Death in trash-filled home shows difficulty of aiding solitary seniors
Stanley Biolowas Jr.'s Ingram home was filled with trash when firefighters found his body Feb. 1, and he had been dead for some time.
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In between two pristinely kept homes in Ingram, Stanley Biolowas Jr. lived in a decaying two-story house filled with trash.
The windows in the rickety, grayish-brown facade were stuffed shut with orangish foam. Inside, debris crammed the home floor to ceiling and a pair of surveillance cameras stood sentry against thieves he feared would steal his possessions.
It was inside this home that the 90-year-old led a life of stubborn independence with no heat. And it was there in a room on the second floor that firefighters, wearing breathing masks to withstand the stench, found his body Feb. 1 after searching for four hours. He perished of heart disease, the medical examiner's office said, and had been dead for some time.
Neighbors said they sought help for the man, calling the Allegheny County Area Agency on Aging at least once. One neighbor reported someone on the street had called the county health department, though the department has no record of a report being made.
"There's been multiple attempts by multiple neighbors to get him some help," said Lori Kownacki, a former veterinary technician who now stays home to care for her two sons. She said she called the county Area Agency on Aging to report his situation, but the call-taker told her there was nothing to be done. "If something had been done awhile ago, it wouldn't have ended this way."
The case, in some ways, illustrates the difficulties in intervening when an elderly person suffers from self-neglect, a problem that in Mr. Bialowas' case was compounded by pathological hoarding, said Don Grant, a case manager with the Agency on Aging. Records show that if someone called to report he needed help, there was no report taken. The agency's only contact with him was last month at a West End senior center.
"It upsets me. It could have been something that we could have looked at," he said. "Perhaps it was preventable, perhaps not."
Mr. Grant said some studies estimate that as many as one in 190 seniors are suffering from abuse, neglect or self-neglect. His agency alone investigates some 1,500 cases a year.
Geraldine Chenot, a licensed psychologist and registered nurse who contracts with the county, is one of those on the front lines of those investigations. Accompanied by a social worker, she determines if an elderly person has his or her "capacities."
Ms. Chenot said of the 30 to 50 cases she investigates a year, she sees about five to seven cases that involve hoarding, in which people collect stuff -- often valueless -- beyond reason, to the point that their homes become unlivable to most. For the worst cases, she has a term, "tunnelling," in which the only passageways around the homes are narrow spaces between mounds of stuff.
Though hoarding is not a diagnosis recognized by the American Psychiatric Association, it's often classified as a form of obsessive-compulsive disorder. It's also one of the proposed additions to the next version of Diagnostic and Statistical Manual of Mental Disorders.
"It doesn't make sense to see it as anything but a psychological disorder," she said. "Nobody would choose to live this way."
She's encountered people who become agitated when she moves a pile of papers to free a space to write while she interviews them and people who save decades-old newspapers and phone books, saying there's an article or phone number they may need later. The problem bleeds into essential living spaces, "to the extent the bathroom can't be used as a bathroom."
"To us, it makes no sense. To them, it's all their possessions," she said.
In Mr. Biolowas' case, neighbors saw his situation go from bad to worse. Ms. Kownacki said she saw him sit in his car during winter months in an apparent effort to stay warm. But last year, his license was revoked after he twice struck parked cars, including one that belonged to a relative of Ms. Kownacki's. Unable to get gas, he could no longer use his car to warm himself.
She said he haphazardly bathed himself at a local Giant Eagle and a local Eat 'n Park.
She attempted to help him, offering to let him shower in her home and bringing him meals on occasion. When she did bring him food, she knew to knock and leave it on the front porch. He waited until she crossed the street to go outside and retrieve it.
Bill Gordon, who lives next door, said he was told by a real estate agent that Mr. Biolowas was fixing up his home, but over the years, it fell into worse disrepair. He did not see that Mr. Biolowas had trash pickup. Refuse appeared to stay in his home and pile up.
But Mr. Gordon said his neighbor seemed self-sufficient. He was in "OK" physical shape and he appeared to be mentally competent.
"It wasn't like he was out of sorts, per se," Mr. Gordon said.
In some cases, the Agency on Aging can compel intervention, forcing a person into a nursing home or mental hospital, by getting a court order. The agency can obtain an involuntary commitment order if the person is found to be mentally ill and hold the person while he receives psychological evaluation. In extreme cases, where the agency can show the person is at risk of dying within the next 24 hours, it can petition for emergency guardianship and force the person into a hospital.
Mr. Grant said that the standard for when the agency can intervene is set high. An elderly person can live without heat or water and in a home with deplorable conditions if he or she chooses as long as the person is demonstrated to be mentally competent.
But hoarding, in and of itself, is not a strong enough basis to compel someone to move from a home, said Ms. Chenot, a fact that is often frustrating to family trying to help elderly relatives.
Compulsive hoarders often admit they want help, Ms. Chenot said, but parting with their possessions is difficult. The county can offer house cleaners, home caretakers, meal delivery and grants to help older people get back their utilities if they've fallen behind on bills.
Sadly, Ms. Chenot said, "the vast majority will refuse those services."
"Do they understand that this is standing between them and a more comfortable life? They do intellectually, but emotionally they will not separate from that stuff," she said. I always feel really sad when I leave these homes ... you think, 'Oh God, if only they would let us help them.' "
First Published February 12, 2012 12:00 am