The assisted living facility in Edina, Minnesota, where Jean Peters and her siblings moved their mother in 2011, looked lovely. \u201cBut then you start uncovering things,\u201d Peters said.<\/p>\n
Her mother, Jackie Hourigan, widowed and developing memory problems at 82, too often was still in bed when her children came to see her midmorning.<\/p>\n
\u201cShe wasn\u2019t being toileted, so her pants would be soaked,\u201d said Peters, 69, a retired nurse-practitioner in Bloomington, Minnesota. \u201cThey didn\u2019t give her water. They didn\u2019t get her up for meals.\u201d Her mother dwindled to 94 pounds.<\/p>\n
Most ominously, Peters said, \u201cwe noticed bruises on her arm that we couldn\u2019t account for.\u201d Complaints to administrators \u2014 in person, by phone, and by email \u2014 brought \u201ctons of excuses.\u201d<\/p>\n
So Peters bought an inexpensive camera at Best Buy. She and her sisters installed it atop the refrigerator in her mother\u2019s apartment, worrying that the facility might evict her if the staff noticed it.<\/p>\n
Monitoring from an app on their phones, the family saw Hourigan going hours without being changed. They saw and heard an aide loudly berating her and handling her roughly as she helped her dress.<\/p>\n
They watched as another aide awakened her for breakfast and left the room even though Hourigan was unable to open the heavy apartment door and go to the dining room. \u201cIt was traumatic to learn that we were right,\u201d Peters said.<\/p>\n
After filing a police report and a lawsuit, and after her mother\u2019s 2014 death, Peters in 2016 helped found Elder Voice Advocates<\/a>, which lobbied for a state law permitting cameras in residents\u2019 rooms in nursing homes and assisted living facilities. Minnesota passed it<\/a> in 2019.<\/p>\n Though they remain a contentious subject, cameras in care facilities are gaining ground. By 2020, eight states had joined Minnesota in enacting laws allowing them, according to the National Consumer Voice for Quality Long-Term Care<\/a>: Illinois, Kansas, Louisiana, Missouri, New Mexico, Oklahoma, Texas, and Washington.<\/p>\n The legislative pace has picked up since, with nine more states enacting laws: Connecticut, North Dakota, South Dakota, Nevada, Ohio, Rhode Island, Utah, Virginia, and Wyoming. Legislation is pending in several others.<\/p>\n California and Maryland have adopted guidelines, not laws. The state governments in New Jersey and Wisconsin will lend cameras to families concerned about loved ones\u2019 safety.<\/p>\n But bills have also gone down to defeat, most recently in Arizona. For the second year, a camera bill<\/a> passed the House of Representatives overwhelmingly but, in March, failed to get a floor vote in the state Senate.<\/p>\n \u201cMy temperature is a little high right now,\u201d said state Rep. Quang Nguyen, a Republican who is the bill\u2019s primary sponsor and plans to reintroduce it. He blamed opposition from industry groups, which in Arizona included LeadingAge, which represents nonprofit aging services providers, for the bill\u2019s failure to pass.<\/p>\n The American Health Care Association, whose members are mostly for-profit long-term care providers, doesn\u2019t take a national position on cameras. But its local affiliate also opposed the bill.<\/p>\n \u201cThese people voting no should be called out in public and told, \u2018You don\u2019t care about the elderly population,\u2019\u201d Nguyen said.<\/p>\n A few camera laws cover only nursing homes, but the majority include assisted living facilities. Most mandate that the resident (and roommates, if any) provide written consent. Some call for signs alerting staffers and visitors that their interactions may be recorded.<\/p>\n The laws often prohibit tampering with cameras or retaliating against residents who use them, and include \u201csome talk about who has access to the footage and whether it can be used in litigation,\u201d added Lori Smetanka, executive director of the National Consumer Voice.<\/p>\n It\u2019s unclear how seriously facilities take these laws. Several relatives interviewed for this article reported that administrators told them cameras weren\u2019t permitted, then never mentioned the issue again. Cameras placed in the room remained.<\/p>\n Why the legislative surge? During the covid-19 pandemic, families were locked out of facilities for months, Smetanka pointed out. \u201cPeople want eyes on their loved ones.\u201d<\/p>\n Changes in technology probably also contributed, as Americans became more familiar and comfortable with video chatting and virtual assistants. Cameras have become nearly ubiquitous \u2014 in public spaces, in workplaces, in police cars and on officers\u2019 uniforms, in people\u2019s pockets.<\/p>\n Initially, the push for cameras reflected fears about loved ones\u2019 safety. Kari Shaw\u2019s family, for instance, had already been victimized by a trusted home care nurse<\/a> who stole her mother\u2019s prescribed pain medications.<\/p>\n So when Shaw, who lives in San Diego, and her sisters moved their mother into assisted living in Maple Grove, Minnesota, they immediately installed a motion-activated camera in her apartment.<\/p>\n Their mother, 91, has severe physical disabilities and uses a wheelchair. \u201cWhy wait for something to happen?\u201d Shaw said.<\/p>\n In particular, \u201cpeople with dementia are at high risk,\u201d added Eilon Caspi, a gerontologist and researcher of elder mistreatment. \u201cAnd they may not be capable of reporting incidents or recalling details.\u201d<\/p>\n More recently, however, families are using cameras simply to stay in touch.<\/p>\n Anne Swardson, who lives in Virginia and in France, uses an Echo Show, an Alexa-enabled device by Amazon, for video visits with her mother, 96, in memory care in Fort Collins, Colorado. \u201cShe\u2019s incapable of touching any buttons, but this screen just comes on,\u201d Swardson said.<\/p>\n Art Siegel and his brothers were struggling to talk to their mother, who, at 101, is in assisted living in Florida; her portable phone frequently died because she forgot to charge it. \u201cIt was worrying,\u201d said Siegel, who lives in San Francisco and had to call the facility and ask the staff to check on her.<\/p>\n Now, with an old-fashioned phone installed next to her favorite chair and a camera trained on the chair, they know when she\u2019s available to talk.<\/p>\n As the debate over cameras<\/a> continues, a central question remains unanswered: Do they bolster the quality of care? \u201cThere\u2019s zero research cited to back up these bills,\u201d said Clara Berridge, a gerontologist at the University of Washington who\u00a0studies technology in elder care.<\/a><\/p>\n \u201cDo cameras actually deter abuse and neglect? Does it cause a facility to change its policies or improve?\u201d<\/p>\n Both camera opponents and supporters cite concerns about residents\u2019 privacy and dignity in a setting where they are being helped to wash, dress, and use the bathroom.<\/p>\n \u201cConsider, too, the importance of ensuring privacy during visits related to spiritual, legal, financial, or other personal issues,\u201d Lisa Sanders, a spokesperson for LeadingAge, said in a statement.<\/p>\n Though cameras can be turned off, it\u2019s probably impractical to expect residents or a stretched-thin staff to do so.<\/p>\n Moreover, surveillance can treat those staff members as \u201csuspects who have to be deterred from bad behavior,\u201d Berridge said. She has seen facilities installing cameras in all residents\u2019 rooms: \u201cEveryone is living under surveillance. Is that what we want for our elders and our future selves?\u201d<\/p>\n Ultimately, experts said, even when cameras detect problems, they can\u2019t substitute for improved care that would prevent them \u2014 an effort that will require engagement from families, better staffing, training and monitoring by facilities, and more active federal and state oversight.<\/p>\n \u201cI think of cameras as a symptom, not a solution,\u201d Berridge said. \u201cIt\u2019s a band-aid that can distract from the harder problem of how we provide quality long-term care.\u201d<\/p>\n The New Old Age is produced through a partnership with The New York Times<\/a>.<\/em><\/p>\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\nUSE OUR CONTENT<\/h3>\n