Whitehall Manor homicide shines light on issues of dementia and violence
The truth of what happened to 89-year-old Frank Schwartz on Dec. 15 at the Whitehall Manor senior living facility may never be known.
Authorities say early that day, Schwartz was hit by an object, likely wielded by a fellow resident of the dementia care unit at the personal care facility in Whitehall Township. But no one witnessed the attack, and Schwartz suffered falls before and after the incident. Forty days later, on Jan. 24, he died.
Though his death has been ruled a homicide, the Lehigh County district attorney’s office has concluded that the person believed to have caused the injury will not be charged.
There’s just no way to prove to a jury that the individual caused the fatal injury, according to District Attorney Jim Martin.
Cases where a resident at a senior living home injures another, particularly when a cognitive impairment like dementia is involved, are not uncommon, according to Churchill Huston, a Philadelphia attorney whose firm specializes in nursing home abuse and neglect cases.
Though fatal injuries from such incidents are rare, Huston has represented families that have lost loved ones this way.
“It’s usually not seen as their fault,” Huston said of the fellow resident who might have caused an injury. “This is often part of another resident’s disease process.”
The question, he said, becomes a matter of what the facility did to protect the resident and others.
Whitehall Manor is a personal care home, meaning it doesn’t provide the same level of medical care as a skilled nursing facility. Personal care can be a more affordable option for people who need some help with daily chores and medication management.
In 2018, there were more than 10,000 violations found in the 1,149 personal homes in the Pennsylvania, according to a state Department of Human Services report. The most common problems were failure to follow and document medication administration and incomplete medical evaluations.
Personal homes are also required to report serious incidents to the department. In 2018, more than a third of the 29,400 incident reports involved a serious injury or trauma that required hospital treatment.
Whitehall Manor’s inspection reports from the Human Services Department since 2016 show mostly minor infractions.
In a statement Wednesday, Whitehall Manor co-administrator Soulima Wahbeh-Younes said the facility strives for quality care.
“All we can say at this time is that Whitehall Manor has always provided the best quality of care to our residents and will continue to do so,” WahbehYounes said.
Schwartz’s family could not be reached for comment.
Dr. Neti Nilesh Vora, associate chief of the Division of Geriatrics at the Lehigh Valley Health Network, said treating and caring for people with dementia is an unpredictable challenge, and that across the country, the demand for such services is outpacing available resources.
Speaking in general terms and not about Schwartz or Whitehall Manor, Vora said there is a need for better funding for facilities to provide enough staff to monitor residents suffering from the cognitive disease. Dementia can erase impulse control, and inhibition can disappear overnight, Vora said. Behaviors resulting from those changes are a hallmark of the disease. When and how these behaviors present themselves can vary and occur without warning.
That is why training for all staff in contact with dementia residents is crucial, Vora said. Regulations that would standardize education and training could improve the quality of treatment for patients in a system where those with more money often receive a higher quality of care.
“Most everything is private pay and it can be a huge financial burden for some families,” Vora said. “It does become a question of who has more resources and it is sometimes heartbreaking for us to see.”
If a resident or patient who demonstrates potentially harmful behaviors cannot be sufficiently monitored, Huston, the Philadelphia attorney, said management at a facility has an obligation to recommend transferring the individual to a place better suited.
But, he said, speaking generally, there’s a financial incentive for some to hold on to such residents.
“I think [the staff ] wants to do a good job in these situations. But they’re put in a position where they can’t, by a system they have no control over and that is fundamentally flawed,” he said. “It’s become the national evolution of a system that views senior citizens as a profit source.”
Without funding to create an ideal ratio of staff to residents,
Vora wonders if technology might be the answer for patients who need closer monitoring because they demonstrate aggressive behaviors. She noted that surveillance is often prohibited as an invasion of privacy.
The challenges of treating dementia won’t be disappearing any time soon, Vora said. As medicine leads to longer lives, the risk of developing dementia increases. It’s important for scientists to continue to search for a medical breakthrough, but Vora said that cannot be the only answer.
“It’s important for us to continue looking for that treatment but it’s equally important for us to invest in how to best manage the disease,” Vora said. “We can’t fix it yet, but we need to be able to at least manage it.”
Reporter Binghui Huang contributed to this story. Morning Call reporter Sarah M. Wojcik can be reached at 610-778-2283 or swojcik@mcall.com.