GRAY MURDERS
UNDETECTED HOMICIDES OF THE ELDERLY
(ORIGINALLY PUBLISHED IN VICTIMIZATION OF THE ELDERLY AND DISABLED,
VOLUME 3, NO. 3, SEPTEMBER /OCTOBER 2000, PAGES 19, 20 & 42)
Joseph N. Soos, Sr.
“One owes respect to the living. To the dead one owes only truth.”
---Voltaire
In 1997, a self-funded study of undetected homicides of the elderly was initiated to determine if homicides of the elderly were being missed by the medical-criminal justice-social services communities, the scope of the problem and the who, why and how of these murders. Other goals of the research included developing offender and victim profiles, risk and offense indicators, which disciplines might constitute an elder death fatality review committee, as well as the feasibility and makeup of a multidisciplinary “SWAT” team as a readily available tool for conferring on suspected elder abuse.
For the purpose of this study, a “Gray Murder” is defined as the unlawful homicide of a person, age 65 years or more, conducted with malice aforethought solely to benefit the offender and in such a manner that it was misclassified or undetected due to age-presumption on the part of the medical-criminal justice-social services communities. It does not include assisted suicides, overt homicides unless misdirection or staging by the offender is involved. Neither does it include so-called “mercy” killings.
This study has been done from the perspective of a medical-criminal justice-social services practioner’s point of view with an effort to create awareness and practical application of study results. The study has not been done from an academician’s perspective. It is intended to assist the working cop, prosecutor, adult protective services investigator, doctor, nurse, paramedic and others to recognize, prevent, detect and prosecute unrecognized homicides of the elderly. It is also intended to create awareness on the part of administrators and the public to rethink their respective understanding and response to elder abuse. Ultimately, its greatest goal is to save and extend the lives of our senior citizens, those who were Private Ryan and Rosie the Riveter.
The methodology employed has focused on studies of more than one hundred cases indicative of offender classes. It has followed a criminal law enforcement-related model. Essentially, “Was there a crime?” “Whodunit?”, “Why?” and “Can you prove it?”. Following this nonacademic model, the study has attempted to build a circumstantial evidence case based on tangentially related research, expert interviews, good old-fashioned detective work and deduction.
The initial question posed in this study was, “Are we missing homicides of the elderly?” Based on experience as a homicide detective, the question was first directed to those we homicide detectives almost always turn to when it comes to answering questions about death, the forensic pathologists. The question was posed to some of those identified as the best and brightest in their field with national and international reputations and vast experience.
Some of these extraordinary physicians included: Dr. Marcella Fierro, MD, Chief Medical Examiner for Virginia, Dr. Cyril Wecht, MD, JD, Coroner of Allegheny County, Pennsylvania, Dr. Joseph Davis, MD, one of the authors of the National Guidelines for Death Investigations, Dr. Michael Baden, MD, former Chief Medical Examiner for New York City, Dr. Boyd Stevens, Chief Medical Examiner of San Francisco and Dr. Jerry Spencer, MD, Chief Medical Examiner of the Armed Forces Institute of Pathology.
Universally, the answer from these medical death detectives was that we were missing homicides of the elderly. None of the medical experts could provide any quantification as to the scope of the problem, nor identify any studies that had been done.
Other Sources
Many other sources were consulted as to any information that might be available. Academicians, homicide detectives, gerontologists with various specialties, elder abuse organizations, sundry data bases, the Internet and other experts and sources of information were consulted including Dr. Henry Lee, Ph D, Connecticut State Police Commissioner, Dr. Rosalie Wolf, Ph. D, President, National Committee for the Prevention of Elder Abuse and Dr. Sara Aravanis, Ph D, Director, National Center on Elder Abuse.
In casting a very wide net for any helpful information, limited, tangentially related studies were found such as one done by Dr. Bea Yorker, RN, JD, Georgia State University. She had studied medical personnel who kill. Another potentially related avenue of inquiry was found at the University of Missouri’s School of Medicine, although it dealt with a completely different age group, young children.
Child Studies from the University of Missouri
NOTE: It is important to understand the author does not believe senior citizens are children. Any references or comparisons between children and elderly citizens is couched in the context that SOME of our elderly are vulnerable to exploitation, negligence, assault and murder due to infirmity, illness and age-related mental and medical conditions.
Epidemiological studies were found that had been conducted by the University of Missouri’s School of Medicine over a period of more than ten years into misclassified deaths of children. Dr. Bernard Ewigman, MD, and others, including the Centers for Disease Control, had conducted these studies. Essentially, the studies found that up to two thousand deaths of children age five and younger across the nation were being misclassified. The studies generally noted the deaths had been attributed to natural, accidental or undetermined causes when they might have been more appropriately classified as due to abuse and neglect.
These child studies were believed to be pertinent to the “Gray Murders” research into elder deaths in that both children and certain segments of the elder population are similarly vulnerable. The methodology seems both adaptable and intriguing when applied to the deaths of adults, 65 years of age and older.
Another Consideration on Scope
(If we don’t look, we won’t find.)
Epidemiological studies aside, a number of other factors have emerged in considering whether homicides of the elderly were going undetected. Some of these factors included the following.
1. Though seniors, as expected, accounted for the vast majority of deaths (1.7 million) in the US in 2000, only about 574 of these were classified as homicides. Conversely, children’s deaths numbered just over 26,000, yet 1,100 of these were classified as homicides. Circumstantially, this indicated seniors were either extremely safe, or something was being missed in assessing elder deaths.
2. Autopsies have been declining over the past twenty-odd years, but more so for seniors than other age groups. One comparison shows that fifty percent of children’s deaths result in postmortem examinations. Less than one percent of the elder deaths have such an examination.
3. A significant, sometimes callous, acceptance of elder deaths, regardless of the circumstances and setting, also began to emerge in the psychology of those whose duties brought them into contact with such deaths. This is not meant to imply a lack of caring or carelessness, but perhaps a lack of awareness and perspective.
4. Dr. Elizabeth Burton, MD, a pathologist, now at Baylor University School of Medicine, also noted that a study she had done showed a 44% discordance rate existed on cause of death between clinicians and pathologists. The manner of death for a huge majority of elders’ deaths is determined by attending physicians.
The Gray Murders Project has identified five primary offender categories based on motive. Two of these have related subcategories. The primary offender groups include:
1. Relief of Burden – Homicides of the elderly designed solely to benefit the offender to relieve caregiver stress.
2. Murder for Profit – Homicides intended to materially benefit the offender. This category has emerged as the most prolific, although it is also the most readily identifiable offender group, usually because of vested third-party interest.
3. Malicious Eldercide, also known as Geronticide – Homicides motivated by a hatred of the elderly or to use an elder’s death to meet a psychological or emotional need of the offender. This category has emerged as producing the most victims per offender, sometimes in astounding numbers that make Sammy the Bull look like an amateur. The offenders noted in this study have all been discovered in medical settings and have ranged from nursing assistants to a geriatric psychiatrist. To the best of my knowledge, it is also the first broaching of a variation on traditional thoughts on Munchausen Syndrome by Proxy in one of the subcategories.
4. Revenge – Homicides motivated by those seeking retribution for real or imagined wrongs done to them by the victims.
5. Gerontophelia – Homicides committed in the course of sexual assaults of elderly female victims. Presentations of this category are received with mixed belief. Adult protective services, medical and elder abuse prevention advocates, as an example, are more receptive of this concept than some law enforcement personnel. To make this more understandable, the awareness segment of this project made the first known use of striking a comparison to pedophiles. This category does not exclude similar homicides of elderly males, but no actual cases have yet been discovered.
The scope of missed homicides of the elderly may be like attempting to calculate the precise number of the stars. What can be reasonably argued is that we are probably missing thousands, perhaps significantly more, homicides of the elderly. This is a bold statement, but one I am completely comfortable in making even taking into account the generally declining homicide rates in the United States.
Presentations of “Gray Murders” for such groups as the: California District Attorneys Association, adult protective services conferences in Texas, Iowa, Missouri, Virginia and others, the National Conference of State Medicaid Fraud Control Units, US Department of Justice, advocates, college students and many, many others have been met with overwhelming success. In many cases, practices have begun to change in terms of ante and postmortem practices of professions including adult protective services investigators, law enforcement, advocacy programs, prosecutors and medical personnel.
It has been validating to see others begin to make concerted efforts to raise awareness in what I have come to call “the ultimate abuse of the elderly”. Several attendees have copied the presentation and begun their own. Other law enforcement, social services, medical personnel, coroners, medical examiners, the ABA Commission on Legal Problems of the Elderly, and others have expressed significant interest in the project by instituting similar awareness training as well. Training attended by staff of the US Senate’s Committee on Aging resulted in staff incorporating a number of ideas the Project provided in the Elder Justice Act.
Academic reception has been puzzling to an admitted amateur researcher. My goals are to create awareness, intervention strategies, better ante and postmortem practices and to facilitate change. Many academicians, who have access to significant research resources, have inquired about the Gray Murders Project. Cooperative efforts have been discussed. Unfortunately, these have usually entailed requests for secrecy to enable sole academic-oriented authorship. This type of academic request has not been productive in fostering cooperation. “Gray Murders” and its spin-off awareness presentations are not about academic aggrandizement. Secrecy is not a cloak that will permit us to take our turn at saving Private Ryan and Rosie the Riveter.
Nursing home deaths and abuse were not part of the Gray Murders Project at its inception. A number of advocates for nursing home reform brought these issues to my attention. Among them, Ila Swan and Coroner Mark Malcolm are to be commended for their patience and information sharing. These areas have now become additional training subjects and well-received in terms of adding practical perspective to elder abuse in long-term care settings.
Other results have included establishing international collaborative contacts and research into better and simple applications of traditional diagnostic and forensic tools.
This project and the opportunity to formally and informally discuss a variety of senior safety issues with many different disciplines also revealed a huge and counterproductive phenomenon. I have identified this phenomenon as “The Grand Canyon Effect”. It is the lack of coordination between human services, law enforcement, the medical community, prosecutors and others. There is no malice involved in this effect, but its existence in too many areas of the country works to the significant detriment of too many of our elders. Conversely, it works to the advantage of those who commit crimes against our seniors, propagates the problem and demeans our societal values of justice.
To address this issue, training has been developed concentrating on strategies to overcome this frequently tragic problem. Better coordination between service agencies is one of the issues that must be effectively addressed by adult protective services administrators, law enforcement and prosecutors.
Strategies and training segments have also begun to be developed to assist seniors in preempting or diminishing their chances of becoming victims of a wide spectrum of elder abuse.
Although significant progress has been made in the profiling of victims and offenders, much needs to be done. Indicators of risk and offense have begun to emerge with certain key factors noted, but more cases for study are needed.
Another result of the Gray Murders presentation has been to identify other needs in terms of how better to recognize and prove crimes targeting seniors, employ more prevention strategies and obtain better proof. Much needs to be done for a wide-array of professionals involved with the elderly. .
Terrific cooperation has been received from law enforcement, prosecutors, advocates, the media and social services agencies across the country in building a base of offender and victim knowledge. More such cooperation is needed. With the graying of America accelerating, no one wants themselves, their loved ones or their fellow citizens to be victimized.
For more information on how you can help, please contact Joe Soos at telephone (703) 455-7068, email graycrimes@aol.com or visit www.graycrimes.com
Joe Soos, aka The Bear, is a retired, thirty-year law enforcement veteran and former homicide detective. In addition to the Gray Murders project, he is a law enforcement and human services curriculum designer on a wide-variety of topics, all uniquely designed to meet the specific needs of the target audience.