HAMPTON -- Helen Garland, accused of beating her 85-year-old sister to death, was taken out of Rockingham County Superior Court by ambulance Wednesday afternoon after tripping and falling facedown on the floor.

The fall occurred at the conclusion of a six-hour hearing to determine whether Garland was a danger to herself or others.

Garland, 76, is charged with second-degree murder in the 2004 beating of her sister Alice Keyho in a Hampton residence, but experts have ruled she is incompetent to stand trial. After her fall in court, Garland initially balked at going to the hospital, but eventually agreed. She did not appear to be seriously injured.

The hearing on Wednesday was to determine if Garland, who is free on bail, should be committed to an institution. Judge Patricia Coffey took the case under advisement. If the judge agrees with prosecutors, a hearing would be held to determine whether Garland should be involuntarily committed. Otherwise, the second-degree murder charge could be dropped without prejudice.

Two expert witnesses agreed Garland has dementia and is incompetent to stand trial, but differed on whether she is dangerous to the degree she must be committed.

Dr. Albert Druktenis testified he believes Garland is dangerous and that she may have been suffering from dementia at the time of the murder.

"Dementia affects the ability to control impulses and judgement," he said. "As it progresses, it is going to get worse, and she has no insight to it and doesn't even think she has it."

Forensic psychologist Helene Presskreischer told the court that she doesn't believe Garland needs to be institutionalized at this stage of her condition.

"I do not believe she is a danger to anyone," said Presskreischer, noting that the only person she has shown aggression to in the past was her sister. "... She had not become aggressive to anyone else.

Hampton Police Detective Lynne Charleston testified Garland threatened her on two occasions during the investigation of her sister's death.

The first time allegedly occurred when she and another officer told her they needed to take the clothes she was wearing into evidence and the other time when they arrested her at her home.

"She told us that it wasn't a good time because she had laundry going and curlers in her hair," Charleston said. "When we told her she didn't have a choice, she held onto the door frame. I told her to let go before someone gets hurt and she said, Yes, someone would get hurt and it wouldn't be me.'"

Charleston testified when she first met Garland she showed more concern for her cat than she did for her dead sister.

"She talked about Alice, but never said a nice word about her," Charleston said. "She never cried and never reminisced about the good times. She was glad her sister was gone (so) she could get back to her normal life."

Assistant Attorney General Elizabeth A. Dunn reviewed the details of the case with Charleston, including the finding that when police arrived at Garland's home on March 23, 2004, her sister had been dead for at least two days.

An autopsy report revealed Keyho had 22 broken ribs and was backhanded so hard imprints of rings that matched the ones Garland was wearing were left on her face and body. It also revealed a rug burn along her back from being dragged across the floor after she died.

Charleston said Keyho's blood was found in every room of their house except the living room and Garland's bedroom.

She testified Garland acknowledged backhanding Keyho three or four times and "giving her a boot" with the side of her foot.

"She told me that Alice had a smart mouth and would back talk her," Charleston said. "She said she would let her have it and that she did kick her, but it was OK because she was only wearing slippers."

Garland later told police she grew frustrated with the fact Alice was living in her home and that "she didn't mean to kill her sister."

Garland spoke out twice in court, once to say the word "Jesus" when Druktenis said she was dangerous, and another time to dispute a medical examiner's opinion concerning how her sister got two black eyes.

"Those two black eyes are from when she hit her head," Garland said.