Kennedy, J.
Appellant Jai-Mar Eli Scott appeals his exceptional sentence for first degree murder, contending that (1) the court's findings of fact and conclusions of law in support of the sentence are erroneous, (2) the court's findings are legally insufficient to support an exceptional sentence, and (3) the sentence is clearly excessive. We affirm.
Facts
1. Procedural Facts.
Scott was charged by second amended information with murder in the first degree, in violation of RCW 9A.32.030-(l)(a) and (c). Scott was tried by a jury on August 16-28, 1990. The jury found him guilty of premeditated murder pursuant to RCW 9A.32.030(l)(a) and felony murder pur[210]*210suant to RCW 9A.32.030(l)(c). The jury returned a special interrogatory finding that the murder was committed in the course of, in furtherance of, or in immediate flight from robbery in the first degree and attempted rape in the first degree.
Scott's offender score was O. His standard sentencing range was 240 to 320 months. The court imposed an exceptional sentence of 900 months.
The court entered written findings of fact and conclusions of law setting forth the reasons for its departure from the standard sentencing range, specifically (1) abuse of trust, (2) the victim's particular vulnerability, (3) deliberate cruelty, and (4) multiple injuries inflicted in the commission of the crime.
Scott filed an appeal of the judgment and sentence on October 4, 1990, cause 27017-6, and an appeal of the court's order of restitution on July 8, 1991, cause 28921-7. The two appeals were consolidated under cause 27017-6 on September 6, 1991. Scott presents no arguments concerning his appeal of the restitution order.1
2. Substantive Facts.
On September 27, 1989, Agnes Jackson, age 78, was murdered in her home located at 8312 Wolcott Avenue South in Seattle. Ms. Jackson, who suffered from Alzheimer's disease, lived alone.
Police investigation revealed that the murderer did not use force to gain entry into the house. There were signs of violence, including bloodstains and displaced items in Ms. Jackson's living room and in both bedrooms of the home.
Ms. Jackson's body was found by neighbors in the back bedroom. Her face was badly beaten and a telephone cord was bound tightly around her neck. The victim was naked from the waist down and her blouse and sweater were pulled [211]*211up to the base of her breasts. Stray hairs and two burnt matches were collected from Ms. Jackson's abdomen.
Detective Lima theorized that the murderer used matches as a source of light during the attack. Numerous matchbooks and burnt matches were found throughout the residence. The contents of Ms. Jackson's wallet were strewn about on the living room couch. Her checkbook, which was found on her bed, had been opened.
Latent fingerprints were lifted from different locations within the home. One bloody fingerprint was located in the back bedroom/storage area where the victim was located. This print was found on a wall approximately SV2 feet from the floor. Next to this print was a bloody afghan, which had been placed over the window. The afghan normally was kept on the living room couch.
An autopsy by the King County Medical Examiner's Office attributed Ms. Jackson's death to ligature and manual strangulation. Ms. Jackson suffered six fractures to her neck, including a fracture through the neckbone to the back of the cervical spinal column. The autopsy also revealed the following head injuries: three fractures to the right eye and cheekbone, a subdural hemorrhage, a fracture to the base of her skull, and two gaping lacerations to the top of her head. An internal examination disclosed eight rib fractures. The autopsy also revealed a faint contusion on the mons pubis. Dr. Fitterer testified that all of the injuries looked as though they had occurred prior to the victim's death.
The police concluded that the victim's own cane and a broken and bloody glass candy jar lid were used as weapons in the attack.
Scott had lived next door to Ms. Jackson for 2 years. His mother, Elizabeth White, took care of Ms. Jackson for $100 a week. Because of this arrangement, Scott often did chores for Ms. Jackson and had access to the inside of her home.
On September 28, 1989, the police matched one of the latent fingerprints lifted from the victim's home to Scott's [212]*212fingerprint. Police executed a search warrant of Scott's home and seized two bloody socks, a T-shirt with bloodstains, and tennis shoes. Scott's fingerprints were also matched to prints found in various parts of the victim's home.
Pubic hairs which were removed from the victim's body and clothing contained the same microscopic characteristics as Scott's hairs. Blood comparison tests confirmed that the blood on Scott's socks and shirt was consistent with the victim's blood and not Scott's. Police also found numerous burnt matches throughout Scott's bedroom and the same brand of matchbook that was found in the victim's home. Finally, a bloody shoe print photographed at the scene was consistent with the size, tread pattern, and wear pattern of tennis shoes belonging to Scott.
Discussion
I
Justification for the Exceptional Sentence Scott contends that the record does not support an exceptional sentence. We disagree.
RCW 9.94A.120, "Sentences", provides that:
When a person is convicted of a felony, the court shall impose punishment as provided in this section.
(2) The court may impose a sentence outside the standard sentence range for that offense if it finds, considering the purpose of this chapter, that there are substantial and compelling reasons justifying an exceptional sentence.[2]
[213]*213Appellate review of an exceptional sentence involves a 3-step process:
(1) are the trial court's reasons supported by the record, (2) do the stated reasons justify an exceptional sentence as a matter of law, and (3) did the trial court abuse its discretion by imposing a sentence that is "clearly excessive" or "clearly too lenient"?
State v. Grewe, 117 Wn.2d 211, 214, 813 P.2d 1238 (1991); see also State v. Allert, 117 Wn.2d 156, 163, 815 P.2d 752 (1991) ; State v. Dunaway, 109 Wn.2d 207, 218, 743 P.2d 1237, 749 P.2d 160 (1987).
The trial court's findings regarding the presence of aggravating factors, being a factual determination, must be upheld unless clearly erroneous. Grewe, at 218 (citing State v. Nordby, 106 Wn.2d 514, 517-18, 723 P.2d 1117 (1986)). See also State v. Spisak, 66 Wn. App. 813, 820, 834 P.2d 57 (1992) . "We will reverse the trial court's findings only if no substantial evidence supports its conclusion." Grewe, at 218 (citing Burba v. Vancouver, 113 Wn.2d 800, 807, 783 P.2d 1056 (1989)).
In contrast, the review of the legal adequacy of the aggravating factors to justify a departure from the standard range is a question of law. Dunaway, 109 Wn.2d at 218; State v. Post, 118 Wn.2d 596, 614, 826 P.2d 172, 837 P.2d 599 (1992); Spisak, 66 Wn. App. at 820-21. An aggravating factor is legally adequate to justify a sentence outside of the stan[214]*214dard range as long as the aggravating factor was not necessarily considered by the Legislature in establishing the standard range, and as long as the asserted aggravating factor is "sufficiently substantial and compelling to distinguish the crime in question from others in the same category." (Citations omitted.) Grewe, at 216. See also Nordby, 106 Wn.2d at 518; State v. McAlpin, 108 Wn.2d 458, 463, 740 P.2d 824 (1987).
Deliberate Cruelty
Scott contends that the record does not support a finding that he exhibited deliberate cruelty. He also asserts that serious bodily injury is inherent in murder and the depravity of this crime does not go beyond that generally associated with premeditated murder. We disagree with Scott's factual and legal conclusions.
RCW 9.94A.390(2)(a) permits an exceptional sentence where "[t]he defendant's conduct dining the commission of the current offense manifested deliberate cruelty to the victim." Deliberate cruelty consists of gratuitous violence or other conduct which inflicts physical, psychological, or emotional pain as an end in itself. State v. Strauss, 54 Wn. App. 408, 418, 773 P.2d 898 (1989); State v. Kidd, 57 Wn. App. 95, 106, 786 P.2d 847, review denied, 115 Wn.2d 1010 (1990). The extreme conduct must be significantly more serious or egregious than typical in order to support an exceptional sentence. State v. Holyoak, 49 Wn. App. 691, 696, 745 P.2d 515 (1987), review denied, 110 Wn.2d 1007 (1988).
Scott's conduct went well beyond what was necessary to establish premeditated or felony murder in the first degree. The victim was elderly, weak, and had diminished mental faculties. Scott could easily have killed her by strangulation, which he did, but only after physically and sexually assaulting her. The medical examiner found that the manual and ligature strangulation were separate acts of violence. The first act of strangulation and/or any of the blows to the victim's head were sufficient evidence upon which to base a finding of premeditation. All of the other blows to the head, face, and ribs, which occurred in three different rooms and [215]*215resulted in 20 broken bones, were additional violent acts separate from the premeditation and the final strangulation.
Scott contends that the cases finding deliberate cruelty involved prolonged attacks or lingering suffering. See State v. Harmon, 50 Wn. App. 755, 757-59, 750 P.2d 664 (defendant cut victim's throat three times during a period extending over a number of hours and bragged that victim was "jumping around like a chicken with his head cut off"), review denied, 110 Wn.2d 1033 (1988); State v. Campas, 59 Wn. App. 561, 799 P.2d 744 (1990)3 (defendant repeatedly bludgeoned and stabbed victim, leaving her barely alive and in pain and agony until she died the next day).
Here, the record supports a finding of a prolonged attack by Scott and lingering suffering by the victim. It took time to break 20 bones, strangle the victim twice, and sexually assault her. The evidence that the assaults occurred in three different rooms also suggests a prolonged attack and lingering suffering.
In sum, the record supports a finding that Scott's conduct exhibited deliberate cruelty. Deliberate cruelty is an aggravating factor which justifies an exceptional sentence as a matter of law. RCW 9.94A.390(2)(a).
Premeditation and Multiple Injuries
Scott contends that the court's findings of multiple injuries were used to establish premeditation, and thus, cannot be used to justify an exceptional sentence. We disagree.
Granted, factors already considered in setting the presumptive sentencing range for the crime cannot be a basis for an exceptional sentence. Nordby, 106 Wn.2d at 578; State v. Payne, 58 Wn. App. 215, 219, 795 P.2d 134, 805 P.2d 247 (1990). However, courts repeatedly have found that infliction of multiple injuries may justify an exceptional sentence. State v. Armstrong, 106 Wn.2d 547, 550, 723 P.2d 1111 (1986) ("infliction of multiple injuries in the course of a second degree assault is a factor upon which a court may rely to justify an [216]*216exceptional sentence"); State v. Dunaway, 109 Wn.2d at 219 (holding that multiple incidents justified an exceptional sentence where defendant shot victim, partially left the room, and returned to shoot him again, thereby inflicting multiple injuries in the course of attempted first degree murder). See also State v. Warren, 63 Wn. App. 477, 479, 820 P.2d 65 (1991) (where defendant was guilty of third degree assault, court held that "multiple injuries standing alone can be used to enhance a sentence"), review denied, 118 Wn.2d 1030 (1992); State v. George, 67 Wn. App. 217, 222, 834 P.2d 664 (1992) (where defendants were guilty of first degree robbery, first degree assault, and rape, repeated blows and multiple injuries to victim justified an exceptional sentence), review denied, 120 Wn.2d 1023 (1993); Campas, 59 Wn. App. at 566 (where defendant was convicted of felony murder in the first degree, court held repeated blows and multiple injuries to victim justified exceptional sentence).
In State v. Franklin, 56 Wn. App. 915, 786 P.2d 795 (1989), review denied, 114 Wn.2d 1004 (1990), the crime of attempted first degree murder was found to be established upon a showing of premeditation and the first stabbing. The second stab wound to the victim was found to be deliberate cruelty. Franklin, at 919.
Similarly, in the present case the first strangulation and/ or any number of the blows to the head establish premeditation prior to Scott's killing of Ms. Jackson by the final strangulation. The additional blows took the attack beyond that ordinarily associated with premeditated murder, and therefore, justify the exceptional sentence on the factor of multiple injuries.
Scott also asserts that the multiple injuries merged with the murder conviction, and thus, those injuries cannot also be used to support an exceptional sentence. Again, we disagree.
Perhaps the State would have been barred from seeking convictions for homicide and assault under the merger doctrine. That determination would involve consideration of the defendant's intent from one crime to the next, whether one [217]*217crime furthered the next crime, and whether the time and place remained the same for both crimes. State v. Collicott, 118 Wn.2d 649, 827 P.2d 263 (1992), setting aside State v. Collicott, 112 Wn.2d 399, 771 P.2d 1137 (1989).
However, State v. Drummer, 54 Wn. App. 751, 759, 775 P.2d 981 (1989) held that torture prior to murder is not encompassed in the crime of first degree murder. Here, the murder itself pccurred by strangulation. The repeated blows, were additional torture, which was not encompassed by the murder.
In sum, even if the jury relied on one or more of the blows prior to the last strangulation to find premeditation, the trial court could still use the multiple injuries as an aggravating factor justifying an exceptional sentence.
Victim Vulnerability
Scott contends that Ms. Jackson's age did not make her particularly vulnerable to this type of crime. We disagree. An exceptional sentence may be justified where
[t]he defendant knew or should have known that the victim of the current offense was particularly vulnerable or incapable of resistance due to extreme youth, advanced age, disability, or ill health.
RCW 9.94A.390(2)(b).
Particular vulnerability has been found where the victim was elderly and the defendant young. See George, 67 Wn. App. at 221-22 (stating that age of 77-year-old victim, as a matter of law, justified an exceptional sentence); State v. Hicks, 61 Wn. App. 923, 930, 812 P.2d 893 (1991) (where defendant was 17 and victims over 70, court found particular vulnerability and exceptional sentence justified).
Here, the victim was 78, suffered from Alzheimer's disease, was in need of a cane to walk, and was in need of daily care and supervision, facts which were well known to Scott. Clearly, she was unable to protect herself from Scott. The record supports the court's finding of particular vulnerability. Particular vulnerability, as a matter of law, justifies an exceptional sentence.
[218]*218Position of Trust
Scott asserts that the record does not support a finding that he used his position of trust to facilitate commission of the crime. We disagree.
Another aggravating factor warranting departure from the sentencing guidelines is the "defendant us[ing] his or her position of trust, confidence, or fiduciary responsibility to facilitate the commission of the current offense." RCW 9.94A-.390(2)(c)(iv). See also State v. Russell, 69 Wn. App. 237, 252, 848 P.2d 743 (finding parent's violation of trust relationship with child an aggravating sentencing factor where parent was convicted of homicide of child by abuse), review denied, 122 Wn.2d 1003 (1993); State v. Creekmore, 55 Wn. App. 852, 868-69, 783 P.2d 1068 (1989) (finding victim's extreme youth, abusé of trust, and lack of remorse aggravating factors for the crime of homicide by abuse), review denied, 114 Wn.2d 1020 (1990). Here, the record supports a finding that Scott had developed a trust relationship with Ms. Jackson and used that trust to gain access to the victim's home for the purpose of killing Ms. Jackson.
Scott's mother was paid to care for Ms. Jackson. As an agent for his mother, Scott did chores for Ms. Jackson and helped with home repairs. The evidence showed that Scott had access to Ms. Jackson's home and that his entry the day of the murder was not forced. This was another proper basis for the trial court to give Scott an exceptional sentence.
'Defendant's Age as a Mitigating Factor
Scott asserts that his youth, 17 years old at the time of the crime, limited his "capacity to appreciate the wrongfulness of his conduct or to conform his conduct to the requirements of the law," RCW 9.94A.390(l)(e),4 and thus, the exceptional sentence was improper. This argument borders on the absurd.
[219]*219Granted, teenagers are more impulsive than adults and lack mature judgment. However, Scott's conduct cannot seriously be blamed on his "lack of judgment", as he contends. Premeditated murder is not a common teenage vice.
1-Year Sentence for Each Year of the Victim's Life
Scott contends that the trial court improperly used the victim's age, 78 years, to arrive at the exceptional sentence of 75 years. The State did recommend a sentence of 78 years, which defense counsel (not the prosecutor) stated was 1 year for every year of the victim's life. The court's basis for the exceptional sentence was (1) deliberate cruelty, (2) the vulnerability of the victim, (3) the violation of the trust relationship, and (4) the multiple injuries. There is no evidence that the court improperly used the victim's age to determine the sentence.
II
Clearly Excessive
Scott contends that the sentence is clearly excessive because he had no prior offenses, an offender score of 0 and, even if he had had three prior first degree murder convictions, his sentencing range would only have been 411 to 548 months. In view of the aggravating factors, we do not find the sentence to be clearly excessive.
Once the sentencing court finds substantial and compelling reasons for imposing an exceptional sentence, the court is permitted to use its discretion to determine the precise length of the sentence. The length of an exceptional sentence is reviewed under the abuse of discretion standard. State v. Pryor, 56 Wn. App. 107, 118, 782 P.2d 1076 (1989) (citing State v. Oxborrow, 106 Wn.2d 525, 530, 723 P.2d 1123 (1986), aff’d, 115 Wn.2d 445, 779 P.2d 244 (1990); State v. George, 67 Wn. App. at 227.
An exceptional sentence is "clearly excessive" (1) if it is imposed on untenable grounds or for untenable reasons, (2) if it is manifestly unreasonable, Oxborrow, 106 Wn.2d at 530, or (3) "if no reasonable person would impose it". Creekmore, 55 Wn. App. at 863 (citing State v. Nelson, 108 Wn.2d [220]*220491, 504-05, 740 P.2d 835 (1987)); State v. Pascal, 108 Wn.2d 125, 138-39, 736 P.2d 1065 (1987); State v. Armstrong, 106 Wn.2d at 550.
Although the standard of review regarding whether an exceptional sentence is excessive is abuse of discretion, ”[t]he length of an exceptional sentence cannot come out of thin air." Pryor, 56 Wn. App. at 123 (quoting State v. Wood, 42 Wn. App. 78, 84, 709 P.2d 1209 (1985) (reversing sentence and remanding case for resentencing where judge considered improper factors to give defendant exceptional sentence of 10 years for indecent liberties conviction), review denied, 105 Wn.2d 1010 (1986)). See also State v. Delarosa-Flores, 59 Wn. App. 514, 520, 799 P.2d 736 (1990) (reversing exceptional sentence for burglary, robbery, and rape where aggravating factors were not so "unusually compelling" to justify a sentence approximately six times the standard range), review denied, 116 Wn.2d 1010 (1991). "[T]he record must reflect the reasons for the particular manner in which the discretion is exercised." George, 67 Wn. App. at 227 (finding presence of aggravating factors and affirming exceptional sentence for brutal assault and rape of elderly victim during the course of a robbery, even though the sentencing judge had considered some inappropriate factors in determining the sentence). "[Tjhere must be a reasonable connection between the reasons given and the duration of the sentence." State v. Elsberry, 69 Wn. App. 793, 796, 850 P.2d 590 (1993) (finding no reasonable connection between the reasons given by the sentencing judge and the duration of the exceptional sentence, which was eight times the standard range, the appellate court reversed exceptional sentence for second degree assault of child by shaking) (citing State v. Chadder-ton, 119 Wn.2d 390, 399, 832 P.2d 481 (1992) and Creekmore, 55 Wn. App. at 877 (Forrest, J., concurring)). But see also Creekmore, 55 Wn. App. at 863-66 (finding that the trial court need not state any specific reason for the exact number of years imposed as long as the length of the sentence is "reasonable" in light of the egregious facts, and affirming a 720-month sentence for a man's murder of his 3-year-old [221]*221son). See also Harmon, 50 Wn. App. at 756 (finding the aggravating factor of deliberate cruelty and affirming 648-month sentence for first degree murder).
Generally, [a remand to the trial court for resentencing] is necessary when the trial court places significant weight on an inappropriate factor, or where some factors are inappropriate and the exceptional sentence significantly deviates from the standard range.
State v. Pryor, 115 Wn.2d 445, 456, 799 P.2d 244 (1990), aff’g 56 Wn. App. 107, 782 P.2d 1075 (1989). See also Dunaway, 109 Wn.2d at 219-20. However, even where the exceptional sentence significantly deviates from the standard range and the trial court has relied in part upon some inappropriate factors, but most heavily upon valid factors, remand is not mandated when the reviewing court is confident that the trial court would impose the same sentence when it considers only the valid reasons. Pryor, 115 Wn.2d at 456; State v. Fisher, 108 Wn.2d 419, 430 n.7, 739 P.2d 683 (1987); George, 67 Wn. App. at 228.
Here, unlike Pryor and Elsberry, the court did not consider any inappropriate factors in determining the exceptional sentence. Rather, in the present case the record clearly supports the court's finding of numerous aggravating factors: (1) abuse of trust, (2) the victim's particular vulnerability, (3) deliberate cruelty, and (4) multiple injuries inflicted in the commission of the crime.
The rational basis for the length of the sentence can be implicit in the record. Here, that rational basis is the numerous aggravating factors found by the court. As long as the sentencing court relies solely on valid aggravating factors, that is, does not rely on any inappropriate factors, as the courts did in Pryor and Elsberry, and so long as the duration of the sentence does not exceed the statutory maximum or otherwise shock the appellate court's conscience in all the circumstances of the case being reviewed, it cannot be said that the sentence, although harsh, is so clearly excessive that no reasonable person would have imposed it. Certainly Scott received the Sentencing Reform Act of 1981's (SRA) [222]*222determinate sentencing equivalent of a life sentence for this crime. The aggravating factors are both numerous and individually and collectively egregious, however. All of the factors fall within the Legislature's own nonexclusive list of examples of valid aggravating factors. It cannot be said that the sentence is clearly excessive in light of all the purposes of the SRA.
The exceptional sentence is affirmed.
Grosse, J., concurs.