The women have taken up residence at a five-star hotel just 20 minutes’ drive from Boston’s McLean Hospital, where Mr Packer is being treated for what his private company, CPH, on March 21 described as “mental health issues”.

Mrs Packer, 80, and a woman ­believed to be Ms Lim, were photographed coming and going from the exclusive $5000-a-night hospital in chilly two-degree temperatures on Thursday and Friday, and Mrs Packer shared a ­tender moment chatting with her son on Friday morning.

The younger woman, who bears a strong resemblance to Ms Lim, weathered freezing conditions and falling snow to join Mr Packer for a smoke in an outdoor timber pergola outside the hospital’s Pavilion wing, where he is staying.

The strain of recent weeks was evident on Mr Packer’s face during the brief outdoor stroll.

The attractive brunette, who wears a solitaire diamond ring on her left hand, was also with Mr Packer’s entourage as he arrived in Boston on March 23 with his friend and housemate Ben Tilley and legal adviser Guy Jalland.

In the past week the woman has been seen running errands for Mr Packer and was overheard at a local supermarket pharmacy asking for a script for her “friend James”.

When The Sunday Telegraph called the hotel and asked to be put through to Kylie Lim on Friday, the woman who answered the room phone declined to comment.

Ms Lim was photographed with Mr Packer in Aspen in December and has spent time on the family yacht, Arctic P, and is also a frequent visitor to Argentina, where Mr Packer has spent the past 18 months based at his ranch Ellerstina.

INSIDE THE $5000 A NIGHT MENTAL HEALTH FACILITY WHERE JAMES PACKER SOUGHT HELP

Her last Facebook post, on March 11, captured her in Aspen where Mr Packer co-owns a $20 million mansion with ex-wife Erica Packer. “We’re back!!!” Ms Lim posted to social media. Mr Packer was not in the image but sources state he was in Aspen that week.

Ten days later he would step down from his post as a director of his casino company Crown Resorts.

The pictures of a gloomy Mr Packer puffing on a cigarette are in stark contrast to images that emerged on Friday showing his ex-wife, who he has repeatedly asked to take him back, taking in the sun while cruising Sydney Harbour with friends.

Ms Packer has spent the past two weeks in Australia with her three children to the billionaire — Indigo, 9, Jackson, 8, and Emmanuelle, 5.

The devoted mother is understood to have flown from Los Angeles, her adopted home town, within days of Mr Packer’s admission to McLean.

The former model spent part of the Easter weekend at the Packer family’s Scone rural retreat, Ellerston Station, also travelling to Gunnedah to catch up with extended family

Ellerston, a cattle property which features world-class polo facilities and a Greg Norman-designed golf course, was recently returned to the Packer family’s coffers following the $62.5 million buy-back of a 50 per cent stake in the property from Crown Resorts last month.

The purchase is understood to have handed James Packer’s sister Gretel control of the property, the final resting place of patriarch Kerry Packer, who was buried there in 2006.

Gretel Packer has endeavoured to maintain a close relationship, post divorce, with her former sister-in-law, nieces and nephew.

During their Australian visit, James Packer’s three heirs also soaked up some Australian culture with a swim at Bondi Beach, a Sydney Harbour Bridge climb and a trip to Taronga Zoo.

On Thursday Erica Packer, without her children, kicked back with friends on a boat on picture-perfect Sydney Harbour. Among the small party of revellers was Cathrine Mahoney, ex-wife of rugby league legend Andrew “Joey” Johns and a radio publicist at Nova Entertainment, who only days earlier had learned her ex, Johns, was expecting a baby with his new partner, yoga instructor Kate Kendall.

Other guests included friends from LA who flew in to Sydney a week earlier and have been staying with the 40-year-old at the $50-million Vaucluse harbourfront mansion Coolong, a luxury rental property.

It is the same house Lachlan and Sarah Murdoch used as their base while renovating their nearby Bellevue Hill home.

The family flew home to the US yesterday morning with a friend saying they had a “fantastic time” in Australia.

A spokeswoman for Erica Packer yesterday refused to be drawn on whether she and the children have plans to visit her ex-husband in the Boston hospital.

Before checking into the exclusive 11-bed McLean Hospital – one of the top psychiatric facilities in the US and famous for treating novelist Sylvia Plath and Nobel prize-winning mathematician John Nash, whose story was immortalised in the 2001 film A Beautiful Mind – Packer begged his estranged wife Erica to take him back.

Desperate to return to a time when he was at the height of his powers and knew the love of a close-knit family, he repeatedly raised the prospect of reconciliation, believing it might restore him and put the genie back in the bottle, erasing the slate of personal and professional mistakes he has made in the five years since divorcing his second wife.

Erica, having seen her ex-husband’s life go off the rails as he spiralled towards mental illness, has so far refused the requests.

The mother of three has her children’s best interests at heart, say friends, and does not want to expose Indigo, Jackson and Emmanuelle to their father’s seismic mood swings.

“Turning back the clock five years might be what James wants but it won’t help Erica,” said a family friend. “She has finally got her life together and has created a stable life in Los Angeles for her kids.

“She doesn’t want to undo the good work she’s done with James repairing the relationship. As platonic friends they are good parents and his children get to see James at his best.”

In a rare interview in October, 50-year-old Packer, with “shaking” hands, acknowledged the years since separating from Erica in 2013 had been “tumultuous”.

Having told his wife he wanted out of their marriage so he might once again taste the pleasures of single life, it would transpire that the middle-aged businessman, once the shyest of men, wasn’t as well suited to a hedonistic bachelor life of clandestine romances, glamorous parties and hobnobbing with the international elite as he might have imagined.

He told The Australian newspaper he was “terrified” in 2015 by the $5 billion debt his two companies — CPH and Crown — were carrying.

A year later, following his turbulent public breakup from American singer Mariah Carey, he was depressed and living as a virtual recluse. The mess he had created in his tyrannical pursuit of wealth and power — from the jailing of Crown executives in China to being caught up as a witness in an Israeli corruption inquiry — made him realise (belatedly) the important role Erica once played bringing stability and calm to his life.

THE STORY SO FAR ...

GOOD TIMES AHEAD

At the start of 2013, before he and his wife of six years separated, Packer had the world at his feet.

He was fit and trim following lap band surgery. His long-held dream of owning a casino in Sydney — an achievement that had eluded his late father — was coming to fruition, with the NSW government poised to approve the $1.5 billion Barangaroo development. His $2.4 billion Studio City development in Macau, China, was on track for its celebrity-studded 2015 opening, as was his $1.3 billion City of Dreams casino-resort in the Philippines.

The Sri Lankan government was set to green-light plans for a $350 million casino. And the billionaire was bullishly on the hunt once more for a slice of the famous Las Vegas strip.

Months earlier, in December 2012, Packer had realised a personal dream of becoming a hotshot Hollywood producer after tipping $100 million into start-up film investment vehicle RatPac with director Brett Ratner.

It would prove a seductive folly that some now believe hastened the breakdown of his marriage.

After Erica quit the couple’s newly completed $50 million Vaucluse home and relocated with the children to Los Angeles in 2013, the billionaire threw himself into his supercharged new life and his obsession with making his mark as an international casino impresario — the sort of man his late father Kerry, a renowned gambler, might have respected.

“He lifted off,” said a former long-time friend. “He had no regard for anyone or anything — just himself and the accumulation of more wealth.

“He made friends only with people he believed could help him generate money and jettisoned everyone else. He became ruder, more obnoxious, more poorly behaved than he had ever been before.”

He was also partying harder than he had before, say insiders.

“He was on one long bender,” said an associate who regularly saw Packer empty a bottle of vodka in a single sitting.

The lap band surgery he’d had in November 2011 to help him shed 35 kilos wasn’t making life any easier for the notorious binger. He would eat his fill, vomit and then eat more, and wash it all down with a large volume of alcohol.

ESTRANGED FRIENDS

By 2014, Packer was battling addictions and creating ugly public scenes with his violent outbursts. On May 4, 2014, his public punch-up with his best friend, David Gyngell, then boss of the Nine Network, erupted on a Bondi street under the noses of incredulous paparazzi.

Packer was enraged a Channel 9 news links truck was parked in his street, something that turned out to be a coincidence.

Gyngell, fed up with his friend’s abusive communiques, was annoyed when Packer rang after disembarking a flight from Israel to abuse him about the truck, of which Gyngell knew nothing.

Over the previous year Gyngell had become tired of what he saw as Packer’s growing disregard for family and friends, chief among them Erica.

“Gyng and his wife Leila (McKinnon) took a dim view of how James treated Erica during the 18 months prior, even before the marriage broke down. He was playing up and Erica would confide in the Gyngells,” a friend said.

“Erica would go and stay with them when James was away. They would comfort her when James disappeared.”

What may have further set Packer on edge that day was his eagerness to catch up with model Miranda Kerr, in town and rumoured to be waiting for him at his Bondi home.

Despite reports to the contrary last week, the men remain estranged and have not spoken for years, their 30-year friendship now in tatters.

The ugly feud made headlines around the world and would not have escaped the attention of Packer’s only sibling, older sister Gretel, who is said to have told her financial advisers to double their efforts in achieving a formal financial separation from James.

In the decade since Kerry Packer died in 2005, the siblings had failed to reach agreement on the complicated carve-up of their father’s estate, the value of which remains a mystery but was once put at $5.5 billion. The estate includes investments in publicly listed companies, private companies, vast agricultural holdings and a web of complex family trusts, some held in tax havens like the Bahamas.

In the years after their father’s death from kidney failure, Packer was using Gretel’s share of the inheritance to bankroll his casino investments. Initially this had not bothered Gretel, one of her brother’s greatest proponents, but sources insist that as he took bigger and bigger risks it became an issue.

This proved the case in 2007 when Packer committed to buy, ahead of the global financial crisis, a stake in four casinos in Las Vegas and Pennsylvania for $2.7 billion.

As the value of US casinos crashed soon after the deal was struck and the Packer family fortune was put at risk, Gretel intervened. In December, 2008, she lodged an appeal against the deal to the Pennsylvania gambling regulator.

Every bit her father’s shrewd and privacy-obsessed daughter, Gretel managed to torpedo the casino licence application by arguing she had not been made fully aware that the investment would require her, as a beneficiary of Packer’s private company, to disclose sensitive financial information relating to Packer family trusts.

JODHI A ROCK

By 2015, with talks of settling the inheritance dragging on, Gretel was shocked to pick up The Australian newspaper one October day and read that the settlement had been achieved.

According to the report, Gretel walked away with $1 billion. It was the first she knew of the resolution.

Crown Resorts’ then chairman Rob Rankin told the newspaper: “The family are confident (Kerry) would be proud (of the settlement).”

However, an investments broker later told The Sunday Telegraph: “Gretel was blindsided. It was less than her lawyers were seeking and less than she was due.

“She was furious it had been deliberately planted with the newspaper — a public memo from her brother who was telling her he was finished talking.

“Had she dug in, she might have received hundreds of millions more, but in the interests of keeping the peace for her mother’s sake, she accepted it.

“She didn’t want an ugly public fight. She just wanted her brother’s financial henchmen to stop making decisions on her behalf.”

James Packer has recently suggested his sister contributed to the financial woes that have plagued him in recent years.

Packer “barked” to The Australian five months ago that “Gretel was on my doorstep” at an inopportune time.

With the division of their assets complete and the inheritance of her three children finally secured, Gretel would encourage her children to start building their own corporate profiles.

In July 2017, 19-year-old Benjamin Barham Packer, Gretel’s eldest son with her first husband, British financier Nick Barham, and a 2016 Cranbrook School graduate, emerged as a director of two new corporate vehicles, Infinite Investments Corporation and its parent company, Perpetual Holdings.

Gretel had been instrumental in encouraging her son’s movement into the corporate world. Since separating her finances from her beleaguered brother she has also been busy establishing new corporate entities for her other two children. For daughter Francesca, FRPB Investments, and for youngest son William, WKAPM Investments.

Benjamin also has an investment vehicle, BEPB Investments.

She has made it abundantly clear she will not let her children be overlooked, a longtime concern.

Her decision to prioritise the financial security of her children over her brother’s ambition, has tested the siblings’ relationship. Whether it survives remains to be seen.

Clearly Gretel was not prepared to stand by and have done to her line what had been done to the line of Clyde Packer, Kerry Packer’s only sibling. Kerry and Clyde Packer famously became estranged after Kerry succeeded his older brother following Clyde’s infamous fallout with their father, Sir Frank, in 1976.

The siblings have had no contact in recent years and while Gretel was happy to accompany her mother, Ros, to Sydney Airport on March 22 to put her on a commercial flight to the US to visit her brother, Gretel remained resolutely on the ground in Sydney.

Into the void left by Gretel has stepped a woman Packer still calls his best friend — his first wife, Jodhi Meares.

Meares has once again become a fixture in Packer’s life. Three weeks ago the fashion designer, whose own second marriage ended last year, flew to Los Angeles to celebrate her 47th birthday. Whether she planned to do so with her ex-husband is unknown.

Packer flew from his Aspen home to his Argentinian property that same week and, sources claim, was keen to catch up with Meares before his admission to a mental health facility in Boston ruled it out.

Meares has become a regular visitor to Packer’s homes and joined him in Melbourne in November as he dealt with the fallout of being questioned as a witness in a corruption scandal involving Israeli prime minister Benyamin Netanyahu, his Tel Aviv neighbour.

By Christmas, Meares, who was married to Packer from 1999 to 2002, was by his side in Aspen celebrating Christmas.

“Increasingly over the years Jodhi has been there in James’s darkest hours,” a source said. “She knows him better than anyone else. She was there when depression consumed him during the One.Tel collapse in the months before their marriage ended, and she has become one of his closest and most trusted advisers during the past year. She jumps when he calls these days.”

SHARE PRICES FALL AS PACKER STEPS DOWN FROM CROWN POST

It was her habit of jumping for Packer that contributed to the end of her relationship with former Noiseworks frontman and rocker Jon Stevens in 2015. When a needy Packer demanded Meares drop everything and fly to the US to spend Valentines Day with him that year, Stevens questioned his fiancee’s love.

Within 24 hours the couple had split after Stevens called police to Meares’ apartment to calm her following a row after an afternoon spent partying.

A devastated Stevens later told close friends Packer had threatened him in the months leading up to the breakup.

SIGNS OF UNRAVELLING

He wasn’t the first person Packer threatened. During the northern summer of 2016, Packer and the man who has become his constant companion, Ben Tilley, extended the invitation to Australian friends to party with them on Packer’s yacht as it cruised the Mediterranean, a new summer ritual.

Among guests was the man widely regarded as Australia’s most successful comedian, Vince Sorrenti, invited on board by Tilley.

At the time Sorrenti had worked a Packer joke into his routine.

Friends of the comedian recall it being about the bad year Packer was having: “Gee, James Packer has had a bad year. His casino investments are in strife, his movies are flopping at the box office and his new girlfriend has a fat arse.”

Having heard the joke, the punchline of which targeted Mariah Carey, Packer, heavily under the influence of alcohol, is said to have confronted Sorrenti and delivered a lacerating spray.

In recent weeks it also emerged that Packer has been in the habit of firing off angry emails from his Argentinian bunker.

Two years ago, Fairfax Media reported last month, he may have had Prime Minister Malcolm Turnbull in his sights when he sent a series of “intense” emails that prompted concern for his well-being.

In the communications Packer displayed “anxiety”, Fairfax reported.

Mr Turnbull, who once worked for Kerry Packer, reportedly picked up the phone and called the scion directly. The Prime Minister’s office would not furnish Fairfax with any details about the subject of the emails.

Full of adrenaline and high on his own power, there have been other outward signs Packer has been unravelling.

At a Sydney charity event for Deborra-Lee Furness’s adoption advocacy group Adopt Change in July, 2015, Packer was openly on edge.

Having navigated the red carpet with his ex-wife Meares, then newly separated from Stevens and attending her first society soiree following high-range drink-driving charges, witnesses recount seeing Packer, seated during speeches, turning a knife over and over in his hands in a highly agitated manner.

This barely concealed white-knuckle fury also contributed to the erosion of his Hollywood partnerships and prompted his retreat from the movie business in 2017.

“His partner, Brett Ratner, famous for his charm offensive, was told not to take James to movie industry parties and events,” an insider said.

“James was considered too unpredictable and people felt intimidated by him.”

Sources say Packer’s alcohol intake had compromised his mental health.