A 48-year-old woman accused of severely neglecting a Frankford woman in her care has been charged with murder.

Prane Paciunas, 89, died Nov. 15, eight days after she was found dirty, emaciated, and suffering from open, maggot-infested sores at her home on the 2100 block of Haworth Street in Frankford. One of the sores was so severe that bones were exposed, police said.

Jean Dombrowski, Paciunas' caretaker, was initially charged with aggravated assault, neglect of care, and related charges. She now faces an additional murder charge after a medical examiner ruled Paciunas' death a homicide.

According to a medical examiner's report, Paciunas died of a blood infection caused by bedsores. The report found that she was also suffering from malnutrition, dehydration, hardening of the arteries, and hypertensive cardiovascular disease.

Prosecutors have called the case one of the worst incidents of elder abuse they have seen.

"This is an outrageous set of facts in terms of the conditions this poor woman was suffering under," said Jennifer Selber, who heads the district attorney's homicide unit.

According to a police report and law enforcement sources, Dombrowski told investigators she became Paciunas' caretaker six years ago and had been cashing her charge's Social Security checks with her permission.

After her arrest on assault charges, she told police she had not been providing Paciunas' basic needs and knew that was why her health was failing.

Dombrowski's bail on the assault charges was set at $2 million. She was denied bail on the murder charge on Wednesday, according to court documents.

awhelan@philly.com

215-854-2961 @aubreyjwhelan