Surveillance in Age-Related Care Facilities: What Are the Limits?

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There are myriad viewpoints on the amount of surveillance present in the daily lives for most people in the Western world. We are used to cameras in most private business, such as stores or banks, to prevent crime and increase security; we see cameras in government buildings for the same reasons. Yet recording people while they receive healthcare is more controversial than cameras at the supermarket. When deciding what age-related care facility in which to place a loved one, the extent and kind of video surveillance employed is an important factor to consider.

The researchers assert that surveillance monitoring and research can help reinforce victim testimony…

Bharucha et al. note that there is a severe underreporting of nursing home and assisted living facility abuse and neglect. The researchers assert that surveillance monitoring and research can help reinforce victim testimony, but note that it does pose a significant ethical problem. They see the arguments as generally two-sided, one arguing that patient safety trumps all, the other arguing for employee protections and pointing out that security cameras do not actually prevent crime.

No Cameras at All

Legislation exists in some states that require age-related care facilities themselves to decide whether or not cameras will be used in patient rooms. The argument against using such is that employees will feel watched and scrutinized by constant monitoring and that, by installing cameras, the privacy of elderly persons is compromised when they are vulnerable enough to need others to help them care for themselves. Americans, in particular, famously love their privacy, and they even resent the monitoring that often comes with Internet use. Certainly, some are opposed to the idea of an elderly person undressing or being undressed in front of a recording camera.

Employees working in long-term care are “overburdened” and “dwindling,” according to Bharucha et al. Adding surveillance cameras, which can lead to a micromanagement of their care techniques, might only drive more employees out of the field.

Surveillance by Resident Approval Only

Several states, including Oklahoma and Texas, allow residents to install their own surveillance should they choose to. This moves some of the financial obligation from the facility and onto the loved ones of residents.

The worries of high staff turnover still apply here, though the inconsistency of some residents having monitoring and others not having it makes it more complicated.

Some also argue that this is insufficient, and that it could lead to some residents getting higher quality care while others still face security concerns and potential abuse or neglect.

However, since the monitoring must be done with consent from the resident, this removes the privacy issue almost entirely. This appears to content many residents, and it is becoming a more popular option (eleven states have adopted some version of this type of law so far).

Cameras for Everyone

Like the first option of no cameras at all, this potential solution takes an uncompromising approach to surveillance in age-related care facilities. This argument largely comes from advocates against age-related care facility abuse and neglect. They demand that employees be monitored, arguing safety and security are more important than privacy or employee morale. Since the U.S. Department of Health and Human Services reported that 85% of nursing facilities had at least one allegation of abuse or neglect leveled at them in 2012, this argument is a convincing one.

 Hiding or leaving cameras in plain sight is also part of this debate…

Concerns about privacy can be answered by informing all patients and visitors that cameras are in use, with signs posted in the front of the facility, as is done in Texas. Hiding or leaving cameras in plain sight is also part of this debate; some may want residents to be able to hide cameras from a facility in order to further protect them from potential abuse, whereas others may find an openly recording camera to be more honest and aboveboard.

Wherever you personally fall on this issue, it is absolutely worth reading up on and inquiring about before placing a loved one in any age-related care facility. Knowing how you and your loved one stand on privacy and surveillance can change where they are and whether or not you choose to pay for surveillance, opt for a facility with no cameras at all, or choose one where everyone is monitored by cameras at all times.

 

Sources

Bergal, Jenni. (September 25, 2014). Nursing Home Cameras Create Controversy. The Pew Charitable Trusts. Available at http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2014/09/25/nursing-home-cameras-create-controversy. Retrieved February 29, 2016.

Bharucha, Ashok J., London, Alex John, Barnard, David, Wactlar, Howard, Dew, Mary Amanda, and Reynolds, Charles F. R III. (2006). Ethical Considerations in the Conduct of Electronic Surveillance Research. Journal of Law, Medicine & Ethics. (Fall 2006): pp. 2-10. Available at http://www.informedia.cs.cmu.edu/documents/Bharucha_Independent_06.pdf. Retrieved February 29, 2016.

Levinson, Daniel R. Inspector General, Department of Health and Human Services. (August 2014) Nursing Facilities’ Compliance with Federal Regulations for Reporting Allegations of Abuse or Neglect. Available at http://oig.hhs.gov/oei/reports/oei-07-13-00010.pdf. Retrieved on February 29, 2016.

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