This story was originally published at PublicSource.org. Stuart Sanderson’s connection to the world outside his Philadelphia nursing-home room was severed because of anxiety over a simple webcam. A compact video camera on his computer monitor allowed him to speak to family even without a voice. Stu, as he prefers to be called, has cerebral palsy, but video calls put him in touch with his ailing father and his brother, who would take the time to read his lips.
But to Inglis House, the camera was a watchful eye, scrutinizing its staff’s every move and potentially capturing images of people whose privacy they’re responsible to protect. Even when Inglis House returned the electronics, tension lingered. Signs warning of advanced surveillance were plastered on the walls of Stu’s room. Caregivers covered or moved the webcam and “forgot” to reposition it.
Stu’s computer equipment was abruptly removed in mid-December, and he was asked to write a note defending his access to it. Family members called it a “cruel hurdle” for a man with limited mobility who selects each letter by pushing the back of his head against a switch.
In a note pleading for his webcam to be returned, Stu wrote: “WE ARE NOT SPYING ON ANYBODY!” The Sandersons unwittingly became part of a splintered national debate about the role of video cameras in longterm care facilities. The conversation includes webcams used for video calls, clocks with hidden pinhole cameras, and motion-activated cameras that broadcast live video feeds to laptops and smartphones.
At a time when police officers wear body cameras and average citizens check video feeds of their children and pets at daycare, the long-term care industry is being forced into a game of catch-up. The facility is now drafting a policy to address cameras for communication needs and those used to monitor care, either visibly or covertly, said Gavin Kerr, president and CEO of Inglis House, a nursing home that serves about 300 people with complex disabilities and health care needs. He said the policy will support residents’ rights to cameras as long as they notify staff.
Pennsylvania, like south Carolina, doesn’t have regulations pertaining to cameras in nursing homes. A state wiretapping statute forbids audio recording without the consent of all parties; video is fine, though. Federal guidelines prioritize residents’ rights, but there are conflicting interpretations.
A handful of states took that decision out of their hands. In 2001, Texas became the first state to expressly allow electronic monitoring in long-term care facilities. New Mexico, Washington, Illinois, and Oklahoma followed suit. Maryland gave its nursing facilities guidance on how to properly allow cameras, but left it up to them if they will permit it. No state has passed a law banning cameras in nursing facilities.
The laws generally require that administrators are notified of the camera and that consent forms are signed by the resident and any roommates. Signs notifying staff, residents and visitors of the cameras are required at the resident’s door or the facility’s entrance.
Hidden cameras have caught abuse at Pennsylvania long-term care facilities. In three notable cases out of Bucks and Delaware counties between 2011 and 2014, families had suspicions and set up cameras. The recordings captured mocking, manhandling and slapping. Collectively, six caregivers were arrested, one nursing home was closed and another operated on a provisional license until it made state-mandated corrections.
Attorneys general in New York and Ohio have used hidden cameras in similar cases. The Pennsylvania Attorney General’s Office has not used hidden cameras to investigate long-term care facilities, “but that doesn’t mean we wouldn’t,” said spokeswoman Carolyn Myers.
The cameras are easy to come by with a basic online search: A hidden-camera alarm clock equipped with night vision and motion-activated recording starts at $99. A $400 air purifier has a tiny camera that can store recordings for up to a month. The hidden variety also come in coat hooks, picture frames and tissue boxes. Some people opt for visible security cameras to let the staff know they’re watching.
Too many family members decide to use video cameras because they feel the duty to protect a frail loved one, said Nina Kohn, a Syracuse University law professor who specializes in elder law and the civil rights of senior citizens.
Several elder advocacy organizations support the use of video technology when the resident wants it and privacy safeguards are in place.
“You’re dealing with a vulnerable population and if a resident wants that to feel more comfortable, we certainly think they have right to have that type of monitoring,” said Amity Overall-Laib, a manager at The National Consumer Voice for Quality Long-Term Care.
AARP has a national policy supporting the use of cameras for communication and surveillance, said Ray Landis, advocacy manager for AARP Pennsylvania.
More and more nursing facilities and retirement communities, he said, are using video conferencing for caregivers to meet with family and are also offering personalized calendars and email updates to show what residents do all day.