TAYLOR - For two years, Robert Gensiak's world was his bedroom.

It was there, his family kept him from doctors, even when his skin cracked and bled and open sores formed from being forced to stay in his child-sized bed covered in feces.

And it was there, the 32-year-old Taylor man with Down syndrome wasted away to 69 pounds because his mother and sisters were starving him to death.

On Wednesday, about three months after Gensiak died, police charged his mother, Susan Gensiak, 59, of 12 Williams St., and two sisters, Joan, 35, and Rebekah, 24, with murder.

"This is the worst case of neglect I've seen the last 26 years," said Lackawanna County District Attorney Andy Jarbola at a press conference Wednesday. "This family, the mother and two sisters, basically let this young man rot to death."

Gensiak had been weakening and could not walk without assistance by the time the family called an ambulance on March 19 at the urging of his doctor, Paul Remick, D.O., whom they had not taken Gensiak to visit for two years. Gensiak was taken to Regional Hospital where doctors said he had severe psoriasis associated with hypothermia. His body temperature was only 92 degrees.

He died March 20, and weighed just 69 pounds, police said.

An autopsy conducted by forensic pathologist Gary W. Ross, M.D., revealed an extreme case of neglect. Autopsy photos show his skin was a sickly yellow with cracked areas that had oozed with blood and fluid. Open sores pockmarked his body, so extreme in spots that his bone was visible.

The remaining teeth he had were loose and ready to fall out. Lice covered his head. Dr. Ross found no food or significant fluid in his stomach.

"It's amazing to me that anyone could allow someone to go through this type of pain and torture," Jarbola said.

His official cause of death was sepsis, due to the breakdown of his skin, plagued by a widespread infestation of Norwegian scabies. His open sores and malnutrition also contributed to his death, Dr. Ross said.

Lackawanna County Coroner Tim Rowland ruled the manner of death as homicide due to neglect.

The house itself did not appear overtly dirty, but it was cluttered, investigators said. At a glance, there would be no indication that there was anything seriously wrong.

But when investigators opened the back bedroom where Gensiak was kept in seclusion, an overwhelming wave of human waste washed over their sense of smell, Detective Castellani said.

Detective Castellani described Gensiak's room as a scene of utter filth. The youth size bed he had to sleep on was covered in fecal stains, as was a chair he would sit on. Additional fecal stains littered the room.

On March 25, police and Children and Youth officials took Joan Gensiak's 2-year-old daughter, fearing her well-being because the home was riddled with scabies, lice and possibly ringworm. Joan Gensiak told police that Dr. Remick had diagnosed her toddler with scabies but she didn't agree with the diagnosis so she refused to use the medication prescribed.

Instead, she decided to treat her daughter's rash with baby oil.

The child was taken to the emergency room of Moses Taylor Hospital where she received treatment for scabies.

Jarbola said he does not believe the house has been condemned.

The day after Gensiak's death on March 20, Taylor Police Officer Stephen Derenick, Lackawanna County Detective Renee Castellani and Paula Welsh, aging care manager for the Area Agency on Aging, paid Gensiak's family a visit to find out how his health had deteriorated so drastically.

Joan Gensiak described herself as her brother's caregiver, having moved into the home with her toddler to help her mother and her sister. The three confirmed Gensiak had not been to a doctor in two years, that he had Down Syndrome and psoriasis, but denied he had any other medical conditions. They said his psoriasis had been taking over his upper chest, back and feet for the last two weeks, but they were treating his condition with over-the-counter ointments and creams. They had no means of transportation, so they could not get medical treatment for him, they told investigators.

When his condition worsened, they were finally forced to call Gensiak's doctor, who urged them to call an ambulance and take him to the hospital.

Family members expressed concern that if they placed Gensiak in a personal care facility, the financial support they received from his Social Security benefits would dry up.

Before the end of the interview, investigators said Gensiak's mother asked if she would still receive her son's Social Security check even though he died.

Police charged Susan, Joan and Rebekah Gensiak Wednesday with third-degree murder, involuntary manslaughter and neglect of care for a dependent person. Joan Gensiak was also charged with endangering the welfare of a child. The toddler is in custody with Lackawanna County's Children and Youth Services. Rebekah Gensiak is roughly eight months pregnant.

All three were arraigned before Magisterial District Judge Paul J. Ware on Wednesday afternoon after their arrest and were sent to Lackawanna County Prison. Joan and Rebekah Gensiak are held in lieu of $250,000 straight bail. Susan Gensiak is held in lieu of $350,000 straight bail.

Preliminary hearings are scheduled for the three on June 26 at 11 a.m.

"To let him suffer the way in which this young man did ... it's horrific in my mind," Jarbola said.

Contact the writer: jkohut@timesshamrock.com