Sentencing Rosa Maria Maione in the Supreme Court, Justice Anne Bampton said the 70-year-old was grossly negligent with her care for Ms Smith falling well short of the standard expected.
"You did not mobilise her from the chair in which she was found. You did not toilet her properly and you did not clean her properly," she told Maione on Friday.
"You did not feed her a nutritional diet or monitor her intake. You knew you were not capable of properly supporting her and you did not seek assistance in providing for Ms Smith's needs.
"Despite the deterioration in Ms Smith's health, you did not seek assistance from your supervisor or medical professionals until it was too late."
Justice Bampton said when Maione called triple zero on April 5, 2020, the paramedics who responded were met by an overwhelmingly putrid smell.
Ms Smith was unconscious and appeared critically unwell. She had a deep and infected pressure wound to her left hip that was found to be grossly gangrenous and necrotic.
The cane chair she was sitting in had started to decompose.
She was taken to hospital and underwent surgery but died the following day from septic shock, multiple organ failure and malnourishment.
Justice Bampton said Maione had absolutely no insight into Ms Smith's physical condition leading up to her death.
"Your incompetence, lack of training, lack of assertiveness and lack of supervision produced an environment where you failed to provide appropriate care," she said.
"Every person living with a disability, every person who requires support, every parent, carer and support worker of persons living with a disability, I have no doubt shudders with fear when they hear of the utter lack of care and human dignity afforded to Ms Smith in those last months of her life."
Had Maione acknowledged your limitations and sought professional assistance, Ms Smith's death could have been prevented, the judge said.
She said Maione's time in custody would be hard and because she was not an Australian citizen she faced the prospect of being deported to Italy on her release from jail.
In sentencing submissions last week Maione offered a tearful apology.
"I'm so sorry that my actions have caused so much distress," she said in a short statement.
"I pray with all my heart that Annie is in heaven. I ask for Annie's forgiveness, knowing that nothing I say can ever bring her back.
"I will bear this guilt for the rest of my life."
Taking into account time Maione had spent on home detention bail and in custody, Justice Bampton imposed a head sentence of six years, seven months and five days and a non-parole period of five years and three months.
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