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. 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.
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."
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 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.