Dr. Laura Mosqueda, “The Forensic Signs of Elder Abuse”


[Editor's note: We first published this page on 30 May 2011. Updated information and a Postscript were added 19 April 2012. ]


Following Saoirse's visit to her mom on December 3, 2009 (read about it here) she went to Dolores' doctor the following day. The GP was not available to her. A registered letter was sent a few days later to the GP, outlining Saoirse's concerns for her mother's safety and health, and asking the doctor to be alert to any signs of injuries or other signs of abuse. The letter was received, although never acknowledged at the time. (It was acknowledged after Dolores' death.) We do not know whether Dolores' GP ever suspected Elder Abuse when she presented with injuries, falls, unexplained weight loss, etc.

We do know that Ethan and Ronan instructed the doctor's office not to release any information about Dolores to any other family member. We do not know why the office would accept instruction concerning a patient from a third party. Perhaps Ethan claimed to have Power of Attorney over all of Dolores' affairs, a claim he made many times to various agencies. Let us state clearly: Ethan never had Power of Attorney in any form. If even a cursory check had been made of his claim, this would have been discovered by those he lied to. According to the Courts, it is illegal to make a false assertion of Power of Attorney.

The silence of Dolores' GP might be understood through doctor-patient confidentiality. We know that Dolores' was not one of the 5% of Elder Abuse victims who report the abuse themselves. It was with great surprise that the doctor's office learned of Dolores' hospitalisation and the concerns about the cause of it some six weeks after Dolores was admitted. “But she never said anything!” Saoirse had called the GP's office at that time to double check on anything her mom might be allergic to; Dolores was to shortly have her leg removed because of a blood clot. [Editor's note: Dolores actually visited this practice less than 48 hours before she was rushed to the hospital on September 26, 2010. More about that when we visit Dolores' last week in Rosslare.]

The Maxwell family used the same GP in Dublin for years and years, and it was under his encouragement that the family tried to address Ethan's abusive and violent behaviour. According to family members present at the time, Ethan was treated at St John of God Hospital, an acute psychiatric teaching hospital, while still a teen. Afterwards, the family doctor was changed several times.
Dolores had treatment at various doctors, hospitals and clinics in the eastern half of Ireland. This frequent changing of health providers is recognised as an indicator of abuse. Ethan is known to have registered her with false information, and because of the lack of computerization in the health field in Ireland, this made it nearly impossible to get a comprehensive view of Dolores' medical treatment. [Editor's note: has sight of some of this material. A complete view is being actively sought by interested parties.]


Mandatory reporting laws concerning abuse were first seen in the U.S. in 1980. Since then, many more countries and jurisdictions have passed laws concerning reporting of various types of abuse. See the FAQ, “Who Must Report Suspected Elder Abuse” for one example. Ireland has no mandatory reporting laws for abuse, although it has been considering the possibility of such since at least 1996. We think they are long overdue.

Maybe Dolores' Priest would help protect her.



Saoirse's registered letter to Dr Melissa Dudley following the events of 03 December 2009 was not acknowledged until 21 September 2011, during a telephone conversation between Saoirse and Dr Dudley. This was some ten months after Dolores died. You can view the letter here:

Following further attempts at communication with Dr Dudley which were not responded to, Saoirse wrote to her and Dr Snyder on 26 September, 2011. Dr Alvin Snyder appears to have been Cecil's GP. He responded to Cecil's death at the Maxwell's home in Rosslare, and signed his Death Certificate.

[Editor's note: At the time of this letter, Saoirse had come to the painful realization that Damian Brass, Dolores' solicitor, had been lying to her repeatedly concerning a wide gamut of issues concerning her Mother for quite some time. The HSE had lied to her, and done what they could to frustrate her attempts at understanding what happened to her mother, and Elder Abuse Services seemed to be committed to nothing more than protecting themselves when it came to Dolores' case. She was really in no mood to be fobbed off or stonewalled by anyone. The letter to Dr Dudley is pointed and frank. ]

Her letter to Dr Dudley:

Letter to Dr Dudley September 2011

Saoirse's letter was answered by Dr Alvin Snyder on 13 October 2011. Dr Snyder is no stranger to the issues of Elder Abuse in Ireland. A few years after he established the practice with Dr Dudley he entered politics, and Dr Alvin Snyder has served both in the Seanad and as TD in the Dáil. He is now a TD in the Fine Gael party. He has spoken often about issues affecting the elderly. Here are a few quotes from Dr Snyder TD concerning Elder Abuse:
  • “My gut instinct from what the Minister said in her statement is that everybody in the Department is politically correct in terms of being seen to do the right thing, have the right policies, put the right structures in place and, yet again, review the recommendations of a previous report but they are not really concerned about what is happening on the ground.”

  • “The Government has shown no leadership in dealing with elder abuse…”

  • “The majority of abuse is happening in the home and is caused by relations, family members and people who know the person.”

  • “One case officer to investigate all the cases and potential cases of abuse in a county is insignificant. It will not work.”

  • “Despite the number of organisations and strategy groups the Minister is establishing to examine the issue of elder abuse, my instinct is that the Minister is just going through the motions and being seen to do the right thing rather than actually doing the right thing.”

  • “It is not enough to have an inquiry or a whitewash report that gets a number of people off the hook. We need to change the way we see and do things within the health service when it comes to elderly abuse.”

  • “…up to recent times, there was a feeling that elderly abuse didn't exist in this country but I can assure you that, as a politician who keeps in very close contact with his constituents, I was aware that there was a problem out there… ”

  • “Elder abuse was never given the importance it deserved by this Government.”

  • “There has been total and utter neglect in the care of the elderly and this, especially the abuse of elderly patients, is a disgrace on the Government.”

  • “We will not stamp out all abuse, be it physical, emotional, sexual or financial. This is because it is far more ingrained within society than the Minister of State cared to admit in her contribution. The least we can do is to care, not to seem to care, and to try to do something about the issue.”
[Editor's note: In fairness, we should probably note Dr Snyder's above comments all occurred when his political party, Fine Gael, was not in power. Fine Gael won the 2011 election and became the “Government” in Ireland. Since then we can find no quotes or comments from Dr Alvin Snyder TD concerning Elder Abuse, hospital closures, conditions in nursing homes, or any other aspect of Elder Care. Of course, we are entirely open to correction.  Submissions

We realise there is a temptation to consider Dr Snyder's comments to be meaningless political noise from another ubiquitous talking head in Irish politics. We resist that temptation with all the resolve we can muster. ]

Having some background now in Dr Snyder's views on Elder Abuse while wearing his politician's hat, let's see his response to Saoirse's pissed-off letter while wearing his GP's hat:

Response from Dr Snyder

We note that Alvin Snyder failed completely to address any of the questions Saoirse asked about Dolores' care. Nor do we have any evidence that Alvin forwarded Saoirse's letter to any “appropriate authorities” or took any other action.

[Editor's note: In a yet to be released study by the Irish College of General Practitioners on Elder Abuse and Neglect, a large proportion of GP's support mandatory reporting regarding Elder Abuse. It is unfortunate mandatory reporting was not in effect during the times Dolores presented with lacerations, burns, broken bones, and bruising. It may very well have saved her life. Of all the referrals received by Elder Abuse Services in Ireland, only 4% come from GP's.

Perhaps Drs Dudley and Snyder feel entirely justified in their failure to take any action in Dolores' case. If so, we think that to be unsupportable. If Mandatory Reporting had been in place, it would have been a crime.] Advice from a Caterpillar - Illustration by John Tenniel, Alice in Wonderland by Lewis Carroll

“Shut up woman.”

“Don't ask questions.”

“Go away.”

It is a common response to questions posed in Ireland, no matter how they are expressed.



World Elder Abuse Awareness Day UN Declaration of Human Rights European Year for Active Ageing and Intergenerational Solidarity Towards a Society for All Ages