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Driven by a mistrust of nursing homes, more families are taking advantage of advances in surveillance technology and using video cameras to help protect loved ones they suspect are being abused or mistreated by caregivers.
Even some facility managers and law enforcement officials are now using hidden cameras to catch workers who mistreat elderly or vulnerable residents, including at least two cases at assisted-living facilities in Minnesota in recent years. No figures are available, but specialists in the long-term care industry say the use of so-called "granny cams" is spreading, though the technology is also raising a host of legal and privacy issues.
Just this spring, an Ohio man placed a hidden camera in a desk fan to catch two nursing home workers abusing and hitting his 78-year-old mother, who suffers from Alzheimer's disease. In New Jersey, workers were caught abusing an 87-year-old woman, prompting a wrongful-death lawsuit in June. In New York, authorities arrested 22 workers last year after hidden cameras revealed maltreatment of residents in two facilities.
Georgia Anetzberger, president-elect of the National Committee for the Prevention of Elder Abuse, said the spread of cameras in nursing homes is part of a broader proliferation of video surveillance in society to catch anything from traffic violations to shoplifting.
"Cameras are used to catch people more than ever before, not just because the technology is there but because it's more widely accepted," she said.
For years, however, the long-term care industry has fought legislative efforts across the United States to legalize the use of cameras, citing insurance costs and resident and employee privacy issues. Critics said cameras would make it more difficult to hire staff and that they also could misrepresent an incident.
In 2009, Minnesota legislators approved a law that allows adult foster-care facilities to install cameras for overnight monitoring of vulnerable residents to save on staff costs, but the legislation does not cover other types of facilities. So far, regulators have approved nine requests for such surveillance.
Some advocates believe Minnesota lawmakers need to broaden the rules to address the use of cameras in all facilities, even though some believe residents already have the right to use such technology.
"We need some clear legal structures around this, with the ultimate right to consent or refuse resting with the patient," said Roberta Opheim, the state's ombudsman for mental health and developmental disabilities. "There needs to be a broad public discussion and the Legislature needs to weigh in. What are the safeguards for everybody?"
Few states pass laws
The push to install video cameras in long-term care facilities started to gain momentum a decade ago. Legislation was introduced in more than 15 states, but only three -- Texas, New Mexico and Maryland -- adopted laws addressing the use of cameras in nursing homes, according to a 2007 article in the Baylor Law Review.
In Texas, which approved the use of cameras in 2001, nursing home residents and their families appreciate having the right to use the technology, said Patty Ducayet, the state's long-term care ombudsman. She said use has been limited, but she believes cameras provide a benefit.
"I really do think it is a deterrent," Ducayet said. "People know you've got a device in your room. It's required to be posted you do. I think it does have the potential to influence the way someone behaves and cares for you in the privacy of your room."
In New Mexico, residents must be notified of their right to have a camera when they move into a facility.
"As it turns out, it hasn't been a big issue from the providers' standpoint," said Linda Sechovec, executive director with the New Mexico Health Care Association, an industry trade group that represents nursing homes. "It hasn't been something that is widespread. I think in general families don't want to intrude [on their loved ones] with cameras unless there's a real serious concern."
Minnesota's two major nursing home provider trade groups -- Care Providers of Minnesota and Aging Services of Minnesota -- declined to be interviewed for this story.
"The provider community believes that use of a surveillance camera is a very personal and private decision best made by each individual, often in consultation with their family and health care providers," Jessica Sorensen, Aging Service's vice president of public relations, said in an e-mail.
In the two recent Minnesota cases, facilities installed cameras after suspected abuse or exploitation. In a 2009 case, an assisted-living facility in Burnsville discovered large quantities of medication missing from at least six residents. The facility installed cameras in client rooms and caught an aide on the night shift stealing prescription drugs.
In a 2007 case, an assisted-living facility in Chanhassen installed a camera that documented an aide abusing a resident late at night in her own apartment. The video showed an aide "forcefully dragging" the woman from her living room to her bedroom, according to court testimony in the case. The family sued and the case was settled out of court.
The Minnesota Department of Health was notified of the incident, but chose not to investigate. Department spokesman John Stieger said he couldn't explain the decision, but he said the department would act differently today. "We would investigate the facility to determine if there were any systemic issues that led to the problem," he said.
Minnesota's Health Department has been repeatedly faulted for how it reviews complaints of abuse and neglect.
Twice in the past four years, federal records show, state regulators did not properly investigate 40 percent of reported complaints.
Some residents were abused by workers who were hired even though they had known criminal records because regulators granted exceptions to rules aimed at protecting vulnerable people.
Violette King, one of the leading advocates for using cameras, believes they are "the only solution" for family members who can't be present 24 hours a day. King founded the nonprofit advocacy group Nursing Home Monitors in 1996 after her father suffered abuse while in a facility.
To try to demonstrate the effectiveness of such cameras, King's group recruited residents in more than a dozen facilities in the early 2000s. The group offered to pay for the cameras, but the effort fizzled. King, based in Illinois, said the homes often resisted or intimidated residents and their families who wanted to participate.
But King thinks the climate for cameras has improved. "I think people are more aware of what's going on in nursing homes," she said.
Not all resident advocates believe cameras are the best way to protect the elderly.
Harbir Kaur, an abuse prevention expert with ElderCare Rights Alliance in Minnesota, said there are better tools: training, education and empowering consumers through strong resident and family councils.
Kaur thinks residents in Minnesota have the right to use a camera, but she is worried that widespread use of the technology would turn nursing facilities into highly monitored zones with less privacy and dignity for residents.
"Where do we want it to go?" Kaur said. "How can we make our consumers comfortable without putting the cameras in? How can we make staff feel more comfortable that you can come talk to us?"
Brad Schrade • 612-673-4777