In nearly 25 years of protecting the public, Union County sheriff's detective Mike Justice has never been as disturbed as he was when he saw the malnourished body of Evelyn Cox.

Cox, 73, of Richwood, weighed just 63 pounds -- the size of an average 9-year-old girl -- when she died in June 2003.

But there was nothing childlike about her hollow cheeks, sunken eyes and almost mummy-like skin-and-bone appearance.

A coroner ruled that Cox had died of dehydration, starvation and pneumonia. In the last three months of her life, she was frequently found with multiple bedsores, in a urine-soaked bed crawling with ants, according to court records.

"I can remember it as if I had walked into the farmhouse just yesterday," Justice said. "It's chilling."

Related stories: Advocates seek more funds to fight elder abuse -- More help needed for Ohio's abused or neglected seniors

Seven months before she died, Cox weighed 114 pounds. But she had dementia and Parkinson's, and her son, Dennis "Jim" Cox, 54, and his daughter-in-law, Lisa Cox, 26, had been caring for her.

She was bedridden and hadn't eaten or taken her medication for a few days, her family told investigators after her death.

An autopsy showed that Cox had quarter- to baseball-size bedsores on her buttocks, hips, back, shoulders, ankles and feet. Some were infected and openly draining.

"It was truly shocking," said Dr. David Applegate, the Union County coroner. "She looked like she had been in a concentration camp."

Court records show that Dennis Cox did not allow his mother to be treated by doctors or put in a nursing home and that he did not give her food, water or nutritional supplements, even after medical professionals voiced concerns about her rapid decline.

As the population of older Americans grows, so does the problem of elder abuse, exploitation and neglect. Every year, an estimated 4 million older Americans are victims.

One form is the type of physical neglect that Evelyn Cox experienced, said Union County Prosecutor David Phillips, who helps train law-enforcement officers and others about the topic.

The culprit is usually a family member, often an adult child who is providing care, he said. Money is generally the motive, whether it's millions in retirement savings or a monthly Social Security check.

Because older adults are usually too afraid, embarrassed or helpless to call for help, the problem of elder abuse remains largely hidden, Phillips said. Even when cases are reported, many victims won't see justice.

The month Cox died, the Adult Protective Services agency in Union County received a complaint about a skin condition caused by lying in urine, according to law-enforcement records. A home health nurse put a catheter in Evelyn, and program officials decided the issue had been resolved, documents show.

Whenever anyone raised concerns about Evelyn's condition while she was still alive, Lisa and Dennis Cox said she was fine and eating well. But on several occasions, home health workers found her soaked in urine, with festering bedsores.

When pressed, Lisa Cox told them she was overwhelmed and worn down trying to keep up with both Evelyn and Lisa's 2-year-old son.

Lisa Cox said she asked her father-in-law for more help, but he refused.

Six days before Evelyn died, Dennis Cox presented doctors with a do-not-resuscitate order. They again urged Mr. Cox to place Evelyn in a nursing home, where they might be able to reverse her downward slide, but he refused, records show.

Neither Dennis nor Lisa Cox could be reached for comment last week.

In February 2008, Dennis and Lisa Cox were charged with involuntary manslaughter in Evelyn's death, but prosecutors later dropped that charge, thinking the medical evidence wasn't strong enough.

Three months later, Dennis and Lisa Cox pleaded guilty to a charge of failure to provide care for a functionally impaired person, a fourth-degree felony. Both were sentenced to three years' probation and 200 hours of community service. They were fined $1,000 apiece.

They now own Evelyn's house and 26-acre farm.

Authorities say the typical physical abuser of the elderly is a man in his late 30s to mid-40s, living at home with his aging parents. Lazy and unemployed, he usually has substance-abuse problems -- alcohol or drugs -- which he supports by sponging off of mom or dad.

Paul J. Roberts, 43, fits that profile to a T, officials said.

Last spring, Roberts was sentenced to 20 years in prison for beating his father, Paul E. Roberts, 63, to death with a hatchet-hammer. He hid the body in an old, unused well under his father's house in Glouster in Athens County. The body wasn't found until nearly three weeks later.

"It was a grisly killing," said Keller Blackburn, the Athens County prosecutor.

Blackburn said Roberts was a heroin addict who lived with his dad and had bullied, threatened and swindled him for years. He admitted to stealing his father's Jeep Liberty, Harley motorcycle, John Deere riding mower and credit cards, Blackburn said. He also used his father's identity to cash checks.

"He'd tell his doper friends to give him $30 in cash to buy drugs and he'd give them $50 in gas" via the credit cards, Blackburn said.

Authorities discovered that something was amiss at the house after the hot-water heater had been yanked out and water was pouring all over the place, Blackburn said.

The younger Roberts and his wife, Rhonda Degarmore, later admitted to taking the water heater, a scooter, refrigerator and other items to sell for scrap to buy drugs.

"I think his dad both loved and feared him," said Jay Barrett, an investigator for the Athens County prosecutor's office. "He was trying to help him, but he ended up enabling him."

Roberts told investigators that he snapped and killed his father because his dad said he was going to throw Degarmore out of the house.

Degarmore, 38, who also was a heroin addict, pleaded guilty to felony counts of theft, receiving stolen property and obstructing justice. She agreed to testify against her husband and was sentenced to four years and 11 months in prison.

"It's extreme that he killed his father," Barrett said. "Most drug-addict children just keep stealing from mom and dad, a little here, a little there, so they can milk it as long as possible."

One goal for authorities is to uncover abusive situations while there's still time to help.

When police in Lima, in northwestern Ohio, responded to a call by a 77-year-old woman about a theft in January 2012, they were shocked at her living conditions.

They found her in an unfurnished apartment with just a mattress on a floor littered with dog feces. She told them that her grandson had moved her there from Kentucky and had left her with little food and no furnishings.

"It wasn't good conditions at all -- I had nothing," said Barbara, who asked that her last name be withheld for fear of retribution.

A few days before she called police, she was so desperate that she had knocked on doors in the neighborhood to find someone to help her.

"I was so hungry, I couldn't stay there any longer," she said. She didn't have shoes or a coat to protect her from the winter cold.

Police suspected that the woman's grandson was trying to take advantage of her $853-a-month Social Security benefits, food stamps and utility subsidies. But she didn't want to press charges.

"I guess he was hard up for money, I don't know," she said. "I just wanted help."

Officers took Barbara to a local hospital, where she was admitted for infections and other medical conditions that had gone untreated. They also called Crime Victim Services, a nonprofit agency in Lima with a program to help elderly victims.

Executive Director David Voth said his agency, in turn, called Allen County's adult-protective-services workers. Once Barbara was out of the hospital, she was taken to a domestic-violence shelter. With the help of many, she then was moved into an apartment -- with furniture -- in a senior-citizen building.

A volunteer for Crime Victim Services helped Barbara set up automatic deposit of her checks and payment of her bills so she doesn't have to worry about her money.

Barbara said she has made friends and enjoys going on shopping trips.

She likes her new home. "I'm sleeping on a bed now," she said.

epyle@dispatch.com

@EncarnitaPyle

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