Warning: Graphic content
An 89-year-old woman with severe dementia was abused by her family before being eventually discovered in a horrific state - fused to a couch and with an ulcer down to the bone.
She was supposed to be cared for by her 42-year-old niece and the niece's husband.
The horrific case of elder abuse can now be reported after High Court documents were released to the Weekend Herald after the niece's guilty plea to a charge of failing to protect a vulnerable adult.
Her husband also pleaded guilty.
The niece, who has interim name suppression, had taken sole responsibility for the fulltime care of her aunt in April 2017. She then relocated the 89-year-old to her Auckland home with her husband.
The elderly woman was incapable of taking care of herself and suffered from acute dementia, incontinence, and immobility.
Her niece, court documents read, was responsible for all aspects of her care, including bathing, toileting, preparing meals, feeding, housekeeping and transport.
She took care of her aunt during weekdays, while her husband did so on weekends.
But on a November morning in 2017, the niece found her aunt was unresponsive, court documents read.
She called an ambulance.
Paramedics soon arrived to a horrific scene.
They walked into the lounge and saw the 89-year-old lying naked and underneath a blanket on a sofa.
When they pulled back the blanket they discovered her body appeared to be fused to the couch at her left thigh, hip and lower back.
She was also covered in urine, faeces and pus, which had formed an adhesive gluing her to the sofa.
Ambulance staff could not separate her from the couch without causing further pain and injury.
They were forced to cut the couch away before taking her to Middlemore Hospital, court papers read.
The sofa material, however, remained bound to her body.
Upon reaching hospital, medical staff found the woman in a life-threatening condition.
She was suffering from bacteraemia, dehydration, and low albumin - a protein made by the liver.
Police were also notified and soon arrived at the home to investigate.
"A strong unpleasant odour emanated in the lounge room," court documents read.
There they also saw several used diapers and visible remains of bodily fluids on the sofa and in the lounge.
The 89-year-old's living conditions meant she sustained several stage four pressure ulcers to her body.
Stage four pressure ulcers are the most severe pressure ulcer formation and are characterised by full thickness skin loss, tissue necrosis, and damage to muscle, bone, or supporting structures, court documents read.
One pressure sore was down to the bone.
Medical staff further noted her skin was broken down, and had dry old skin peeling away from parts of her back.
They found she was also "clearly underweight" and had a fixed flexion of her arm and right hip which may have taken weeks to develop.
The doctor who examined her couldn't say how long it would have taken for these injuries to develop.
But he did say it would've "taken more than a few weeks of lying on her back and left side to sustain this degree of pressure sores".
The niece took responsibility for the condition of her aunt.
She told police it was the result of her "own stupidity" and she should have called for help sooner.
Her husband, however, said the decision to call an ambulance lay with his wife, but upon reflection thought he too should have also called for help.
Both will now be sentenced later this year and face a maximum prison term of 10 years.
Simon Wallace, the chief executive for the New Zealand Aged Care Association (NZACA), said this was "an appalling case of elder abuse".
But he said the NZACA, which is the representative membership body for those in rest homes, found that while one case like this is one too many, such instances are rare.
Wallace said elderly New Zealanders are vulnerable members of our society and "we all need to be vigilant to ensure they are properly cared for".
A similar case to that reported by the Weekend Herald today was discovered in Hawke's Bay during 2011.
Maureen Quinn, 82, died from bronchial pneumonia six weeks after she was discovered in her Napier home embedded in a couch and blanket with festering leg wounds.
She had been abused by one of her daughters Joanne Quinn, who let her elderly mother rot away on the couch.
Joanne Quinn was jailed for two years and six months in May 2014 for what Judge Jonathan Down described as a "severe case of neglect'' never before seen in New Zealand.
She was later paroled in March 2015.
Age Concern New Zealand's Hanny Naus, a professional educator on elder abuse and neglect, told the Weekend Herald there were many different forms of abuse.
Other types of elder abuse Naus said she's seen include; psychological assaults, caregivers giving too much or too little medication, and financial abuse which could involve restricting or stealing money.
Sadly, she said, the majority of elder abuse is committed by family members.
"The biggest percentages are [adult] children, or children's partners."
Smaller groups of cases include the partners of the older person and other relatives, such as niece, nephew, or grandchildren.
Because family members are most often the offender, Naus said, many elderly people won't report the abuse because they're often dependent on that family member.
Naus encouraged those who may suspect elder abuse to report it to Age Concern, which can be done anonymously and any names given are not required to be provided to police or any government agency.
"We would prefer that people just ring to say 'I've got a hunch that something's not right' and then get some advice about what would be the next step, rather than waiting until it's too late.
"We want to be at the preventive end before we get such serious abuse as what's obviously occurred in this case."
Naus said Age Concern surveys also had shown that generally there was less reporting of elder abuse than what actually occurs.
- Data reporting by Chris Knox