Lisa Quinn was so shocked to see the ''dramatic deterioration'' in her mother she had to leave the hospital room, the Napier District Court has heard.
Her sister Jo-Ann Quinn, 51, was the sole caregiver of their mother Maureen and is on trial for failing to provide the necessaries of life.
The 82-year-old had been left on the couch for three years. The fibres of the blanket covering her had grown into a leg ulcer infested with maggots, when medical staff were called to the house on November 15, 2011.
Quinn claimed it was the first time she had noticed the maggots.Her mother's face was stained blue from the couch and her left toenails were so long that her right leg had become embedded on them.
She was wearing nappies, and appeared not to have showered for some time.
She died 36 days later of pneumonia.
Maureen Quinn had existing heart trouble, type 2 diabetes and osteoporosis, and relied on her daughter's care.
Crown prosecutor Steve Manning said Quinn endangered her mother's life because she did not seek timely medical care.
Quinn claims her mother was difficult and she was adhering to her wishes by not seeking medical help.
Quinn's younger sister Lisa Quinn realised something was wrong when her mother started crying in pain on the phone.
Her mother resisted medical care because she did not like a ''fuss'' but she was not one to cry either.
She told her sister to ring a doctor and arranged a flight across the Tasman to see her mother.
It was dreadful seeing the dramatic deterioration, she told the court.
"I had to leave the hospital room."
Her sister had cared for their mother since 2006 and lived off her pension.
Lisa Quinn said her mother was happy on the couch and did not like people touching her because of the pain.
"She was a very independent lady and she wanted to die at home."
She was ''skin and bones'', dehydrated and malnourished when she arrived at Hawke's Bay Hospital, chief medical officer John Gommans said.
Medical staff gave her three litres of fluid in the first few hours of her arriving at the emergency department. It was not done lightly, as too much fluid could cause heart failure, Gommans said.
"The pain, fractures, medical conditions, maggots, wounds and impact it had on staff, was stunning."
Maureen Quinn was last admitted to hospital in 2006, lawyer Matt Dixon said. At that time she told doctors she found it difficult to move and used a bucket as a toilet.
Gommans acknowledged he identified her needs as chronic in 2006, under cross-examination. But Maureen Quinn refused hospital-based care and was resistant to home help.
She was "markedly worse" in 2011, Gommans said.
Dixon suggested that tissue loss was consistent with ageing, especially to people who were bed-bound.
Gommans said mild muscle wastage was to be expected but this was "profound"."I've seen fat bed-bound people, it depends how much food they get."
Judge Jonathan Down will give his decision on the judge-only trial tomorrow.
- The Dominion Post