Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697634089004.pdf (Australia)
Inquiry into violence, abuse and neglect against people with disability in institutional and residential settings, including the gender and age related dimensions, and the particular situation of Aboriginal and Torres Strait Islander people with disability, and culturally and linguistically diverse people with disability.
Tunstall Healthcare Submission June 2015 Violence, abuse and neglect against people with disability in institutional and residential settings, including thegender and age related dimensions, and the particular situation of Aboriginal and Torres Strait Islander people withdisability, and culturally and linguistically diverse people with disabilitySubmission 120 Table of contents Introduction .......................................................................................................................... 3 1.
Background ........................................................................................................................... 3 2.

Evidence .................................................................................................................................. 4 3.

4.
Summary ................................................................................................................................ 6 Appendix 1: Virginie’s Story ........................................................................................................ 7 Appendix 2: Krystyna’s Story....................................................................................................... 8 Tunstall Healthcare Page | 2 Violence, abuse and neglect against people with disability in institutional and residential settings, including thegender and age related dimensions, and the particular situation of Aboriginal and Torres Strait Islander people withdisability, and culturally and linguistically diverse people with disabilitySubmission 120 1.
Introduction On 11 February 2015, the Senate referred the following matter to the Senate Community Affairs References Committee for inquiry and report: Violence, abuse and neglect against people with disability in institutional and residential settings, including the gender and age related dimensions, and the particular situation of Aboriginal and Torres Strait Islander people with disability, and culturally and linguistically diverse people with disability.
The aim of this submission is to provide information and share experience of domestic violence and abuse protection and prevention technology solutions which currently exist throughout Australia and New Zealand.

These include the provision of assistive technology installed in home settings as well as wearable alarms developed in a wrist watch design with GPS location tracking.
These communication devices, when linked to a 24/7 monitoring centre with professionally trained response personnel, provide a much needed service to support some of the most vulnerable people in our society, in particular those with disabilities and culturally diverse needs.

The information and evidence presented in this submission in particular relates to the following terms of reference.
a. what needs to be done to protect people with disability from violence, abuse and neglect in institutional and residential settings in the future, including best practice in regards to prevention, effective reporting and responses; b. identifying the systemic workforce issues contributing to the violence, abuse and neglect of people with disability and how these can be addressed; c. the role of the Commonwealth, states and territories in preventing violence and abuse against people with disability; d. the challenges that arise from moving towards an individualised funding arrangement, like the National Disability Insurance Scheme, including the capacity of service providers to identify, respond to and prevent instances of violence, abuse and neglect against people with disability; and e. what elements are required in a national quality framework that can safeguard people with disability from violence, abuse and neglect in institutional and residential settings.
2.

Background Tunstall Healthcare is the world’s leading provider of telehealthcare solutions, operating in over 50 countries and supporting more than 3.6 million people worldwide.

Tunstall has been delivering pioneering remote management support solutions for more than 55 years, and remains at the forefront of transforming health and care services.
Tunstall has played a significant part in the complex Australian health system since 2002, contributing to the safety, health and wellbeing of over 70,000 people and their carers.

Tunstall is a leading provider of personal alarms, smart home technologies, lone worker and GPS tracking devices supported by 24/7 emergency response monitoring services.
Tunstall Healthcare Page | 3 Violence, abuse and neglect against people with disability in institutional and residential settings, including thegender and age related dimensions, and the particular situation of Aboriginal and Torres Strait Islander people withdisability, and culturally and linguistically diverse people with disabilitySubmission 120 Tunstall’s monitoring platform is capable of monitoring many different types of products and equipment in the market.
The comprehensive system provides a wide range of reporting capability, including real time response data linked to individual client records along with call recording and incident management.

Tunstall’s telehealth solution, Integrated Care Platform, helps people understand and manage their own health.
Using the myclinic health interview software, available via a dedicated telehealth hub (portable PC tablet) or the mymobile app for smartphones, a client is able to monitor their own vital signs and health condition from home, with the comfort that if readings go beyond set limits, their care team will be informed.

3.
3.

Evidence The following information describes various programs that are being delivered in the Australian and New Zealand settings which could be developed to address some of the concerns raised by the Committee: 3.1 24/7 Emergency Monitoring Services Currently there are more than 300,000 people within Australia who are utilising personal emergency alarms.

An emergency medical alarm comes with a wearable wireless pendant which can be discretely worn around the neck, on the wrist or waistband.
Some users are funded to have an alarm under community aged care funding with the aim to help them remain safe and independent in their own home environment.

Department of Veterans’ Affairs (DVA) clients who hold white and gold cards can also receive funding for a personal alarm under the Rehabilitation Appliances Scheme.

Of the 300,000 people currently utilising alarms, approximately 100,000 choose to have their alarm go directly to a family or friend rather than a professional monitoring company.
The service costs approximately $24 - $35 per month, including rental of the alarm and 24/7 monitoring.

For approximately $1 per day, vulnerable people can get immediate response should they need it including help following a fall, safety concerns, social interaction, and medication reminders.

In many cases these types of services prevent an ambulance having to attend a false or unnecessary call out.
In all cases, the ambulance service will be called for the right reasons due the nature of the call triage service available at the end of the line.

The Monitoring Centre is able to support people with diverse needs, including those with disabilities, dementia related illness, mental health issues and loneliness.
The Monitoring Centre works closely with the National Interpreter Service to support those with language interpretation needs and other service providers such as the National Relay Service who assist people with hearing communication devices such as the TTY (telephone typewriter).

Tunstall develops customised emergency aids for people with special needs.
The simple button is converted into a puffer or wand switch which can be designed and fitted to an individual’s unique requirements according to the layout of their living environment.

The specially designed switch performs the exact same task as a standard pendant – in that when it is activated a call is sent through to the Monitoring Centre whereby the operator provides the support that is described on the client’s individual record.
These services are known to allow people to remain living in a place of their choice rather than having to go into other more expensive care.

See Appendix 1: Virginie’s Story.
Tunstall Healthcare Page | 4 Violence, abuse and neglect against people with disability in institutional and residential settings, including thegender and age related dimensions, and the particular situation of Aboriginal and Torres Strait Islander people withdisability, and culturally and linguistically diverse people with disabilitySubmission 120 3.2 Wearable Devices There are many GSM/GPS devices on the market that are used to track people – wearable and lockable tracking devices usually worn on the ankle and reserved for people under criminal orders.
When considering the vulnerable individual, a person with a disability and/or requiring protection in and outside the home, the wearable device becomes an option.

However, it must be a device that is reliable and can be discretely worn and activated.

Wearable devices should not be an impairment to the person’s comfort and every day living.
When supported by a professional 24/7 monitoring service, these devices can aid in providing intervention and act as a deterrent to escalating events, along with protection and immediate emergency response.

Using GPS tracking, the operator is able to coordinate emergency responders to the location of the wearer.

These wearable device and monitoring solutions currently exist and can be provided for around $75 per month under a rental/monitoring service.

See Appendix 2: Krystyna’s Story.


3.3 Domestic Violence Protection Services Tunstall has over 12 years’ experience supporting people under Domestic Violence Protection Orders, managing the complex and often life threatening responses that are required.
Since 2002, Tunstall’s New Zealand based monitoring services has been working with the New Zealand Police and Shine, New Zealand’s largest domestic abuse charity, for domestic violence and other vulnerable members of the community, and at times, police officers themselves.

The central hub of our service is the personal medical alarm that can be used to quickly and easily make contact with our 24 hour monitoring centres.
When a call for assistance is activated by a trigger device, the Monitoring Centre call- handling platform automatically accepts the call and presents to an operator who is then able to identify the caller, where they live, any major medical conditions they have, their appropriate call response plan, who should be contacted in an emergency, and what device has activated the alarm.
In an emergency the Tunstall response operator will speak with the client and discuss their condition and what action needs to be taken, such as calling a family member or friend, after-hours doctor or emergency services.

Alternatively, if listed on the call response plan, the operator will answer the call in ‘silent mode’, arranging the appropriate assistance for the client without alerting a potential perpetrator.

The operator can also stay on the line until help arrives.
Reporting is also integral to these types of services.

All monitoring calls are recorded for reporting and quality improvement processes.

Other reports include: • Real-time reporting of all alarm activations • Accurate real-time reporting of locations and individuals with alarms installed • Monthly reporting of alarms not currently in service • Monthly and annual reporting of recorded faults, maintenance, test calls, and activations (including a count of false activations).
• Time and date of installation, relocations and de-installations.
Tunstall Healthcare Page | 5 Violence, abuse and neglect against people with disability in institutional and residential settings, including thegender and age related dimensions, and the particular situation of Aboriginal and Torres Strait Islander people withdisability, and culturally and linguistically diverse people with disabilitySubmission 120 3.4 Young people Currently more than 6,000 young people with disabilities are living in residential aged care settings in Australia.
Smart home technology and wearable devices with GPS tracking can provide alternative solutions to allow people to remain independent and safe in their home for longer and/or delay entry into aged care settings not necessarily suitable for a younger person living with a disability.

Since 2013, Tunstall has been working with the Endeavour Foundation on an innovative project to provide modern accommodation options for people living with a disability.
With over 20 smart homes currently located across Queensland, Endeavour plan to add more in the coming months.

A maximum of four people live in each house, ensuring greater choice and independence for each individual.

Each home is fitted with a Tunstall medical alarm, programmed with a number of care and activity sensors, included help buttons, smoke detectors and door and gate exit sensors.

Aided by this assistive technology, residents are also supported by an offsite carer.

4.
4.

Summary Tunstall presents this information as a source of reference for the Committee.

Assistive technology systems and services provide a cost-effective means of supporting people who are at risk of neglect, abuse or violence.
If further information should be required or any enquiries result from this submission please do not hesitate to contact Lisa Capamagian: Lisa Capamagian Tunstall Healthcare, Corporate Development Manager 1/56 Lavarack Avenue, Eagle Farm Queensland 4009 t: 07 3637 2202 | m: 0434 318 425 e: lisac@tunstallhealthcare.com.au | w: www.tunstallhealthcare.com.au Tunstall Healthcare Page | 6 Violence, abuse and neglect against people with disability in institutional and residential settings, including thegender and age related dimensions, and the particular situation of Aboriginal and Torres Strait Islander people withdisability, and culturally and linguistically diverse people with disabilitySubmission 120 Appendix 1: Virginie’s Story Virginie has multiple sclerosis and lives alone in her own home.
She is only able to move her neck and head and spends long periods of time alone between carer visits.

Virginie is still capable of living alone and does not want to move to a high care facility.

She loves spending time outside in her garden and does not want to lose her independence.

The solution Tunstall developed a customised solution for Virginie, allowing her to maintain her independence and stay in her own home, while taking the need for constant supervision and concern off her carers.
A wand switch was installed on the back of Virginie’s wheelchair so all she needs to do is tilt her head back to activate an alarm call for help or answer the telephone.

Tunstall also fitted out Virginie’s bed with a sip/puff switch, enabling her to activate an alarm call from the bed.

The switch is attached to a flexible rotational tube which allows Virginie to blow into the device to activate an alarm call.
Tunstall’s response operators are alerted to Virginie’s specific medical conditions and can organise the appropriate help whether that is emergency services, family, friends or a carer.

How it works The wand and sip/puff switches are triggers which allow people with disabilities to activate a Tunstall personal medical alarm unit.

The wand switch is positioned so that the client is able to move a part of their body to trigger the spring ended switch.
This is connected to a Tunstall ROM (radio output module) or to a Bellman telephone transmitter.

The sip/puff switch is positioned using a unique flexible tube so that the client is able to either suck or blow in the tube to activate the trigger.

Each switch may be attached to a wheelchair, table top or a bed frame.

When the trigger is activated by the client it will raise an alarm call to the Tunstall monitoring centre or the immediate carer.
When used with a Tunstall alarm unit, the wand switch can also be used to answer incoming telephone calls, allowing a hands free telephone call via the alarm unit.

The outcome Virginie says “I will never give up; I am so glad I have my mind unlike some others.

Before my new wheelchair and the Tunstall alarm I would be put in one spot where I would have to stay until the next carer visit.
Now I can control my chair and I am working on ways that I can begin my artwork again– I have works of art inside my head just waiting to come out!” Virginie believes the Tunstall sensors have allowed her to remain living in her own home and enable her to feel safe and secure, should she ever need help.
Tunstall Healthcare Page | 7 Violence, abuse and neglect against people with disability in institutional and residential settings, including thegender and age related dimensions, and the particular situation of Aboriginal and Torres Strait Islander people withdisability, and culturally and linguistically diverse people with disabilitySubmission 120 Appendix 2: Krystyna’s Story Krystyna’s son Brad has an acquired brain injury.
He has recently moved to a care facility and has been using the Find-Me Tunstall Watch during this transition period.

Krystyna has been the primary caregiver for her son Brad since his accident.

Brad suffered an acquired brain injury and was experiencing episodes of disorientation and depression following his diagnosis and transition to a care facility.
Brad’s clinician recommended to Krystyna that they trial the Find-Me Tunstall Watch as a reliable yet unobstrusive method of monitoring Brad during the difficult transition period.

The solution The Find-Me Tunstall Watch is an alert button, inbound mobile phone and GPS tracking locator in one.

Brad used the watch for a period of 10 months whilst he readjusted to his new environment and situation.

The watch allowed Brad to send an alert for help with the simple touch of a button.
It also allowed Krystyna to track Brad’s location should he become disorientated and not arrive on time, or disappear during one of his episodes.

Krystyna said “At one stage he was half way home and became disorientated.

He ended up in a park, but we were able to track and find him quickly using the computer mapping - we only had to jump onto the laptop.” Krystyna admits she found the watch, its software and the alert features to be very user friendly.
“I’m a self-confessed computer illiterate, but the watch and software is so simple to use, I use it on my mobile as well”.

The different wearing options available for the Find-Me Tunstall Watch were also an advantage.

“He prefers to wear it around his neck on a cord instead, but he could also wear it on his wrist just like a watch if he had wanted,” Krystyna said.

How it works The Find-Me Tunstall Watch is pre-programmed and set up using a simple web interface.
The user simply needs to wear the watch and charge when required.

The watch works by using a pre-installed SIM (similar to a mobile phone) and will work anywhere there is mobile phone coverage.

The alert button is programmed to contact Tunstall’s 24 hour monitoring centre and advise an additional four numbers with a map location via SMS and email.
The watch can be contacted by any landline or mobile phone and an authorised user can also login using their individual username and password to monitor the wearer’s location.

The outcome Krystyna found the watch offered Brad a sense of security and put her own mind at rest.

“The watch has been a real benefit at different times... it helped put my mind at rest,” she said.
Tunstall Healthcare Page | 8 Violence, abuse and neglect against people with disability in institutional and residential settings, including thegender and age related dimensions, and the particular situation of Aboriginal and Torres Strait Islander people withdisability, and culturally and linguistically diverse people with disabilitySubmission 120