Nine Urns

On June 26, 2020, Austin Hopp, a former Loveland, Colorado, police officer, rolled up in his squad car to a suspected criminal who was walking along the side of the road. The suspect didn’t initially respond to Hopp’s commands to stop and appeared to be ignoring him. “I don’t think you want to play it this way,” Hopp warned as the suspect turned to walk away from him. “Do you need to be arrested right now?”

 As a sworn law enforcement officer, Hopp had the authority to use physical force to gain compliance from a suspect disobeying his lawful commands, and so he did. He grabbed her, swept her to the ground, and twisted her arm behind her. “I was like, ‘Alright, let’s wrestle girl,’” he would later tell two of his fellow officers back at the Loveland police station, recounting his war story for the day. “Let’s wreck it!”

 That was shortly after Hopp and his partner had arrived back at the Loveland police station and put the combative perp in a holding cell to cool off. She was Karen Garner, seventy-three years old, about five feet tall, and eighty pounds.

 Garner was walking home and picking wildflowers when Hopp arrived to investigate a complaint that she tried to shoplift thirteen dollars’ worth of merchandise from Walmart. Garner suffers from dementia and sensory aphasia, which makes it difficult for her to communicate and understand others. Body camera footage of the arrest showed Hopp taking a disoriented Garner to the ground a mere thirty seconds after stepping out of his cruiser. “I’m not doing anything,” Garner yells in the video. “I’m going home.”

 Garner’s attorney included the footage in a lawsuit filed last April. The suit alleged that Hopp fractured Garner’s arm and dislocated her shoulder. I first saw the complaint a few days after it was filed, while browsing through recent civil rights lawsuits. Only a local Colorado newspaper or two had covered it at that point. Within a week, the New York Times picked up the story. It’s not a great day for a small police department, public relations-wise, when the Times is writing about how one of your officers body slammed a little old lady, but usually you can hunker down and see whether the outrage blows over. At least nothing more damaging could come out.

 Astonishingly, it got worse. Garner’s attorney then released closed-circuit camera footage from the police station the day of Garner’s arrest. The footage showed that, after Garner was put in a cell, Hopp and several other officers watched the body camera video of her violent arrest for entertainment.

 “Ready for the pop?” Hopp asked the other officers as they watched the video. “Here comes the pop.”

 “What’d you pop?” one cop asked.

 “I think it was her shoulder,” Hopp responded.

 “I hate it,” another officer says.

 “I love it,” Hopp says.

 Garner was sitting handcuffed to a bench in a holding cell roughly ten feet away while they watched video of her arrest. Her lawsuit alleged that she did not receive medical care for more than six hours.

 It’s not hard to see why Garner’s case made national headlines. It was outrageous, and it was caught on camera. But it was not as unusual as we would like to think. Law enforcement and court systems are sometimes indifferent or outright malicious to the elderly and those with disabilities. Scammers and fraudsters ply their trade on the other side of the thin blue line. Senior citizens have a rough go of it in this country.

 Courtroom footage of a Michigan state judge went viral in January after the judge berated a seventy-two-year-old man with cancer and threatened to throw him in jail, all because of out-of-control weeds on his property. “You should be ashamed of yourself!” Judge Alexis Krot said. “If I could give you jail time on this, I would.” The man, Burhan Chowdhury, tried to explain that he had been too weak to keep his yard maintained, and his son, who usually took care of it, had been away from home for several months.

 The judge was having none of it. “Did you see that photo? That is shameful. Shameful!” she repeated. “The neighbors should not have to look at that. You should be ashamed of yourself!”

Although the judge steals the spotlight here, don’t forget that one of Chowdhury’s neighbors—neighbor only in a strict geographical sense—must have reported the code violation to the government rather than helping him. I’d like to say I can’t think of a better example of this country’s depraved carceral mindset than threatening to jail a sick elderly man over unruly weeds, but there’s some competition. This year, the seventy-eight-year-old Clayton Shriver filed a lawsuit against police in Westminster, Colorado, which happens to be just forty miles from Loveland. Shriver says two Westminster officers assaulted him and tased him while he was having a mental health episode inside a McDonald’s, which was itself inside a Walmart. (If you want a grim window into where all your taxpayer-funded police resources go, look up the number of calls for service at the nearest Walmart.)

 According to Shriver’s lawsuit, a Westminster officer responded to a complaint from McDonald’s employees that Shriver was sitting in a “no sitting” area. Shriver was having difficulty communicating, but he tried to explain to the officers that he was having a medical emergency. His lawsuit says he suffers from “severe arthritis, diabetes, neuropathy, gout, polymyalgia rheumatica, bipolar disorder, and three brain injuries.”

Shriver thought he was being kicked out, the lawsuit says, so he stood up and tried to leave, at which point a Westminster officer tackled and tased him. As Shriver writhed and struggled to pull the taser prongs out of his flesh, another officer arrived and joined in, tasing him again in the back and buttocks. Shriver’s lawsuit included pictures showing heavy purple bruising on his arms and weeping open wounds on his legs and lower back where he was tased. Shriver was arrested and charged with trespassing, obstruction, and resisting arrest. Prosecutors later dismissed all of the charges against him.

 These sorts of stories stick out because we imagine that surely there must be a better way to handle a confused person. But inept police manhandle the old and infirm for the same reason they handcuff and arrest children as young as six. (I’m not exaggerating. The youngest juvenile arrestees in Florida for the fiscal year 2019-2020 were a five-year-old boy charged with felony vandalism and a six-year-old girl charged with misdemeanor assault, according to the Florida Department of Juvenile Justice.) It’s the same reason that a police officer in Rochester, New York, pepper sprayed a handcuffed nine-year-old girl last January. Petty authority is too brittle to bend, and law enforcement agencies have been slow to adopt training on how to deal with people with disabilities, mental health issues, and conditions such as autism.

 In addition to heavy-handed police and cruel judges, there are wider institutional forces at work against senior citizens. These aren’t the clumsy injustices that end up as viral videos. They’re the sort of things you have to pay lobbyists to pull off. For example, an investigation by the New York Times last year found a troubling increase in the share of nursing home residents diagnosed with schizophrenia since 2012.

 There was no great innovation in detecting schizophrenia in 2012, but it happened to be the year that the federal government began requiring nursing homes to report prescriptions of antipsychotic drugs. Medicare uses that data in its public ratings of nursing homes, which are supposed to help families choose safe facilities for their loved ones. For decades the feds and watchdog groups have been trying to crack down on nursing homes abusing medications to keep residents in states of drug-induced torpor. (It costs less and requires fewer employees to take care of people when they’re stupefied.)

 The new public disclosure rule had a loophole, though: it didn’t include prescriptions for residents diagnosed with schizophrenia and two other uncommon conditions. In the years since the requirement went into effect, the share of residents with schizophrenia diagnoses rose seventy percent. The Times reported that now, one in nine nursing home residents has received a schizophrenia diagnosis, a disorder that only affects about one in one-hundred fifty people in the general population. The result of all this is that the true number of residents on antipsychotic medications is obscured, which also boosts nursing homes’ Medicare rating.

 I live in Florida, where scams of all varieties thrive: Medicare fraud, drug rehab kickback schemes, grafts. But for the past several years officials here in the Sunshine State have been dealing with the fallout from a disturbing scandal where a woman filed “do not resuscitate” (or D.N.R.) orders against the wishes of the elderly people whose care she was entrusted with by courts.

 The trouble started in May 2019, when the daughter of seventy-five-year-old Steven Striker filed a complaint with state authorities that her father had suddenly been placed in a guardianship against his will, and without notifying his family. AdventHealth, a local hospital network, had petitioned a court to find Stryker “incapacitated,” the legal term in the state for someone who lacks the mental wherewithal to make their own decisions. The complaint also said Stryker’s court-appointed guardian, Rebecca Fierle, had also filed a D.N.R. for Stryker.

 Many Americans became familiar with guardianships, also known as conservatorships, last year because of Britney Spears’s legal odyssey to regain her civil rights after she had an apparent mental health breakdown in 2008. In short, courts can appoint guardians to take over the financial and personal affairs of those who can’t take care of themselves—children, adults with disabilities, and the elderly. The guardian gains legal control over the ward’s healthcare decisions, property, and day-to-day life, and the ward loses much of what we consider adult autonomy and basic civil rights. Usually courts turn to family for this role, but when family is unavailable or unqualified, they turn to professional guardians.

 Four days after Stryker’s daughter filed her complaint, her father choked to death while hospital staff watched, legally restricted from saving him due to the D.N.R. order.

 Multiple state agencies began investigating Fierle following Stryker’s death and found she had regularly filed D.N.R. orders for her wards. Courts stripped her of all of her guardianship cases, and judges terminated all of the D.N.R. orders she had filed for other wards. Fierle had around four-hundred fifty wards spread across nineteen Florida counties when her little empire collapsed under scrutiny.

 Fierle’s downfall, though, revealed a deeper rot. The Orange County Comptroller found that AdventHealth had paid Fierle nearly four million dollars during the span of a decade and often specifically requested her to be appointed in guardianship petitions it filed. This conflict of interest was not disclosed to courts. Nor was it disclosed that Fierle was double-billing hospitals and wards’ bank accounts for her services. Investigators also found that AdventHealth lied in court about being unable to contact or even locate Stryker’s daughter.

 Hospitals have a financial incentive to discharge patients once their insurance coverage runs out, just as restaurants would rather flip tables rather than have customers linger. What multiple news investigations over the years found—the Miami Herald wrote about it in 1994—is that hospitals in Florida were filing guardianship petitions with dubious and overstated claims of elderly patients’ mental decline. The basic scheme, as critics describe it, is simple enough: once patients are placed in guardianships, they’re shuffled off to nursing homes. The guardian gets paid by the hospital and gets control over the ward’s assets, the nursing home gets a new resident, and the hospital gets an open bed.

 In the wake of the scandal, AdventHealth announced that it would no longer pay guardians and support reforms to the state’s guardianship laws. Fierle was arrested in February 2020 and charged with aggravated abuse and neglect of an elderly person. The Florida Department of Law Enforcement found that doctors who examined Stryker believed he was capable of making his own end-of-life decisions and “had a strong desire to live.” She has pleaded not guilty and is still awaiting trial.

 When Fierle’s office was searched, investigators recovered nine urns containing cremated human remains. There are plausible if not entirely satisfying explanations for why a guardian would have urns sitting around; they are responsible for funeral arrangements, and their wards sometimes don’t have immediate family nearby. But you can imagine what the newspaper headlines were like.

 This is what happens when the elderly are treated as nothing but a cost to mitigate or a resource to extract. We break a profound trust when we leave them to the wolves, after they cared for and defended us. And we set ourselves up for a hard reckoning. After all, we’ll have to grow old in this world, too.

 As for Mrs. Garner back in Colorado, prosecutors dropped the charges against her, writing that she “appears to be incapable of understanding her surroundings or her actions.” The city of Loveland settled her lawsuit for three million dollars. Probably a bargain. No sane city attorney would risk letting a jury decide how much to award her.

 Four Loveland officers resigned as a result of the scandal. Prosecutors filed criminal charges against Hopp for second-degree assault, attempting to influence a public servant, and misconduct. He initially pleaded not guilty, but this March prosecutors struck a plea deal with him, against the wishes of Garner’s family, that allowed him to plead guilty to only one count of assault. Garner’s family wanted to go to trial, believing they had an overwhelming case. They did, but not for the justice system.