Then-senior constable Kristian James Samuel White fired his weapon at 95-year-old Clare Nowland after being called to Yallambee Lodge nursing home at Cooma in southern NSW on May 17, 2023.
Intensive care paramedic Anna Hofner was present at the time and told an inquest on Wednesday that she felt "absolute shock and disbelief" when he deployed the stun gun.
"I didn't think the use of a Taser was proportionate to the magnitude of the incident ... it seemed excessive," she told Queanbeyan Coroners Court as the three-day inquest began.
Emergency services were called to the facility in the early hours of the morning after Mrs Nowland grabbed two serrated steak knives from the kitchen and refused to give them up.
The 48kg great-grandmother, who had symptoms of dementia, fell and hit her head after being struck by the Taser's barbs.
She did not regain consciousness and died in hospital a week later after a brain bleed.
Ms Hofner told the inquest the use of a "pause point" - when first responders stopped to discuss the next steps as an incident escalated - could have been valuable.
Given Mrs Nowland's mobility issues, police and ambulance officers had the opportunity to hash out a plan, she said.
Counsel assisting Sophie Callan SC earlier said one alternative was for first responders to simply wait it out, closing the only door to the room Mrs Nowland was in and monitoring her through the window.
This did not happen and police force was used instead.
The elderly woman's death "rocked her family, the local community and the broader NSW community to its core", Ms Callan said.
The 95-year-old was described as an extremely generous woman who carried out charitable work and pursued a range of interests including golfing and travel until her late 80s.
Judge Teresa O'Sullivan will examine systemic issues that existed prior to the tasering incident and will focus on dementia care and training for aged care staff, police and ambulance officers.
It was an opportune time to make recommendations that would save lives given Australia's aging population, Ms Callan said.
One in four people over the age of 80 had dementia, the court heard.
It was anticipated the number of people with dementia would double in the next 20 years, leading to over four per cent of the population living with the condition.
Ms Callan said the situation confronting White as Mrs Nowland stepped towards him and his police partner with a knife was not exceptional enough to warrant shooting her with a Taser.
At the time of the incident, neither NSW Police nor NSW Ambulance officers were put through training that specifically dealt with responding to incidents involving people with dementia.
In 2024, ambulance officers were taught how to respond to a dementia patient wielding a spatula in an aged care facility, Judge O'Sullivan heard.
A NSW Supreme Court jury found White guilty of manslaughter in November 2024.
He was sentenced to a two-year good behaviour bond in March 2025, a decision that was later upheld by the NSW Court of Criminal Appeal
During the two-minute and 40-second encounter at Yallambee Lodge, White drew his stun gun and pointed it at Mrs Nowland for a minute before saying "nah, bugger it" and discharging the weapon at her chest.
The 36-year-old Cooma man was removed from the force in December 2024.
He took action against NSW Police in the Industrial Relations Commission to regain his position but dropped that bid in August.
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