Surveillance cameras in nursing-home facilities

A pilot program will install video cameras for some nursing-home residents. They will also allow family members to see each other as they talk on the phone.

Sue Hecht knew something was wrong when she knocked on the door of her mother's room in a Maryland nursing home and heard an angry voice yell back, "What do you want?" When Ms. Hecht entered, she found an aide screaming and swearing at her mother. The older woman was crying.

Shocked, Hecht reported the incident to administrators, and the abusive aide was fired. "They took very appropriate action," she says approvingly. But, she adds, "I also know this wasn't the first infraction. If I hadn't walked in, I don't know how much longer that person would have been there."

To prevent abuses like these, Hecht, a delegate in the Maryland legislature, introduced a bill that would allow nursing home residents to install video cameras in their rooms, at their own expense. Roommates would need to give written consent. A notice posted on the door would indicate the presence of a camera.

No federal law forbids video cameras in nursing facilities. But, Hecht adds, "Nursing homes in a lot of states are blocking cameras and saying, 'No, you can't do this.' "

A 1999 study by the US General Accounting Office found that one-fourth of the nation's nursing homes have deficiencies serious enough to have harmed residents or placed them at risk of injury or death.

Opponents of surveillance cameras regard them as an invasion of privacy. "People need to understand that some very private moments can be captured," says Deborah Cloud of the American Health Care Association, which represents nursing homes.

Critics also caution that behavior caught on film can be easily misinterpreted. They offer an example: If a resident is in the dining room and asks an employee to retrieve an item she left in her room, a tape of the worker opening a drawer with no one present could be used to allege theft.

Such incidents could make facilities "ripe for frivolous lawsuits," says Adam Kane, director of public policy for the Mid-Atlantic Nonprofit Health and Housing Association. Unlike cameras in banks or stores, he adds, nursing facilities do not own the tapes or even see them. "We're worried the tapes would end up in a law firm."

With staffing shortages reaching what Ms. Cloud calls "almost crisis proportion," she and others fear that cameras might drive caregivers away by creating an atmosphere of distrust. Hecht counters that video surveillance does not represent a threat to employees who are doing their jobs properly.

Hecht's bill died in a committee hearing this month. As a compromise, the Maryland Department of Health will fund a pilot program in two nursing homes to test what Mr. Kane calls technology upgrades. These include video cameras for residents who request them. Video conferencing will also enable family members to see each other as they talk on the phone.

Results of the pilot program, Kane says, could help to shape any future legislation.

Defending the need for legislation, Hecht says, "I keep telling the industry, 'I'm not the enemy.' They should join with me in working together on this. So many positive applications can come out of this."

She notes that only 40 percent of residents receive regular visits from family members. "If we can decrease the isolation through technology, how wonderful that would be," she says.

Cloud emphasizes that nursing homes know they must be "ever vigilant" in preventing abuse. At the same time, she says, people need to acknowledge that caregivers "perform a very demanding job that few of us are able to take on. We need to elevate and celebrate the work of those who provide direct hands-on care to nursing-home residents."

(c) Copyright 2001. The Christian Science Monitor