Updated: Dec 30, 2019
Westerly, a small Rhode Island town, made national headlines recently for all the wrong reasons. On December 19th, 47-year-old Julie Lynn Cardinal, a single mother of five who worked at Babcock Village, an affordable housing complex for elderly and disabled, was shot and killed by 66-year-old Joseph Giachello, a resident of the facility who then took his own life. Besides fatally shooting Ms. Cardinal, Giachello shot two other employees identified as 38-year-old Robin Moss and 66-year-old Donna Thornely, both of whom are expected to recover. We at Connelly Law send our condolences to the Cardinal family.
This senseless incident shook this quiet town, and the entire state, to its core. How could this have happened to a person who loved working with seniors and those with disabilities and how could a senior be a perpetrator in such a horrendous act?
As in all such incidents, politicians soon raised the age-old argument about gun control, but that is an issue for another day. In reality, a bigger problem exists here and it has to do with a new generation of senior and disabled citizens and the appropriateness of placing them in such housing complexes. And before we call this an "isolated incident", it may be surprising just how many such "incidents" occur.
In Norfolk, Virginia on the same day as the Westerly tragedy, a 74-year-old man named William Felton fatally stabbed a 71-year-old neighbor at an assisted living facility. The cause, according to police, was the victim playing the television too loud in an apartment below him.
In November, an 80-year-old man identified as Robert Breck opened fire at a senior living apartment in Vancouver, Washington, killing one and injuring two others. It was said that the dispute started over a “caregiver showing more attention to [the victim]”. The dead man was identified as 75-year-old Dean Leon Tunstall.
In September, two neighbors, one a 73-year-old and an 82-year-old attacked a younger woman with a brick, bludgeoning her to death in Bladensburg, Maryland, and dragging her dead body behind the affordable housing project. Police had no immediate motive.
In August at an elder care facility in Carmichael, California, a husband and his wife died in a murder-suicide at the Aegis Senior Living Center. Police officials stated that both individuals were older than 60.
In July, a murder-suicide occurred at the Parkshore Senior Living Community in Madison Park, Washington. Both victims were identified as being in their 8os.
And in the same month, two people were killed and a third wounded at an Elkhart, Indiana senior housing complex. The deceased victims, both 66 years old, were identified as Gail Shields and Jon Malk. The suspect, 76-year-old Lawrence Faso, took his own life following the shooting. Police say an argument over smoke from a grill led to the violence.
Earlier in the year at the Serenity Villas Community, for seniors and the disabled, located in Pomona, California, the burning body of 58-year-old Ronnie Wall and her dog were discovered by police. Chauman Wayan Tyner, aged 50, was arrested and charged with the murder and mutilation of the victim's body. Tyner used a pair of scissors.
In New York City, police continue to investigate the murders of two elderly residents of a senior housing community. Jacolia James, 83, was beaten to death on April 30 in her apartment in Brownsville at the Woodson housing projects where 82-year-old Myrtle McKenny was also murdered in her apartment in the same building months earlier. Police say the owners of the complex promised security cameras but so far none have been installed. They also state that "someone knows something" but that residents say they are living in fear and refuse to cooperate.
In Detroit, a security guard, Kenneth Hall, showed up for his first day of work at the Philip Sims Senior Center and became one of two people murdered by a senior assailant identified by police as James Fleming, who they describe as a “career criminal.” The other victim was identified as 66-year-old Bernice Clark, also a resident of the facility.
Security Issues at Senior Residences
Security and background checks are also a problem in some senior housing communities. Just such a concern may be at the center of what may be turning into one of the most horrific serial killing sprees in the history of this country, involving a man who is in this country illegally who targeted elderly women in senior communities.
Police in Dallas, Texas report the arrest of 45-year-old Billy Kipkorir Chemirmir for the murders of "at least" 19 elderly women, ranging in age from 79 to 94, at the Tradition-Prestonwood Independent Living Facility. According to police, he strangled and suffocated the victims to steal their valuables. He gained access to them by working as a caregiver in some cases and posing as a maintenance worker in others.
The arrest of Chemirmir, in this country illegally from Kenya, has raised questions as to how he was able to gain employment given his lack of citizenship or proper paperwork. As if the deaths of "at least 19 elderly women" isn't frightening enough, Dallas’ assistant police chief, David Pughes, is now seeking information into the deaths of 750 elderly women and their possible connection to this suspect.
Police are seeking more information on what may be one of the most prolific serial killers who preyed upon seniors.
A New Type of Senior
There is one thing we do know, those who are aging into the system are coming with baggage not seen in previous generations. Here are some numbers to consider, by 2031, adults age 65 and older are expected to double. These are the baby boomers. And what problems do they bring with them? Multiple and many.
According to the Centers for Disease Control (CDC), it is estimated that 20% of people aged 55 years or older experience some type of mental health concern. The most common conditions include anxiety, severe cognitive impairment, and mood disorders (such as depression or bipolar disorder). Mental health issues are often implicated as a factor in cases of suicide and violent acting out.
Drug abuse among this age group has also become a prominent issue when compared to the previous generation. Much of this use is the result of the era in which they were raised - the free love, drug and rock and roll generation of the 1960s. Among baby boomers, those seeking treatment in the last five to ten years for heroin addiction have nearly doubled, prescription drug abuse has increased by nearly 500% and overdose rates for those 55 and older have nearly tripled.
And the free love generation has carried this behavior into their senior years. Doctors report that those over the age of 60 comprise the largest group of new Sexually Transmitted infections seen in their offices. Diagnosis rates for herpes simplex, gonorrhea, syphilis, chlamydia, hepatitis B and trichomoniasis rose 23 percent in patients over age 60 between 2014 and 2017, according to the latest statistics.
Homelessness among this group is also an issue and presents as a problem for institutional caregivers. Between 2007 and 2014, there was a 20 percent increase nationwide in individuals over 50 living on the streets. Today, this group now makes up more than one-third of the homeless in the United States and the older homeless have mental illnesses, chronic physical illnesses, diabetes, heart disease, addiction and mobility issues, and histories of violence and incarceration.
And speaking of incarceration, seniors are showing up here as well. Between 1993 and 2003, the inmate population ages 55 and older mushroomed by 400 percent, but, according to the Department of Justice, the overall crime rate among this group has leveled off and may be dropping, but that's not the whole story. What they don't tell us is that many crimes committed by seniors are reduced to misdemeanors or outright dismissed, because of their age or other circumstances such as mental illness. This certainly skews the numbers.
But here is one number that we need to know, nearly two-thirds (65 percent) of the 55+ prisoners had been sentenced for violent crimes, the highest percentage of any age group. And in 2017, over 25,000 Boomers were arrested for the four index crimes of violence (murder/non-negligent manslaughter, robbery, rape and aggravated assault). A fact that those working with seniors in elder housing residences need to be aware of.
Staggering Staff Statistics
And here is another staggering number, according to the Bureau of Labor Statistics, healthcare and social service workers are nearly five times more likely to experience a serious workplace violence injury than employees in other industries. Senior living and care communities are at the heart of this striking statistic. Nursing aides in long-term care facilities have the highest rate of workplace attacks mostly attributed to working with those with dementia or mental illness, according to the McKnight Senior Living News.
But a ruling earlier this year may help to protect healthcare workers when dealing with potentially violent clients living in community housing or affordable housing programs that require on-site visits.
In Secretary of Labor v. Integra Health Management, Inc., a background check was not done on a client prior to Integra assigning an employee to do a home visit and conduct an assessment. Unknown to the employee and Integra, the client had a prior criminal record, including convictions for aggravated assault and battery, something an extensive background check would have turned up.
After several home visits with the client, the employee submitted reports to her supervisors in which she identified disturbing behavior from the client and said she was uncomfortable being alone with him. Notwithstanding, the employee was told to return to his home to complete her required assessment. During her visit, the client attacked the employee and fatally stabbed her nine times.
This resulted in OSHA issuing Integra a citation alleging a violation of the general duty clause for exposing employees “to the hazard of being physically assaulted by [residents] with a history of violent behavior.” The general duty clause states “each employer … shall furnish to each of his employees' employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees.”
In the Westerly case, the perpetrator also had a background that should have raised red flags. Records indicated that the perpetrator, Joseph Giachello, was hospitalized in 2002 after he said he had planned to buy a gun at Walmart and kill his wife and himself. He was initially admitted to a South County Rhode Island hospital “for being homicidal and suicidal” in September 2002. Later that month, he was admitted to Butler Hospital in Providence for psychiatric treatment. Records also state that his wife obtained a three-year order of protection in Newport Family Court during that time and pursued a divorce. Family Court Judge Raymond Shawcross granted the divorce in September 2003, ruling that Giachello was violent and abusive towards her. They were married less than a year when his actions came to the attention of the mental health and criminal justice system.
And one other thing, the statistics mentioned above only include those cases reported. I have experienced, in a professional capacity, resistance from the criminal justice system in following up on senior assaults on staff. At an affordable housing program I supervised, a resident assaulted a staff member and when police arrived, they questioned why we were seeking to press charges, stating, "Isn't this what you people get paid to do?"
What This Means
With the trend towards "aging in place" growing, this is not good news for many senior providers. Those who can age in place are often the ones with appropriate support systems, financial capability, access to resources and healthier, both physically and mentally. Those who cannot "age in place" end up in affordable housing units or other senior housing residences and bring with them issues like mental illness, drug addiction, and physical illnesses.
Facilities, organizations, and agencies that serve this generation of aging Americans will need new strategies and techniques to recruit and train their staff to meet the changing needs of the seniors they will be providing services to -- and screening these seniors makes a whole lot of sense.
Let's be clear, background screening is legal and permitted under federal law. The cost to run a background check is small when compared to the human and financial cost of dealing with a tragic incident. And remember this, past behaviors are an excellent predictor of future ones. Screening at senior communities has value for both residents and staff. It sends the message that program operators are serious about creating a safe environment for everyone. Ignoring problem backgrounds just to fill a bed may solve a short term concern but the long term ramifications could be disastrous. Programs must also adopt policies and follow them -- and make sure they are applied fairly and equally to everyone.
A Personal Story
In an affordable housing program for seniors and disabled individuals in the greater Boston area, guidelines were in place aimed at protecting both residents and staff. As time went by, some staff became lenient with a few residents based on personal feelings for them, at first around the rules on smoking. Although strictly prohibited, these residents openly smoked in their rooms with the full knowledge of some staff members. Other residents, who were not staff "favorites", were held to strict account when it came to similar behaviors. The result --- those who smoked with the staff's blessings began to take more and more liberties, from using alcohol to intimidating other residents who attempted to confront the behaviors.
This led to a community in crisis, where those who complied with the guidelines staying isolated in their rooms out of fear of retribution by the openly defiant rulebreakers. Violent arguments became the norm and flagrant disregard of all the guidelines became commonplace. The staff members who tried to hold all residents to the same set of guidelines were openly ridiculed and disrespected, causing them to leave their positions rather than be caught up in the chaos.
At one point, several residents began selling drugs out of their apartments which resulted in a police sting, forcing the agency to do a wholesale cleanup of the residence and the staff. Although the troublemakers were just a handful of residents, they created such a hostile environment that dozens of others hid in their apartments. In speaking with some of these residents, they were well aware of the drug dealing for months but refused to tell housing supervisors out of fear.
One resident told me, "They would smoke right in front of staff who acted like they didn't see anything. When we tried to address it, we were targeted by these people, often verbally abused and threatened with physical harm. So why would we tell the administration about the drugs? If they abused us over the cigarette smoking, I couldn't imagine what they would have done if we told about the drug dealing."
The staff members involved, who were terminated following an investigation, stated that they initially wanted to "be liked" by the residents but became frightened when they realized things "were out of control" so they said nothing. One of the staff terminated stated about a resident involved in the drug activity, "He was so nice to me so I let him go, but when I tried to get him to go back to following the rules of the lease, he became a different person, threatening and very mean. He acted like he was my friend until I told him no. I was scared."
In working with the staff that remained, I told them about a teachable moment for me that occurred during a disturbance at a prison in New Jersey during the 1970s. At that time, I was a senior corrections officer and on the first tactical response team. During the incident, inmates had attacked and injured another correction officer who was viewed as "cool (lenient)" and would often bring inmates sub sandwiches, newspapers and hand out cigarettes (all against the guidelines), while another officer, who was considered a "no-nonsense guy" who followed the rules with everyone, was spared the attack. When the main perpetrator was asked why they attacked the "cool guard", the answer opened the eyes of most of us.
"Yeah, he's cool," said the leader of the uprising. "But he breaks the rules, man. He can't be trusted. We don't know where he's coming from." In other words, when a person who is charged with keeping others safe cannot be trusted, they serve no purpose for those individuals intent on stirring up chaos and will be turned against.
Guidelines must be enforced and policies adhered to otherwise a total loss of control will occur. In most cases, when a program is in disarray, it is not solely because of a few "troublemaking residents", but because the overwhelming majority of other residents feel unsafe. It takes just one problem resident to upset the culture of a community.
The phrase that I learned to live by when working with people of all ages and all backgrounds was to be "fair, firm and consistent".
We will never be able to control everything and prevent such attacks from ever happening, but we can take steps to keep programs and housing units as safe as possible. We can never know what incidents we have prevented through good policy development and enforcement of guidelines, but one thing is for sure, it's better to be proactive than reactive.
In our next blog, we will discuss outside threats, background checks, how to "red flag" resident behaviors and using a biopsychosocial assessment to determine risk. It's also important to let everyone know that the Rhode Island Assisted Living Association (RIALA) provides an excellent training on active shooters and workplace violence.
Connelly Law also offers free seminars on Seniors Who Bully Seniors. There are two versions of this seminar, one strictly for residents of senior living communities and one that is more clinical in nature for program staff. Those interested in this can call me at Connelly Law Offices (1-855-724-9400) or send me an email at email@example.com.
Don Drake oversees Connelly Law's Community Education Programming. He is a retired licensed clinician in the Commonwealth of Massachusetts with over three decades of experience working with older adults diagnosed with HIV/AIDS, substance abuse disorders, chronic homeless and mental illness. Prior to his retirement, he was the director of a unique treatment program for older adults with histories of mental illness, cognitive disabilities, and addiction at Shattuck Hospital in Boston. He was also a director at Steppingstone, Inc. in Fall River, Massachusetts where he was the clinical trainer, program and curriculum developer for the agency and oversaw treatment programming for older adults. He has over 40 years of human service and law enforcement experience and has worked as an administrator at programs in Boston, Hartford, Providence, and Philadelphia, helping to structure, hire and train staff in providing behavioral and addictions treatments for adolescents and adult clients. Drake also worked as a trainer for the Massachusetts Department of Public Health presenting training on QPR, a suicide prevention curriculum for the general public, the Massachusetts Council for Problem Gambling and the Crisis Prevention Institute, an international training organization that specializes in the safe management of disruptive and assaultive behaviors. He is also a retired professional wrestler who is in the New England Professional Wrestling Hall of Fame. Drake can be reached at Connelly Law Offices, Ltd. at firstname.lastname@example.org