Content warning: This article contains descriptions of serious abuse.
On a Sunday morning in April 2020, paramedics attended a call at a house in Adelaide’s south. Inside was an unconscious and emaciated 54-year-old woman, Ann Marie Smith.
The smell in the house was “putrid”. Ann Marie had yeast infections under both of her breasts and her bottom teeth had decayed and fallen out. She was bound to the chair in which she was found and as a result had pressure wounds that had become infected to the bone.
The chair she had been sitting in had started to decompose and it had been saturated with urine and faeces that had been accumulating for well over a year. Ann Marie’s flesh was dead and decomposing.
Ann Marie was alive but she was literally rotting to death. A day later, she died.
According to the sentencing handed down by Justice Anne Bampton in South Australia’s Supreme Court, Ann Marie’s death was manslaughter. Her sole carer, Rosa Maria Maione, was sentenced to six years, seven months and five days, with a non-parole period of five years and three months.
This sentence for Ann Marie’s neglect and death is yet another indictment on all the bureaucratic systems that failed to value her existence and continue to fail many others in similar ways. The fact that her carer was charged with manslaughter and not murder says everything.
As early as September 2017, the National Disability Insurance Agency was made aware that Ann Marie was deteriorating. It was also noted that an in-person interview was necessary to accurately gauge her support needs. That meeting wasn’t done in person. It was done over the phone and Ann Marie was assisted by Maione, not by a friend, as she had requested.
After her parents died, Ann Marie Smith had lived by herself on a nice street with friendly neighbours in the middle-class Adelaide suburb of Kingston Park. She had a good house, a well-kept garden. She owned two dogs, whom she adored more than anything. Gregarious and compassionate, she loved dancing and watching old movies. She was known for her infectious laugh.
Ann Marie never left her home dishevelled. She was fastidious about her appearance. She got her hair and nails professionally done. Gold jewellery was her signature. Her blonde hair was often held out of her face by gold clips, worn with matching bracelets.
Ann Marie was sensitive and cared deeply about people. As most of her family and friends had moved away over the years, she rarely had visitors. The only people Ann Marie had contact with were support workers or healthcare professionals. After her beloved dogs died, her three-bedroom house fell eerily quiet. By April, neighbours hadn’t seen Ann Marie out for at least a few years. They just assumed the person who came every day to care for her was doing just that – providing basic care.
Ann Marie Smith was held captive in her own living room and deprived of the basic things she needed to survive. Her body gradually wasted away over years in the wicker chair she had inherited from her now-deceased parents, in the house they lovingly built for her.
When I tell you that Ann Marie wasn’t physically tied to that chair, that she was a wheelchair user, and needed daily assistance to live her life, does your emotional response change? Do you start to think about the burden of her care, or the emotional state of her “carer” who withheld that functional support daily?
Any change in your thinking is indicative of an unspoken hierarchy of human worth and of suffering. Historically, Disabled people have been thought of as “less than”, as “the unfortunates”, as “burdens”. These are not labels we have chosen for ourselves. This is the systemic discrimination that is built into the Australian psyche. As former South Australian politician and disability advocate Kelly Vincent states, “there’s an underlying societal attitude that Disabled people are not quite human, and our support workers are seen as long-suffering heroes”.
On hearing the details of Ann Marie’s death, many non-disabled people’s sympathies go first to her carer. “That poor woman. How hard it must have been for her. Care work is so hard sometimes. Surely she herself is a victim of the system.”
No. There is absolutely no rationalisation for any cruel and unprovoked killing. It should never be written off as a lapse in judgement, a side effect of a casualised workforce, an unfortunate consequence of the killer’s poor mental state.
Many people were aware of Ann Marie’s living conditions but only one person was charged. Maione’s employer, Integrity Care SA, was fined just $12,600 for failing to report Ann Marie’s death in the 24 hours required by law. The company is yet to co-operate with ongoing investigations, including into theft of Ann Marie’s property while she was in their care.
In the years prior to Ann Marie’s death, Maione had an active claim with SafeWork SA for a back injury and couldn’t lift more than 10 kilograms. Integrity Care were made aware that she was unfit to work with Ann Marie, who was assessed as needing two people to safely move her. Despite this, Maione was the sole worker employed to provide care to Ann Marie and assist her to live well. For six years, for six hours a day, Maione had opportunity and a legal duty to do that. She did not.
Maione’s lawyer, Stephen Ey, stated in court that Ann Marie was a “stubborn and difficult person” who refused to be interfered with. Justice Bampton substantiated this by referring to Maione’s apparent lack of assertiveness and insufficient training as mitigating factors in discussing her guilt. Rehabilitation, aged and palliative care specialist Professor Craig Whitehead testified that Ann Marie’s condition was “so abnormal that you would not need a formal qualification to recognise it as abnormal”.
Rosa Maria Maione showed awareness of Ann Marie’s deteriorating state and her inability to deal with it. On two occasions, shortly before Ann Marie’s death, Maione contacted the gardener to help lift Ann Marie, claiming the hoist broke. If she had called any other authority, Ann Marie would almost definitely still be alive.
Commenting on Ann Marie’s case, Kelly Vincent said that “stubborn and difficult people still deserve to live … Often people feel they have to choose between having inadequate or even abusive and negligent support and no support at all.”
When a death such as Ann Marie’s can be treated as the result of mere lazy and careless behaviour, it conveys a clear message that Disabled people don’t matter to society, that we are not deserving of civil rights, not to mention basic human rights.
I wish I could say it is inexplicable to me that there are no protests and there is no public outcry about the horrific systemic abuse, domestic violence and downright corruption in the care sector. However, like so many people within the Disability community, I am outraged but not surprised. Unfortunately, so often do we hear about members of our community being neglected, mistreated, abused, defiled, raped, murdered, denied the right to basic human decency and classification, that it has lost the shock factor it deserves.
In learning to accept our Disabled existence it is necessary to learn to live with a perpetual broken heart. We must find a way to coexist with our constant dehumanisation, with the knowledge that most of our community lives through some level of neglect, that statistically we probably will be abused at some point.
People with Disability Australia president Sam Connor says that Ann Marie’s story is one Disabled people hear every day. Members of the Disability community who are victims of abuse or violence are usually “regarded as other – we’re not treated in the same way as other people are, because the types of violence we experience are interpreted as being different”.
Connor commented on the ironic timing of Ann Marie’s death in the middle of the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability, “in the middle of a time when the focus on violence against disabled women should have been at its peak. Instead, she died silently, invisible to the world.”
I have cerebral palsy, the same diagnosis as Ann Marie. I am non-verbal, I dribble, my right limbs don’t often co-operate with my brain, which causes me to limp when I walk, and my clothes often have food stains on them. Strangers don’t look me in the eye; they are reluctant to talk directly to me, as if I’m not just another person trying to survive. As Disabled people, we are only valued if we can be “inspirational” and otherwise are treated like we should be hidden away, which so many of us are. We fade into non-existence. We die and no one cares.
As I stood at the kitchen sink after learning about the ruling in Ann Marie’s case, I was despondent. I tried to concentrate on the soapy water and do the dishes – a simple, menial task that, in light of what I had just read, I felt grateful to be able to do. The question kept circling my head: “How can I live in a society that places so little value on my life?”
How do you keep going on when society is constantly telling you that your life is not valuable, that you don’t deserve the same dignity and basic care than non-disabled people? The answer is simple: You just do. You just keep existing. You keep reminding yourself that you have value and that you belong to this world. You keep doing the dishes.
This article was first published in the print edition of The Saturday Paper on April 2, 2022 as "The devaluation of Ann Marie Smith".
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