It’s no way to live, and it’s a horrible way to die.

“The photos of the death scenes are even worse, to see what state people are left to die,” Dr.  Carmel Dyer said.

The victims? Elderly people.

The places? Their own homes here in Houston.

So who is to blame?

“Nobody wants to think that their son or daughter could do this,” UT-Houston’s Dr. Dyer said. But he said they’ve seen it over and over again.

The people who abuse or neglect the elderly are almost always someone who knows them, often their own children or grandchildren who were supposed to be looking out for them.

Take the case of a 78-year-old woman who lives in Pasadena. On a Sunday two weeks ago, she came to her church, her arm in a cast.

Her pastor prodded her: How did it happen?

She eventually said a man twisted and broke her hand. He is her son, and court records indicate it’s his second arrest for injuring an elderly person.

The fact that this alleged case of elderly abuse was caught then reported makes it unique. Researchers believe many such cases, especially when they happen in people’s homes, are never reported. But there is work under way in Houston to change that.

One place they’re starting is where abuse sometimes so tragically ends: the county morgue.

“We are talking about abuse and neglect that is so severe that it causes people to die as a result,” Dr. Dyer said.

Dr. Dyer is heading up one of the most aggressive studies of its kind in the country. They’re re-examining dozens of autopsies done on elderly people where abuse had been suspected but usually not prosecuted. They want to see if there are patterns of injuries or conditions that might have been overlooked.

“Why did this person die?” Angela Goins said. “What can we do to prevent this from happening again?”

Goins and the caseworkers with the state’s Family Protective Services are often the first investigators on the scene.

“They’re the perfect victims because they’re vulnerable,” she said.

Vulnerable just like children, but unlike with child abuse, there are far fewer investigators specializing in it and no standards to help establish what social workers or doctors or police should look for.

The work of Dr. Dyer is aimed at changing that.

Already, Texas has responded with increased funding for more caseworkers.

Still, researchers believe only a tiny fraction of abusers are ever prosecuted.