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The Honolulu Advertiser
Posted on: Sunday, February 16, 2003

SUFFERING IN SILENCE: HAWAI'I'S ELDERLY VICTIMS
Counting up the cases of neglect

 •  Abuse of elderly called state's 'hidden epidemic'
 •  Man's death sad but not unusual
 •  Elderly care takes place mostly in caregivers' own homes

Advertiser Staff

Three-quarters of abuse and neglect cases investigated by Adult Protective Services in Hawai'i involve victims 60 and older. Victims are more often female and perpetrators are most often relatives.

* Percent of total abuse and neglect cases investigated, including those younger than 60.

** Where decubitus ulcers are an underlying cause of death. Decubitus ulcers include bedsores, plaster ulcers and pressure ulcers, which can be an indication of neglect. Number of all adults: 33.

• • •

Who is to blame? Ten cases investigated by authorities, and the results:

MAY 14, 1999
Lack of evidence, no prosecution

On May 14, 1999, an 84-year-old Pawa'a woman died on the floor of her apartment. The woman had fallen three weeks earlier and her daughter, who lived in the apartment next door, told investigators she was respecting her mother's wishes by not calling for help.

The woman died of blood poisoning caused by large decubitus ulcers. She was emaciated and dehydrated and covered in her own filth.

The Honolulu prosecutor could not find any law broken and could not prosecute the daughter on any charge that might stem from neglect.


AUG. 10, 1999
Care-home owner convicted

Pearl City care-home owner Raquel Bermisa was found guilty of manslaughter in 1999. Her 20-year sentence was commuted to four years.

Advertiser library photo • Oct. 28, 2000

Chiyeko Tanouye was a 79-year-old resident of a licensed adult care home in Pearl City when a doctor diagnosed her, in June 1999, with decubitus ulcers. Follow-up appointments were urged but the next time Tanouye saw a doctor was in August after she was left in the emergency room at Kapi'olani Medical Center at Pali Momi by Raquel Bermisa, the owner of her care home.

Tanouye, a retired Diamond Bakery clerk, died the next day, Aug. 10, 1999, of septicemia — an infection, brought on by the ulcers, that poisons the blood.

Bermisa was convicted of manslaughter in October 2000 and sentenced to 20 years in prison.

Last December, however, then-Gov. Ben Cayetano commuted her sentence to four years. A hearing scheduled for Thursday will determine how much of that four-year sentence she will serve.


AUGUST-SEPTEMBER 1999
Woman assaulted in Waipahu care home

An autopsy report details the cause of death of Mildred Nomura, who was assaulted in her Waipahu care home in August 1999.
Mildred Nomura lived in a licensed adult care home in Waipahu run by a woman named Vicky Gasilos.

On Aug. 31, 1999, fellow resident Wallace Curtis entered Nomura's room. The 80-year-old Nomura grabbed the man's cane. Curtis, 52, grabbed it back and then used it to beat Nomura. She was taken to The Queen's Medical Center and died the next day. Under a plea bargain, Curtis pleaded guilty to charges of second-degree assault.

Gasilos told licensing officials at the state Department of Health that she had left the home unattended. She voluntarily closed the home.

But the state attorney general charged Gasilos with endangering the welfare of an incompetent person, a misdemeanor. Gasilos pleaded no contest and was granted a deferred acceptance of no contest, which meant she had to stay out of legal trouble for a year.

In April 2001, having complied with the court's terms, the charges were dismissed.

Nomura had no known relatives in the Islands. Instead of scattering her cremated remains, Borthwick Mortuary kept them. About a year later, a relative from the Mainland claimed them.


AUG. 1, 2000
Man punched by fellow home resident

Alfred Micallef, an 81-year-old retired electrician for Ford Motor Company, died Aug. 1, 2000 after he was punched in the face by a fellow resident of the Gilo Care Home in Kalihi Valley. Micallef was a sergeant in the Army during World War II and was buried in the National Memorial Cemetery of the Pacific (Punchbowl).

Nolan Quintal, 37, was charged with manslaughter but was found not guilty by reason of insanity on Aug. 30, 2001. The court, however, ordered he be sent to the Hawai'i State Hospital, where he remains today, and placed on medication.

Care-home owner Glorita Gilo was charged with endangering the welfare of an incompetent person, a misdemeanor, and pleaded no contest. Gilo was granted a deferred acceptance of no contest on March 8, 2002 and ordered to stay out of legal trouble for one year. A judge will decide on Friday if she has complied with the court's terms, and if she has, the charges will be dismissed.

The state Department of Health, however, revoked Gilo's license after discovering that she had left her home at the time of the assault on Micallef. The decision, made in September, allowed her to keep the home open for six months under a provisional license so her residents could find another place to live. The provisional license expires Thursday.


JAN. 19, 2001
Lack of medical help for resident of home

Torao Nishimoto, 86, lived in a licensed adult residential care home in Hilo, Hawai'i, that was owned and operated by Francilla Malaka.

On Jan. 19, 2001 an unresponsive Nishimoto was rushed by ambulance to Hilo Medical Center where he was pronounced dead.

An autopsy found Nishimoto had been suffering from a fractured hip for up to three days and that he had contracted pneumonia. His body was bruised and he had decubitus ulcers.

The state attorney general successfully prosecuted Malaka for endangering the welfare of an incompetent person, a misdemeanor, but no one was able to determine how Nishimoto fractured his hip.

The case hinged on proving that Malaka did not seek medical aid for Nishimoto. A judge found her guilty on Aug. 9, 2002.

Malaka faced up to one year in jail and a $2,000 fine but suffered a stroke on Aug. 15 and fell into a coma. She died 16 days later.

Her care home was closed by the state Department of Health.


APRIL 2002
Death ruled case of self-neglect

In April 2002, a 75-year-old Hilo woman died at her home from extensive pressure sores, or decubitus ulcers, that became so infected, maggots were already living in them before her death. The ulcers created blood poisoning that caused her death.

The Honolulu medical examiner, which performed an autopsy for Big Island authorities, considers it a case of self-neglect because the woman told her husband she did not want to see a doctor, or even her friends.

The woman's husband called emergency personnel after she died.

Initially the woman's case was not identified as possible neglect because paramedics and emergency room nurses did not remove her clothing to inspect her body. If they had, they would have seen the infected ulcers.


APRIL 9, 2002
Neglect suspected in patient's death

On April 9, 2002, Ushi Kaneshiro, 102, was rushed from her Waipahu care home to St. Francis Medical Center-West where she was pronounced dead. The retired owner of Iwilei Chop Suey and great-great-grandmother suffered from infected decubitus ulcers that were the size of her fist. They were so deep doctors could see bone.

The 59-year-old care-home operator turned herself in to police

Jan. 9, 2003 and was arrested for investigation of second-degree murder.

The case was turned over to the attorney general. Charges are pending.


JUNE 2002
Woman dies at home; lack of care

In June 2002, an 85-year-old Hilo grandmother died in the home she shared with two other generations of her family. An autopsy by the Honolulu medical examiner,

who does consulting work for Big Island authorities, found she suffered from advanced stages of decubitus ulcers which poisoned her blood.

Her family told investigators that they could not lift or move her and, because they had no car, they could not take her to see a doctor. She was found to be emaciated.


JUNE 2002
Death by starvation being investigated

In June 2002, the nearly skeletonized body of an 86-year-old O'ahu woman was found in her home by the caregiver she had hired to bring groceries. She lived alone and could get around her home without trouble.

The medical examiner determined that the woman had starved to death. She weighed 45 pounds.

The Honolulu prosecutor's office is reviewing the case.


SEPT. 9, 2002
Malnutrition, neglect suspected in death

On Sept. 9, 2002, the partially decomposed body of an 89-year-old Waialua woman was found in her home by her son.

The son told investigators he had last seen his mother a month earlier when he brought her monthly groceries.

The only food in the home was in the refrigerator, which contained old miso and ice.

Although the woman died of a heart attack, the medical examiner concluded that neglect was evident and that malnutrition could not be ruled out as a contributing factor in her death.

Sources: State Dept. of Health, Dept. of Human Services, Honolulu Medical Examiner