Neglect, necrosis, decomposition and death – the sad, criminal final days of lovely Annie Smith revealed in court submissions

For the first time, the true scope of Annie Smith’s cruel death and carer Rosa Maria Maione’s heinous neglect can be revealed. WARNING: Distressing content

Annie Smith loved to let her nieces braid her treasured blonde hair as they watched Disney movies and snacked on junk food.

She also loved her brother, Steve, but they argued – he worried she associated with people trying to take advantage of her, and she rejected that outright.

Ms Smith was known to all as a fiery, lively, stubborn and, at times, difficult woman who guarded her independence and was determined never to leave her home.

These were important considerations for a proud, private woman living with cerebral palsy, meaning she required the help and care of others to live life on her terms.

And it was one of those carers – the very associate about whom Steve Smith was so concerned – that left Ms Smith to die, in the most horrid of circumstances, in her own chair.

On Friday, the Supreme Court will sentence former carer Rosa Maria Maione for Ms Smith’s manslaughter, ending a saga that has mortified the South Australian public since 2020.

But while much has been said and written about Ms Smith’s life, and Maione’s unquestionable culpability, little has been known of her tragic, final months.

For the first time, the true scope of Ms Smith’s death – and Maione’s heinous dereliction of her duty of care – can be revealed.

A vigil for Annie Smith at Parliament House on North Terrace. Picture: Naomi Jellicoe.

APATHY TO BLAMING OTHERS

By April 2020, Maione – an employee of Integrity Care, which is now under investigation – had been providing in-home care to Ms Smith for six years.

As per an NDIS assessment, she was paid to care for Ms Smith six hours a day, seven days a week, with an additional two hours set aside for her grocery shopping.

Both prosecutors and defence counsel agree that, for a period of time, the arrangement went as it was supposed to, even as Ms Smith’s needs increased.

By 2007, she had limited use of her left arm and no use of her right arm, and by 2018 she needed two people to lift her to her feet.

At no stage, however, did she lose her voice or her ability to communicate – a fact seized upon by Maione’s barrister, Stephen Ey, on Thursday.

He told the court the “clinical role barriers” between Maione and Ms Smith eroded, claiming the latter had insisted on dieting, not seeing doctors and never leaving her home.

Rosa Maria Maione. Picture: NCA NewsWire / Dean Martin.

Ms Smith was 54 when she died from extreme neglect in April 2020.

“There’s no doubt that the victim was a stubborn and difficult person … my client compromised herself and could not make hard decisions,” he said last week.

“It appears the victim was in fear of going into a home … she was stubborn, demanding.

“Maione just did not have the wherewithal or strength of character to be able to overcome what the victim demanded.”

Maione had, he claimed, neither adequate training nor support from Integrity Care and little to no reporting responsibilities, leaving her alone to deal with Ms Smith.

Prosecutor Lucy Boord, however, said that submission was characteristic of Maione’s “range” of responses to her crime, running “from complete apathy to victim-blaming”.

She said it was clear Maione realised she needed help because she had sought it from a gardener, who twice assisted lifting Ms Smith around the house.

“I do not know we are ever going to be able to say an exact period of time over which the neglect occurred,” she said.

“But the neglect of Annie Smith was absolute.”

UTTERLY VULNERABLE

For an undetermined period prior to April 2020, Ms Smith was left to sit upright in a cane chair in her living room.

Rather than toileting her, Maione cut, folded and stuffed towels underneath her, and never bathed her.

She did not provide her adequate food nor water, never cut her nails and did not brush her teeth.

When she finally called an ambulance, the court heard, it was only because Ms Smith had become “moribund” and was no longer capable of speech.

Ms Boord said one of the doctors who attended Ms Smith in the emergency room described her presentation as “the most extensive” instance of neglect “in my professional career”.

SA Police officers seize evidence from the ongoing Annie Smith investigation at Integrity Care's office in Edwardstown. Picture: Tom Huntley.

“She was suffering sepsis, dehydration and malnutrition … muscle tissue and bone were exposed … her flesh was necrotic … she was wasting away and malodorous,” she said.

“She had a 15cm deep pressure sore on her hip, through which the bone was visible … that wound was necrotic, the flesh had died.

“When I say ‘the neglect of Annie Smith was absolute’, the chair and carpet under the chair were soiled – and the chair itself had started to decompose.”

While Mr Ey sought to question Steve Smith’s absence from his sister’s life, Ms Boord said that was utterly irrelevant to Maione’s criminality.

“This was her job, she was being paid to care for Ms Smith,” she said.

“Despite what must have been the obvious deterioration of Ms Smith’s health, Maione did not seek medical assistance until it was too late.”

Originally published as Neglect, necrosis, decomposition and death – the sad, criminal final days of lovely Annie Smith revealed in court submissions