(AP) — A Pennsylvania woman and her two daughters have been charged in the neglect-related death of their 32-year-old son and brother with Down syndrome.

Police say Robert Gensiak weighed just 69 pounds and was covered in scabies at the time of his death March 20. He was taken to the hospital a day earlier because he was semi-responsive and couldn’t stand up.

Authorities say 59-year-old Susan Gensiak and her daughters, 35-year-old Joan and 24-year-old Rebekah, were charged Wednesday with third-degree murder, involuntary manslaughter and neglect of care for a dependent person.

The victim reportedly hadn’t received any medical treatment since 2009.

The suspects said little to reporters as they were led into their arraignment.