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My mom lives on her couch. She can’t walk or get up at all (it’s been like this for 15 months). She eats, drinks, watches tv, and yes even goes to the bathroom (on pads) on this couch. Her husband passed away 3 weeks ago. He was very ill for a long time. She just turned 76 and is of sound mind. We can’t force her to go to a facility. She has a few bed sores that we noticed when she slid off the couch and said her back hurts. The bed sores are pretty big in size - like the size of an orange.
She wants to live like this and my brothers and I have a routine to get her meals, do laundry, etc.
She refuses medical help, too. So, I would like to know at what point do we call 911 to get her to a hospital to treat the bed sores?

Going back to the immobility - in one desperately sad case you have reminded me of - and the charge wasn't neglect, it was manslaughter, and the daughter was found guilty - the mother initially refused to stand from her easy chair because she had a broken hip (and a sharp tongue). That was only the start of the story, which dragged on for years (three, as I recollect) until the mother died, the authorities at last involved themselves, and the post mortem must have been the stuff of nightmares.

So. If only to cover your own behinds, get professionals involved.
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MaryKathleen May 27, 2022
right, document, document, document, take videos of her telling the ambulance personnel she won't go. try to get a copy of the AMA she has to sign. Take a photo if you can't get a copy. document, document. If she objects, say tough times, I am calling 911 anyway.
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Now.

Not to get the bed sores treated in hospital, but to get professional eyes on her and professional methods of communication to her. She isn't listening to her children but she might listen to someone in uniform.

She probably doesn't need to go to a facility, seeing as she's only 76 and you don't identify any reason other than disinclination for her immobility. She needs someone competent to tackle her deep mental distress. Take that small first step - you can't possibly make her any worse off, and she can always tell them to go away.
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Bedsores need medical evaluation. You say MIL will not go into care of any kind. You say she is of sound mind.
Will she go to her doctor regarding the sores?
This getting sores in someone who does move about is unusual. Is your MIL diabetic?
I cannot know what you are evaluating as a "bed sore". As big as an orange? The big doesn't matter nearly as much as how deep, and in a "real" bedsore as big as an orange there would be depth that would be startling, often down to the bone.
So even as a nurse, from what you have said I can have no idea what you are evaluating as a bedsore.
Bedsores themselves do not kill. The resulting sepsis from not caring for them can kill and kill in days even for a tiny sore, so again, what is needed here is medical evaluation.
Being of sound mind means understanding that medical evaluation is needed. If she refuses this, then her condition is self limiting in that it will REQUIRE medical transport to ER at "some point" whether that is days, weeks, months or even years.
My brother died of sepsis from a tiny wound on his shin that was none healing and that he kept hidden. By the time he understood that his 3 days of illness was NOT "that flu I get every year" he was confused, and found to be in a state of no return; he had a reisistant bacteria and was dead in less than two week time from multiple system failure.
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MaryKathleen May 27, 2022
My heart goes out to you. Makes you want to dig him up and shake him doesn't it.
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Stacey, my heart goes out to you. You are in a hard place. Why is she couch bound? Could she get up if you and your brother stopped helping her?

I would explain to your mother that bed sores are dangerous and you were going to call 911 and get an ambulance. If she says "don't do it". I would say, I am going to do it anyway, then do it. I have done this with my husband at least 4 times. She might sign an AMA (Against Medical Advice) slip and not go (husband did this last time). OK, the paperwork is started that show the world that you tried. I got a copy of the AMA, if you can't get a copy, take a picture and record the time and date. If she does go, when she can come home, tell them there is no one to care for her and it would be a "unsafe discharge" (hopefully these are magic words, so use them). document, document, take videos and photos.

So she gets mad, she can't get off the couch and hit you can she LOL.
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BurntCaregiver May 28, 2022
You're right, MaryKathleen. The OP is going to have to just have to call an ambulance for the mother and have her taken to the hospital.
She isn't in her right mind and cannot be reasoned with, so it will have to be done against her will for her own good.
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Bedsores can be managed, but they can also go from being fairly small to huge and septic in a short period of time.

It's not to say the patient isn't getting good care, but the sores need to be dealt with and require 24/7 changing and care.

The first time I saw a really bad bedsore, I threw up (in the bathroom of the NH where my gma was) You literally see her spine (by her tailbone).

She could not move, she was actively dying and these moron CG's kept telling her they'd have her 'up and dancing' in 2 days. She wasn't stupid. She had me roll her over and look at the bedsore and made me tell her what it looked like.

OMG.

She didn't last a week in this NH, not from lack of care, b/c that was 'fine', but because she was dying. Giving her false hope and being all perky and cheerful just made her feel like she wasn't trying hard enough. Good grief. I spent my time with her just talking and singing and 'remembering when'. Either mom or I was there most of the last days of her life.

Gma's bedsores were not painful. She actually couldn't feel anything on her body, as the ciculation in her extremities got worse and worse. I guess that's a blessing, she was able to be coherent and chatty to the day she died.
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To be blunt, you are way past "when should we call 911." Is her Primary Care Physician aware? If not, why not? Have your reached out to your local Dept of Social Services for guidance? You give the impression she can not walk. Is that correct? Who is taking care of her during the day? Do you help change her? This needs to be addresssed immediately. As another poster noted, you and your siblings could face neglect charges.

As my Mom's son and caregiver, I was big on making sure she did not get a pressure ulcer under my care. Every two hours, I assisted her as she walked (with her walker) to a different chair. At least three times a day, I helped her change her pull-ups. At least twice a day, I put Calmoseptine on her behind to form a barrier. The only time she experienced an ulcer was when she was in the nursing home after her hip surgery (So much for "rehab"). When she came home, my daily routine with her started, and it worked well.
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KaleyBug May 27, 2022
Rehab and hospitals where the only time my mom got them too
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I would call in APS, Adult Protection Services. Ask if they can please try and talk her into going to ER. Bed sores are painful and need a woundcare nurse to tend them. Plus, you want to get her on their radar. They may not be able to talk her into going to the ER but you will have it on record that they tried. If you call an ambulance and she is competent and says no, they will not transport her. Maybe her PCP has a nurse practitioner that will come out and look at the sores.
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If you and your brother “have a routine to get her meals” etc, then you are enabling her to live this way and are responsible for her condition. No one of sound mind would want to live like that. Don’t hesitate, call APS now! Tell your mother that you can no longer provide any help if she refuses medical treatment. If you wait until she is dying from sepsis and then call 911, you will be charged with negligence. This is serious
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My last care client was bedridden and had a pressure ulcer on her tailbone. She had it for five years and it is not what she actually dies of. It was very painful even though she was kept immaculately clean and her wound was properly cared for.
The "sores" you're seeing that are the size of an orange are in their earliest stages and can still be treated and healed. If they weren't she would be crying in agony.
You say your mother is of sound mind. She is not. No one in their right mind lives like she does.
No, you cannot force her into care but the state can. Please call APS and explain what's going on with her before her become to serious to treat.
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"Once a bedsore develops, it can take days, months, or even years to heal. It can also become infected, causing fever and chills. An infected bedsore can take a long time to clear up. As the infection spreads through your body, it can also cause mental confusion, a fast heartbeat, and generalized weakness."

Bedsores | Johns Hopkins Medicine

You mentioned that she is "of sound mind." Hmmmmm...It sure sounds like she isn't. Your willingness to serve her and care for her is admirable, but it is the reason she can continue to live on the couch in such a deplorable existence. Please call 911 and get her transported to the hospital. Refuse to pick her up until they have the results of a 72 hour psych eval stay. A Hospital Social Worker can make it all happen and start the process for a state placement.
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