Why Delaware struggles to investigate long-term care facilities
Delaware has struggled for about a decade to investigate long-term care complaints – particularly for assisted living facilities.
Wochit
On the night of Aug. 5, 83-year-old Shyuan Hsia was fatally beaten at The Summit Assisted Living in North Star, where she had resided since 2020.
A resident who lived across the hall from Hsia in the facility’s memory care unit left her bleeding and unconscious on the floor of her room, according to medical records, police reports and a state health investigation. Delaware Online/The News Journal is not identifying the man because he has not been charged due to his severe dementia.
Records obtained by Delaware Online/The News Journal, as well as interviews with Hsia’s family, show that the assailant had been aggressive before − both with staff and other residents.
As a result, Hsia’s family has been left wondering why the man remained at The Summit.
This is what we know about the assailant.
How long had he been a resident at The Summit?
The assailant was admitted on Sept. 18, 2023, state health inspection records show. He was diagnosed with dementia and other ailments.
When had he previously been aggressive?
According to the state investigation, the assailant was seen by a psychiatrist on May 3 for medication management. He had been taking several Alzheimer’s medications but was suffering from “increased aggression.”
Staff reported he had been yelling at them and “getting (in)” their faces. It’s unclear whether his medication was adjusted, though it doesn’t appear any medications were added.
When did he first attack someone?
Two months after that visit to the psychiatrist, on July 15, the state received a report that the man had entered another resident’s room and was hitting him in the stomach and legs. Facility staff noted a bruise on the resident’s arm as a result.
Following the assault, The Summit ordered a psychiatric consult for the man, where he underwent a dementia evaluation and his medication was increased. Staff also monitored and documented his behavior for nine shifts.
“No additional behaviors” were noted, inspection documents said.
About two weeks later, on July 31 − five days before the attack − the man was again seen by a psychiatrist. This was for “breakthrough aggression” and irritability, documents show.
The assailant was “still acting out at times,” staff wrote.
Seroquel, an antipsychotic often used to treat schizophrenia and bipolar disorder but that also can be used for agitation due to Alzheimer’s disease and other forms of dementia, was added on an as-needed basis.
Another attack the same night Shyuan Hsia beaten
Less than a week later, the same night he attacked Hsia, the man was found punching another resident in her room.
He was found quickly and taken to his room, where he “became combative” with staff.
“Once a moment of calmness happened,” the man was given Seroquel, the progress note stated. He was then monitored and helped into his pajamas until he was calm.
A note in his file from that night said he was to be placed on one-on-one supervision.
He remained at The Summit for more than a week after the attack before being transferred to a different facility. He has not returned.
Got a story tip or idea? Send to Isabel Hughes at ihughes@delawareonline.com. For all things breaking news, follow her on X at @izzihughes_
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