One month before Chrissie Treacy died, the Health Service Executive (HSE) notified gardaí about concerns for Ms Treacy's welfare arising out of ongoing difficulties she was having with her nephew Michael Scott over land, the Central Criminal Court has heard.
The trial heard that concerns for the 76-year-old's welfare had first been made known to the HSE by a nurse in April 2017, one year before Ms Treacy's death.
The purpose of notifying gardai in March 2018 was to "escalate the concern in respect of Ms Treacy's welfare", the court heard.
A psychiatrist also told the trial that Ms Treacy had a fear of dying and suffered from anxiety and depression following the deaths of her two brothers in 2006 and 2011.
Michael Scott (58) of Gortanumera, Portumna, Co Galway has pleaded not guilty to murdering Ms Treacy outside her home in Derryhiney, Portumna on April 27th 2018, by driving over her in an agricultural teleporter.
Mr Scott's lawyers have said Ms Treacy's death was a tragic accident.
On Tuesday, Ann Gardner told Dean Kelly SC, for the prosecution, that she is the area manager for Family Carers Ireland which provided home care to Ms Treacy from 2016 until her death.
Concerns
Ms Gardner confirmed that one home carer, Susan Keane, had reported to her that she had concerns for Ms Treacy's welfare arising from ongoing difficulties between Ms Treacy and Mr Scott over land.
In March 2018 Mary Hanley, a support officer with the care provider, also communicated her concerns for Ms Treacy's welfare arising from ongoing difficulties with her nephew.
As a result of those concerns, Ms Gardner said she filled out a "Safeguarding Referral Form" on March 26, 2018 in respect of Ms Treacy.
She said that the purpose of the form is to highlight concerns for the welfare of elderly people or vulnerable adults and communicate those concerns to the HSE and elsewhere so that appropriate steps can be taken.
Among those she sent the form to were Concepta Birmingham, a home help coordinator with the HSE, and Freda Quinlan, a team leader in the safeguarding team for the HSE West.
Ms Quinlan told Mr Kelly that Ms Treacy's case was first referred to her in March 2017 by Pauline Gordon, a community registered nurse.
The referral made reference to "there being concerns for the welfare of Chrissie Treacy arising from ongoing difficulties over land between her and her nephew Michael Scott," she said.
Ms Quinlan contacted Ms Treacy by phone and advised her to contact gardai if she was in fear or if she was threatened.
She also spoke to a garda who told her that Sgt Gerard Cleary would be in touch with Ms Treacy.
Ms Quinlan said she then contacted Ms Treacy's neighbour and close friend, Regina Donohue, and advised her to contact gardai if she had any concerns about Ms Treacy's welfare.
Court order
In December that year, Ms Quinlan was contacted by Concepta Birmingham who raised concerns about Ms Treacy's ongoing difficulties with her nephew and resulting concerns she had for Ms Treacy's welfare.
In January 2018 Ms Quinlan visited Ms Treacy's home and asked if she would consider seeking a court order directed towards ensuring her welfare.
On February 20 that year Ms Quinlan again visited Ms Treacy and found her to be upset and asked if she would consider moving to Portumna. "She was adamant that she would remain," she said.
Six days later Ms Quinlan again asked Ms Treacy about court orders directed to her welfare.
On March 21 Ms Quinlan visited again and noted that Ms Treacy was "very anxious". On March 26th she received the safeguarding referral form from Ms Gardner.
Having spoken to Ms Gardner, the witness sent a notification document to An Garda Siochana. The purpose of the notification, she said, was to "escalate the concern in respect of Ms Treacy's welfare".
Ms Quinlan said she had already been in touch with Sgt Gerard Cleary, but the notification put that contact on a more formal footing.
Concepta Birmingham told Mr Kelly that she was the home help coordinator for the HSE based in Loughrea. Following the death of her brother in 2011, Ms Treacy was "at a low ebb" and was referred to the elder life psychiatry team.
Following surgery in February 2016, Ms Treacy required home care which was provided by Family Carers Ireland. In 2016 Ms Birmingham spoke to Michael Scott and explained the care plan to him.
In April 2017 Ms Birmingham was contacted by Regina Donohue who made her aware of concerns she had for Ms Treacy's welfare arising from ongoing difficulties between Ms Treacy and her nephew, in particular over land.
Freda Quinlan confirmed to Ms Birmingham at the end of May 2017 that a safeguarding plan had been put in place in relation to Ms Treacy.
Safeguarding referral
In December that year Ms Birmingham spoke to Ms Quinlan about changing the sequence of responders on Ms Treacy's personal alarm, which she wore around her neck.
In March 2018, one month before Ms Treacy died, Ms Birmingham saw to it that the safeguarding referral form made its way to Ms Quinlan at the HSE, to nurse Pauline Gordon and to a psychiatrist with the later life psychiatric team.
Ann Keavney told Mr Kelly that she knew Ms Treacy through her work as a nurse with the Portumna Daycare Centre which, she said, was a "great source of joy" to Ms Treacy on the two days per week that she would visit.
Ms Keavney had a good relationship with Ms Treacy who she said had "a good sense of humour and a good turn of phrase".
On days when Ms Treacy couldn't get to the centre, Ms Keavney would drive out to collect her.
She said Ms Treacy was able to walk to the car and could walk unaided but "very slowly" due to her weight and health problems.
Dr Sabina Fahy told Mr Kelly that she is a consultant psychiatrist with St Brendan's Community Nursing Unit in Ballinasloe. She specialises in treating people who develop mental illness after the age of 65.
From 2011, she said, Ms Treacy became a patient due to depression following the death of her brother.
She was later diagnosed with recurrent depressive disorder with anxiety features.
Dr Fahy said life events, such as the deaths of her brothers or others in her community or her own health problems, would cause Ms Treacy's depression and anxiety to worsen, and she would require extra medication and support during those times.
She also had a fear of dying, she said.
Following treatment her condition would improve, and she would "return to her baseline" but if another life event occurred she might deteriorate again.
