s produced an impressive roster of socially conscious politicians—Hubert Humphrey, Eugene McCarthy, Walter Mondale, Orville Freeman—and ranks at or near the top among the fifty states in social services, education, and cultural advantages.

But these days in Minnesota, there lingers the stigmatizing taint of elder abuse—the shocking (especially to a Minnesotan) revelation by the Star-Tribune of Minneapolis that “each year, hundreds of Minnesotans are beaten, sexually assaulted, or robbed in senior care homes. Their cases are seldom investigated, leaving families in the dark.”

A 2010 study showed a six-fold increase in reported incidents in the state’s senior care facilities, which may have been a catalyst for a 2017 investigation by the Star-Tribune that uncovered another disturbing statistic: in 2015, “the Minnesota Department of Health received 25, 226 allegations of neglect, physical abuse, unexplained serious injuries, and thefts in state-licensed homes for the elderly.”

Said a board member of the Minnesota Elder Justice Center, Iris Freeman: “We should all be appalled at this picture. Minnesota used to be at the top of the heap when it came to elder-abuse enforcement, and now we’re becoming known for being non-responsive.”

But the state did mobilize its legislative, law enforcement, and senior care resources in response to the Star-Tribune’s investigation. It was a response you’d expect in a state with a strong collective instinct for change when change is demanded. It improved compliance standards, developed better programs for training and monitoring employees, and opened communications between law enforcement and other agencies.

“It haunts me,” her son, Robert, said two years ago of his mother’s assault, and her emotional suffering in the dwindling days of her life. “It haunts me.”

Eric Klang, the police chief in Pequot Lakes, Minnesota, who investigated one of the worst elder-abuse cases in the state in recent years, told the Silver Standard: “Now elder abuse is on everybody’s radar. It’s on the news every night.”

And elder abuse advocate Susan Scheller said that while Minnesota still has less of a problem with elder abuse than many other states, “we expect a lot better.” Referring to the crisis in recent years that has only somewhat abated, she said, “This [situation] is not acceptable.”

The ultimate definition of “not acceptable’ in elder care—other than a suspicious death—is sexual assault. And that occurred on May 8, 2016, at an assisted-living complex called Heritage House, located in the northern Minnesota town of Pequot Lakes.

A 78-year-old resident of the facility named Jean Krause, a former nurse, was assaulted by David DeLong, 59, a caregiver at the facility, who had worked there for several years and had a clean record. DeLong was found that night by a female aide, a few feet from Ms. Krause, with his jeans and underwear at his knees. He was trying to pull them up.

No one at Heritage House called the police for two hours. DeLong, meanwhile, was sent home for the night.

Krause’s red nightgown and mattress pad—crucial evidence in the crime—had been placed in the facility’s washing machine, possibly by DeLong himself.

Klang, the police chief in Pequot Lakes, told the Star-Tribune it was an “infuriating” case. “We had an eye witness to a sexual assault of a frail woman with dementia, and the perpetrator was kept there and then sent home without anyone calling us. That’s not proper protocol.”

DeLong at first denied the assault, but when DNA evidence proved his guilt, he asked a surprising question: “Why didn’t the people who saw me do it arrest me on the spot that night?”

But Klang said DeLong has still not expressed regret for the attack. He’s been in the Pequot Lakes jail since December and will do a year’s time, with ten years’ probation.

Heritage House’s license was eventually revoked by the state health department, and an outside agency took over its operations. The facility had been under investigation since the previous year for other incidents; Klang said he’s still dealing with violations there. “Now we’re looking mainly at failure to provide care—not giving adequate medications to survive,” Klang said. And, he noted, medications had been stolen from Heritage House, a common problem in such facilities.

Since Krause was assaulted, an arsonist also struck at the beleaguered Heritage House, and a patient died due to apparent errors by nurses during a complicated procedure. The head nurse, on whom investigators focused, is no longer employed at the facility.

Staffing problems are a root cause of the deficiencies of a facility like Heritage House, according to Klang and others in the field. “It’s hard to find good help,” the chief said. “Who wants to wipe peoples’ butts and work for a low salary? It takes a special kind of person to do that kind of work.”

Scheller, the elder advocate, pointed to another complex element of staffing, as well as the responsibilities of staff. Since facilities themselves cannot be charged with a crime, a “fine line” between negligence and criminality must be applied to individual nurses. She said there needs to be better communication between law enforcement and elder-care professionals in drawing that line—in defining criminality. And the origins of negligence by nurses can itself be hard to determine.

For instance, Scheller said, in addition to other factors, a death might be the result of a “bad transition” of a patient from a hospital to an elder-care facility.

My home state has made considerable progress in restoring its sterling reputation in elderly care since the Star Tribune investigation. But, unfortunately, a difficult question remains for facilities with culpability for elder abuse that’s ongoing and entrenched. The question: can a facility like Heritage House ever achieve a truly effective fulfillment of its demanding caregiving mission?

Scheller’s answer: “It’s very hard for a facility to turn a corner on elder abuse.” And the main reason, again, is the challenge of adequate staffing. She said that although the major step of an outside takeover was accomplished at Heritage House, the new management did not bring in new staff. So although the head nurse left, there’s apparently been minimal change in staffing since the assault of Jean Krause two years ago by the experienced caregiver charged with helping her survive as her life wound down.

And that traumatic incident must remain a burden for Heritage House to bear. It’s certainly a burden for Krause’s family. They weren’t told of the assault until the summer of 2017, nearly a year after she died. They didn’t understand until then why, in the spring of 2016 after she’d been assaulted, she lay in her bed staring mutely at the walls. They couldn’t understand why she didn’t respond when her children brought her flowers or her favorite desert. They wondered why she always asked if the windows in her room were shut.

“It haunts me,” her son, Robert, said two years ago of his mother’s assault, and her emotional suffering in the dwindling days of her life. “It haunts me.”