James Kirkland, who ran for the Montgomery County Council last year, stands accused of abusing his 87-year-old mother after she arrived at a hospital with pressure ulcers so bad that her spine was exposed. (WUSA9)

To Montgomery County detectives, the care that James Kirkland provided to his 87-year-old mother — who had pressure ulcers so severe that her spine was exposed — amounted to felony abuse of a vulnerable adult.

To Kirkland, the situation is more nuanced and complicated.

And to those who work with the nation’s rapidly aging population, the case may be a demonstration of the kind of misfortune they expect to become more common.

“We don’t have systems in place for abuse and neglect not to happen,” said Mary Twomey, until recently co-director of the National Center on Elder Abuse. “As a country, we haven’t woken up to the fact that this is not sustainable.”

Twomey said there is a range of people who get caught up in such cases — from the cruel and uncaring to the saintly and overwhelmed. There are many factors that can come into play: mental health, financial means, trying to think through what the older person wants. The caregivers are often family members and are more apt to be guilty of neglect than more overt forms of abuse, she said.

BETHESDA, MD - MAY 6: James Kirkland is accused of neglecting his 87-year-old mother, who lives with him in Bethesda. She was hospitalized recently with pressure ulcers on her back and legs. The Bethesda home where James Kirkland and his mother live was described by police as "extremely messy" inside. (Photo by Dan Morse/The Washington Post) (Dan Morse/TWP)

“The sins of omission are more common than the sins of commission,” Twomey said.

Kirkland, the suspect, puts it this way: “End of life issues are tough for all families. I did the best I could.”

His mother remains hospitalized in very serious condition, a Montgomery County police spokesman said Friday.

Meanwhile, the home on Beech Avenue in Bethesda where she and her son lived has been condemned as a result of the case, Montgomery officials said Friday.

Housing code inspectors cited excessive clutter, hoarding conditions, non-working toilets, mold, an absence of working smoke detectors and overall “extreme” fire hazards. No one will be allowed to live in the home until repairs are made, officials said.

Kirkland has been charged with two criminal counts: Abuse resulting in serious injury to a vulnerable adult, and abuse to a vulnerable adult under his care. He posted a $10,000 bond and awaits a May 29 court date. He has described himself in the past as a part-time yard worker.

According to arrest records, Kirkland’s mother arrived by ambulance at Suburban Hospital on Friday. She was found to have large pressure ulcers on her back and legs. Social workers and detectives were summoned.

“Hospital staff stated these wounds were packed with newspaper and a powdery substance,” police wrote in charging documents. “When the staff removed the newspaper from the area, the victim’s spine could be seen. Furthermore, on both of [the victim’s] feet were compression socks that were on her for such a long period of time that they were fused to her feet. Both socks had to be removed surgically.”

Detectives spoke to the victim at her bedside in the hospital. She said her son had been at the hospital earlier but had left.

Several officers went to the Beech Avenue home and found Kirkland there. They asked him to step outside while they went in to search.

“The home was extremely messy and very hard to navigate,” detectives said.

They spoke further with Kirkland. He told them that he was his mother’s primary caregiver and that she had seen a doctor for wound care several months earlier.

He told detectives that “he feeds his mother soup on wheat bread, tuna fish or they split a can of fruit,” according to court records. Kirkland said he was responsible for changing his mother’s diapers.

Kirkland has been in the news before.

Last year, he ran for the Montgomery County Council. In a video statement that he provided to myMCMedia, he said he was running “to support truck owners, car enthusiasts, single people, millennials and the nightlife community — the kind of people who have been given the short shrift by the Democrat monopoly on the County Council.”

During the campaign, an anti-Semitic e-mail he had written surfaced; in it, he blamed a Jewish couple in his neighborhood for filing an anonymous complaint about his roof and said that Jews were responsible for half the county’s property code complaints.

Along Beech Drive, his home, with its heavy foliage obscuring the front door, stands out because of what it doesn’t have: Well-maintained shrubbery and a lush and open front lawn. Five old cars are parked in the driveway or along the street outside his home.

Kirkland said he summoned the paramedics to get his mother. “I did call because I thought it was time to call. She did not want to go,” he said.

He denied at least part of the police case against him.

“I dispute some of the allegations in the charging documents,” Kirkland said.

Shortly before he called the paramedics, he said, he had trouble putting on his mother’s diapers.

He also had grown concerned about the compression socks on his mother’s legs and how she would have reacted to him changing them. “It would have been very painful to take them off and put them back on,” he said.

Twomey, the elder abuse expert, said that government systems in place tend to be reactive rather than preventative. One example: There are few places where caregivers can take an older person for a week so the caregivers can have a respite.