A "fiercely independent" pensioner who lived alone and refused medical care died due to natural causes contributed to by "self neglect", an inquest heard.

Marion Short, 86, died in the Cumberland Infirmary, Carlisle, on February 25, 2021.

The former postmistress had been found unresponsive in her Furze Street home four days' earlier.

Her nephew, Alan Short, lived on the same street and visited her at least twice a day - cooking, cleaning and helping out, the inquest heard. His wife, Margaret, also supported Mrs Short.

The widow had been bed bound following a fall in April 2020.

An inquest in Cockermouth on Tuesday heard that when she arrived at the Cumberland Infirmary in Carlisle she was showing signs of sepsis, dehydration and malnutrition and had a number of skin ulcers.

Following a post mortem, pathologist Dr Alison Armour gave the medical cause of death as sepsis as a result of neglected pressure ulcers and a neglected compound fracture of the right tibia and fibula.

Mrs Short's lower limb was "severely distorted" due to the compound fracture and had an open wound, the inquest heard.

A police investigation was carried out following Mrs Short's death. No further action was taken.

DCI Patrick McDonnell led the inquiry, which involved Mr and Mrs Short speaking to police.

While the paramedic had said her bed linen was filthy "the rarely changed sheets were accounted for by Mrs Short's wishes", said DCI McDonnell.

She also "categorically refused any medical assistance", he said.

"The family was unaware of pressure sore issues as they never bathed her or assisted with toileting," he said.

Gary Short, the deceased's great nephew, said he had organised a carer for Mrs Short but she refused to accept this. He had wanted to organise a video call with her GP but been told this was not possible by the health centre, he said.

"She would not agree to medical support, it was in the height of lockdown and she did not want to take any risks," he said.

"I had never seen any injuries other than the grazed heel, she was always covered up."

Area coroner Kirsty Gomersal accepted the medical cause of death.

After hearing all the evidence she said: "Marion lived on her own and relied on family to help with daily living.

"She was very independent and resistant to medical help.

"I have heard that while Mrs Short's family assumed some responsibility for her they were not medically trained.

"They did not do any personal care or treat her injury as she did not wish them to."

She noted that in a statement to police, Mr and Mrs Short said they had not seen the back of her leg.

Mr Short said he was not aware of the severity of her injuries and had no knowledge about the pressure sores.

"Everyone tried all sorts but she didn't want assistance. She didn't want people in the house, she didn't want doctors or carers," said Ms Gomersal.

"Mr Short said he must have mentioned medical assistance 50 times."

Self neglect is when someone lives in a way that puts their health, safety and well being at risk, said Ms Gomersal.

"In my opinion, Marion neglected herself. Her injuries went untreated despite encouragement.

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"It's clear she had capacity, she was ordering food and making financial decisions (up until days before death).

"She brushed off multiple suggestions of medical assistance, she was fiercely independent."

The coroner concluded: "Her death was from natural progression of disease contributed to by her self neglect."