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A caregiver can be brought up on charges for 'neglect' for failing to get the patient needed medical treatment, even when a DNR is in place or the patient is under hospice. (Do not resuscitate does not mean do not give treatment) per Jude.
If the patient has diabetes, this is not an acceptable way to let her die.
I can hardly wait for Veronica and Maggie Marshall to weigh in on this question, because, I give up! Call 911 would be my advice.
My grandmother died of gangrene. It was slow, painful and horrible, so I'm not just talking theoretical here. Folks with poor circulation in their extremities can become very ill very VERY quickly.
But APS involvement can be a gamble - sometimes they act, sometimes they don't. And you probably don't them involved in any other decisions you would need to make.
EMTS have seen this before. They can be very persuasive. And if they can't persuade the elder to be transported, at least you've shown that you tried.
Something to think about...family caregivers have been charged and convicted of neglect in situations like this. "She wouldn't let us" sounds really weak in court when the elder has died of gangrene or sepsis.
Since your profile says your Mom-in-law has Alzheimer's/Dementia, it is impossible to argue with someone in that condition, depending on her stage. Sometimes when an elder refuses to see their doctor, we have to call 911 and get the EMT's over to assist.
The EMT's are clever when it comes to getting an elder to come with them to the hospital. They can run a EKG of the heart and mention they saw something they didn't like but it would be best for a doctor to review this immediately. That got my sig other to climb into the ambulance pretty quick and he was of clear mind but had fallen.