March 7, 2002 - Clark Houghtling lives more than 300 miles away from his mother, an 87-year-old who suffers from dementia. But Mr. Houghtling and his sister see that she is tucked into bed every night at her assisted-living apartment outside Buffalo, N.Y. How? They log onto their computers and switch on a video camera in her bedroom.
The siblings had the cameras installed in their mother’s apartment several years ago, after she fell and spent hours stranded on the floor. (The computers and cameras are linked by telephone lines.) "It was very disturbing to us when we realized it could have been 12 to 16 hours before someone came to check on her," Mr. Houghtling says. A few years ago, his sister, using her laptop, saw their mother fall again. She called the facility, and within minutes three aides were there to help. "These cameras are a wonderful thing," he says.
For years, the long-term care industry has largely managed to block the use of "granny cams," video-surveillance cameras that families sometimes use to watch over elderly or disabled residents in nursing homes or other facilities. There are no laws against such cameras. But many nursing-home owners, as well as employees and insurers, discourage their use, on the grounds that they are an invasion of privacy.
"When [residents] are having diapers changed and wounds changed, their bodies are being exposed," says Sherry King, a doctor at two Jacksonville, Fla., nursing homes and president of the Florida Medical Directors Association. "To have that on camera constantly is really bizarre."
Yet granny-cams are starting to get lawmakers’ attention. At a Senate hearing, Michael Peters, an Orlando, Fla., attorney who represents nursing-home residents, testified that cameras would potentially eliminate abuse and neglect if employees knew they were being watched. Meanwhile, legislators in at least a dozen states are trying to make it easier for families to install cameras. Texas enacted a law spelling out families’ surveillance rights last summer. A pilot project employing cameras is on the drawing board in Maryland, and a similar one would be authorized in Florida as part of a bill now making its way through the legislature, after state regulators last month recommended permitting cameras’ use.
Many lawmakers who support cameras do so after personal experience with nursing homes. Maryland Delegate Sue Hecht introduced one of the first granny-cam bills after walking in on a nursing-home worker cursing and screaming at her mother. "I felt like I had no control over seeing if this happened again," she recalls.
Her proposal would require nursing homes to permit residents or their families to install cameras at their own cost. The families would have to obtain the consent of roommates and post signs stating that a camera is in use. Anyone tampering with the camera would be subject to criminal penalties. "This bill is designed to jump-start what everyone is going to eventually embrace-an extra eye and ear for an industry that truly needs help," Ms. Hecht says.
The U.S. nursing-home industry-comprising 17,000 facilities and 1.5 million residents-disagrees. Managers and labor leaders say cameras make it tough to attract workers. "Adding the stress of ... constant surveillance to these very demanding jobs is another reason why people would ask, ‘Why do I want to do this for $7 an hour?’" says Dale Ewart, secretary-treasurer of Local 1199 of the Service Employees International Union, Miami.
The industry frets that cameras will drive up liability insurance premiums by touching off a landslide of lawsuits. Already, some insurers are weighing whether to pull out of markets where legislation is pending. "As an underwriter, the way we can deal with this is to refuse to write the coverage," says J. Sterling Shuttleworth, chief executive of Uni-Ter Underwriting Management Corp., an Atlanta unit of U.S. RE Cos., who testified against cameras at a Florida hearing last fall.
Even some families who have successfully fought to use cameras discover they have limits. In Anchorage, Alaska, Marty Margeson lobbied for months for permission to tape her father’s room at a nearby assisted-living facility. The camera put an end to "unexplained bruising on his arms and hands," she says. But some of her complaints have gone unheeded. "I don’t know what I can do with all this footage," she says. "A solid year of watching your father being jerked out of bed in a sheet, and you’ve tried and tried to stop them - it gets old."
A few facilities have embraced the cameras. Gerontologist Jacqueline DuPont-Baum runs six homes for Alzheimer’s patients in Irvine, Calif. Cameras are in place in residents’ bedrooms and common areas. She obtains written consent of families and workers.
"The cameras are really useful as a deterrent," Dr. DuPont-Baum says, protecting workers from false allegations of abuse and attracting "really kind people," who don’t mind being monitored on the job. Nursing homes already "allow for shared rooms ... [and] for a diaper to be changed in front of another resident," she adds. "Where’s the dignity in that?"
Cindy and Mark O’Steen, who own and run Southland Suites, a 36-bed assisted-living home in Lake City, Fla., installed cameras in common areas and hallways eight years ago, after they stopped living on the premises. The O’Steens and family members log onto a Web site to observe residents. The extra eyes help make sure their staff is trained well, Ms. O’Steen says. And in contrast to operators’ fears, the couple’s liability-insurance premium has dropped, to $11,000 in January from $57,000 last year. (The O’Steens say they don’t know if the drop was directly related to the cameras, but they did give their insurer information about the cameras.)
Families say cameras will only become more valuable as the nursing-home population grows. Thor and Becky Hallen, a Beaverton, Ore., couple, used a hidden camera several years ago to catch a worker at a Texas nursing home throwing Mr. Hallen’s mother into a chair. The couple told the administrator about the camera and left it running. "When they found out about the camera," says Ms. Hallen, "it was amazing how good the care got."