Warning: Graphic content.

A woman who neglected an elderly relative so severely she was found fused to a couch by emergency services has been sentenced to six months' community detention.

The offender appeared before Justice Grant Powell at the High Court in Auckland today.

Her 89-year-old aunt, who suffers from severe dementia, was fused to a couch and had an ulcer down to the bone when emergency services arrived to help her in November 2017.

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She was supposed to be cared for by her niece and the niece's husband - the latter was sentenced to home detention earlier this year.

The elderly woman was incapable of taking care of herself and suffered from acute dementia, incontinence, and immobility.

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Her niece, who holds interim name suppression, pleaded guilty to ill-treatment or neglect of a vulnerable adult.

The niece, court documents read, was responsible for all aspects of her elderly relative's care, including preparing meals, housekeeping, transport and using the bathroom.

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.

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They walked into the lounge and saw the 89-year-old lying naked 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.

The woman has made a full physical recovery and is now in a rest home, the court heard.

Defence lawyer Philip Hamlin said that his client's good character and guilty plea should be taken into account.

"She has never been in trouble before," Hamlin said.

The offending had occurred because she had been overwhelmed by mental health issues and she was "ashamed" at falling short of the standard of care her aunt should have received, he said.

When the elderly woman became immobile she should have been moved to a rest home, or received in-house care, but that did not happen, he said.

"There was no malice or intention to cause any harm to her aunt. In fact the relationship was always a positive one."

Also in her favour was that the restorative justice process had been undertaken and the accountability she had shown to her family, he said.

"A lot of positive factors have come out as a result of criminal justice intervention."

The family recognised the pair shared a special understanding of each other, he said.

The risk of re-offending is negligible considering the circumstances, he said.

Crown prosecutor Yelena Yelavich argued the neglect was serious by any standard and that the physical injuries, suffered by an elderly and extremely vulnerable woman, were severe.

Ambulance staff were forced to cut the couch away before taking the victim to Middlemore Hospital, court papers read. Photo / Dean Purcell
Ambulance staff were forced to cut the couch away before taking the victim to Middlemore Hospital, court papers read. Photo / Dean Purcell

Yelavich said the Crown had held the position that a sentence of imprisonment was appropriate given the seriousness of the offending.

However, she said she accepted the prospect of a decision today being made between home detention and community detention.

Of those two options the Crown preference was home detention, she said.

Justice Powell said this was a "complicated and tragic case".

There was no dispute whatsoever that the pair were and remain very close, he said.

The victim had acted as a mother to the offender when she was a child, he said.

The elderly woman had been in the primary care of the niece's mother, who suddenly died, before the niece assumed that role.

The niece, having previously helped her mother care for the elderly women, immediately took over her primary care despite having only recently recovered from cancer herself.

"There does not appear to be any dispute that you provided the best care to [the elderly woman] that you could in a loving environment."

She managed to care for her elderly relative for many years before she became overwhelmed in the weeks leading up to the call to emergency services, he said.

It was an almost "perfect storm of circumstances" that made it hard for the offender to get help, Justice Powell said.

"It is not clear to me you were aware of the options of help that you had," he said.

"You are your own harshest critic over what happened.

"That offending has weighed very heavily upon you."

Justice Powell said she had shown courage in the manner in which she undertook restorative justice, apologising to the elderly woman's son face-to-face.

He had asked the court for leniency in her sentencing.

Justice Powell sentenced the offender to six months' community detention with a curfew between 8pm and 7am, to be followed by a year of supervision.

He reserved his decision on the offender's application for permanent name suppression.