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Web cameras and the elderly -- whose right is it to decide?

I want to pose the question -- again. Just because we can set up all kinds of security in our elderly parent's home, is it right to put it there? Saw this from SmartHome's Web Camera section, a Web-Enabled Securelink Elderly Kit -- this turns out to be a PERS pendant -- the camera is extra. And security vendors Alarm.com and ADT both offer video monitoring, not yet specifically targeting seniors, but for worried adult children, a camera may seems like a good idea. Maybe.

Cameras make folks feel safe, right? Those who care for elderly parents from a long distance might see this as a great relief -- a way to enable a parent to stay longer in independent living, perhaps keep the costs of a move to assisted living down, perhaps keep a parent with some dementia safer while the adult child is at work. And maybe it does make sense to place a security camera at the doorway of a home (with a large display sticker on the door) to deter criminals.

Motion sensors may be enough. But I have some concerns about web cameras that are aimed at people inside their home, an invasion of personal space in a way that remote sensor-based monitoring does not. Motion sensor monitoring, typically sold through dealers to independent living, assisted living, or continuing care communities -- is part of offerings of Healthsense, GrandCare Systems, GE QuietCare, and Wellaware Systems. Each of these is designed to work with an outside-the-room responder to monitor the information collected by the motion sensors, ideally converted into exception information and linked to health trends over time.

A right to privacy. Compare that with the camera that transmits streaming images of a person moving around a private room. We're not talking about family video calls with a PC, camera or video phone. Assuming anyone is paying attention to these images as they're streamed, or reviewing them if they're aggregated on a server, this feels like a boundary has been crossed in the name of 'preserving' a parent's right to remain in their home of choice. The right to stay, apparently, but not the right to be left alone.

Aging in place does not imply watching us age. I think we need to recognize the insecurity of adult children who see a camera aimed at the home interior as a relief for them, a way not to worry as much about a parent. But a parent who generates this much worry when left alone -- should they really be alone?  This is the nightmare of our future -- come to haunt us now. Is this really what we want for ourselves or our parents -- the right to 'age in place', a place with a camera aimed at our moving alone around the kitchen?

Better products, but maybe a move. Along a continuum of PERS pendants at one end and the ADT camera aimed at us, let's see vendors solve the conundrum of maximizing safety with minimizing invasion of privacy. Or let's be realistic about choices -- maybe it's time to attend an adult day program for activities and supervision. Or perhaps it's time to move out of an isolated living situation and into one of the broad ranges of monitored senior housing -- making sure that if a parent moves, that the facility understands the balance between safety and privacy. And when frailty is the greatest and funding is the most frail, high quality nursing homes may be where we are safest and most secure.

 

Comments

How do people feel about tracking an elderly parent via GPS in the cell phone? MY mother had a fit when I suggested it. She also resists any video, sound or movement monitoring in the Bath Area. Including outside or on the door. She is very modest.

I tend to lean to the side of being for using web cameras. We have a person who sometimes does not take her medicine always at the predetermined times. My wife would drive over at first to give it to her two times a day. As that stressed our family life out, we started using a recording device with a button that flashes until she presses it. She has 20 minutes. Then is calls us if she did not press the button. This has proved to be successful most of the time however we still sometimes find her pills taken out and sitting next to her not taken. I believe that with a webcam, any of the 4 children could go on and monitor her at the two times of day she takes meds or a recording of that time. If she stalls and forgets, it saves a trip over. She has dementia and is borderline for living at home. Anyway you can help them and the caregiver to stay at home, should be tried. Its not intrusive if its just used for certain times of the day.

Hi Gary, so did you get a webcam in the end? If not, then why not? If you don't mind my asking... Jonathan 

Unfortunately, the age wave is rapidly multiplying the number of older, frailer, and poorer people whose mobility and financial constraints preclude them from getting to adult day care or affording ALFs or nursing homes. Then what?

As a former caregiver for a Mom with Alzheimers and a Dad with a broken hip and macular degeneration, I can attest to the tremendous stress those years placed on me and my wife when we tried to take care of them and run a very demanding business at the same time.

I believe my parents would've accepted a few sensors and webcams for their own sense of security and to deal with reluctance to impose on their caregivers.

In sum, I think that privacy issues will be less of a barrier to the adoption of survaillance systems than will their affordability.

In many interviews I have had with seniors on this topic, I find that there is great variability in the sensitivity to technology for monitoring. For some, even motion sensors are too invasive. For others, web cams are fine if proper security is maintained (i.e., no unauthorized access). However, most seniors seem to recognize that the cost of losing some privacy must be evaluated with respect to the benefits of staying independent. A typical response is "if it keeps me in my home longer, I'm all for it". Any kind of monitoring system must be carefully considered and agreed upon by the senior and the care givers. It gets more difficult when there might be a problem with the senior being able to fully understand what privacy rights they are giving up due to dementia, lack of technical knowledge, etc.

Moreover, although I am not crazy about the idea of using web cams for monitoring, motion sensors do not always give an accurate picture of what's going on, particularly in multiple person households or households with pets, etc.

My mother is 87 and cannot get out of bed.  My dad is 86 and gets in and out of bed but uses a wheel chair.  The cameras have allowed them to stay at home.  My wife and I live 10 min away and they also have rescue squad 2 min away.  We check the cameras in each room at night.  Nursing staff comes in from 6 AM to 8 PM.  After that we monitor them and it saves them approximately 3000 to 4000 a month for a nurse that mainy sat in a spare room watching to see if anything happened.  Is it just as good?  No!  But, it is cost effective and doesn't put them in a nusing home where they would have less attention then they get now.  So, I am a big believer in the concept but it is not perfect as the system, like any electronic computer system, is not 100% reliable. 

 

First of all, I'd really like to thank Laurie Orlov for sharing her expertise with the eCareDiary audience of care providers and family caregivers last week (you can find that interview at http://www.ecarediary.com/RadioShows.aspx).

Yes, privacy is paramount when it comes to any kind of camera-based technology, but as an expert in the field of eldercare (both professionally and as a care provider for my own dad), I think the pros far outweigh the cons. Through his process of aging in home, my dad was fiercely independent -- I believe that some of the monitoring advances available now would have empowered us to be much more present to my dad's moment-by-moment needs and allowed both he and us to have more security and peace of mind.

It also would have provided a watchful eye around his healthcare workers. While the vast majority of care providers are dedicated and amazing, as a society we cannot ignore the rise in elder abuse. Like babysitting cams, "eldercams" could give working famlies an added level of security and protection for their beloved elderly patients.

Please feel free to visit our blog and our radio show for other expert interviews and articles around issues of eldercare, aging in home and care providing.

John Mills, Co-Founder of eCareDiary
http://www.ecarediary.com/RadioShows.asp

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