This issue of #Full Disclosure explores the highly-charged and often polarizing topic of electronic monitoring (including video and audio monitoring) in assisted living facilities. Perhaps these short articles will spur conversation about the issue, and together we can find common ground for a reasonable way forward.
|
|
The Short Life of AB 3138 (Waldron)
Chris Murphy, MS-Gerontology
|
|
CARR worked extensively with the office of Assembly Member Marie Waldron (R - Assembly District 75) to develop a fair and reasonable electronic monitoring bill for introduction into the 2019-2020 legislative session. The goal of the bill was to, once and for all, create a framework giving families the statutory authority to install privately-owned closed-access electronic monitoring equipment in their family member's room or apartment in an assisted living facility.
While there is no California law preventing residents of assisted living facilities, or their families, from installing privately owned and closed-loop-accessed or application-based electronic monitoring equipment in their assisted living rooms or apartments, some facilities unilaterally prevent this equipment from being installed. Facilities thwart a resident’s voluntary use of monitoring equipment either through the admissions agreement, contract terms, the house rules, or by intimidation - threatening eviction if the equipment is not removed (nevermind having electronic monitoring equipment in the room is not one of the five grounds for eviction).
AB 3138 would have brought clarity to the voluntary use of privately-owned monitoring equipment by residents of assisted living: it gave residents and their families the unequivocal right to have such equipment in their rooms, subject to reasonable and common-sense procedural requirements and privacy considerations.
There are nine states in the nation having laws on the books (some for many years) allowing privately owned and installed equipment in both skilled nursing and assisted living settings. We were hoping that by October 2020, California would be added to the ranks of forward-thinking 21st century states. But because of the highly-unusual circumstances resulting from COVID-19, the legislative session was truncated. The shorter-than-normal legislative session required many bills to be cut (so many bills, so little time); unfortunately AB 3138 was among those jettisoned.
CARR believes the issue of video and/or audio surveillance is a serious discussion that should be had among consumers of assisted living services, the RCFE providers and the licensing agency. We believe AB 3138 offered balanced and common sense solutions to the objections of ombudsman and the assisted living industry.
Meanwhile, you can read what the bill would have afforded residents and family members at this link. We believe the bill has merit and answers an unmet consumer need. 2021 is another year . . who knows AB 3138 may be reprised.
|
|
A Family's Best Friend: Video Surveillance
Rebecca Ruiz, Research & Data Analyst
|
|
 |
There are many thoughts that run through your mind after you've placed a loved one in assisted living: Worry that they won’t like it there. Your hope that staff will be friendly and provide great care. And quite possibly your guilt about them needing care that you can't provide, or that you can’t visit as often as you’d like.
Video cameras, or audio monitoring might be great solutions to help alleviate some of your fears, by helping you keep tabs on the care your family member is receiving. By installing electronic monitoring equipment in mom's room, you'll be able to see, or hear, what's happened in her room any time you want, and you can check in with her, or she with you; you can even share a happy hour with her.
Electronic monitoring (video cams or audio devices) is a double-edged sword: electronic monitoring can reveal the care delivered care by the facility (how often staff come to check on the resident, the time between repositioning, who has access to the room and many other things), or facilitate a remote method for staying connected with family and friends.
There are plenty of news stories of families catching facilities and caregivers in the acts of negligent or abusive behaviors towards vulnerable residents using secret or hidden cameras. And CARR has reviewed documents where facilities install their own cameras in private living quarters, without the resident’s and family’s permission, seemingly to avoid hiring more staff.
More and more families want the ability to install privately-owned monitoring equipment in their loved-ones rooms. But facilities and some advocates object to this strategy. Criticisms include that their installation would remove even more of assisted living residents’ already diminished dignity & privacy. Depending on the placement, cameras could record bedroom areas where residents might be changed and cleaned. For shared rooms, the presence of cameras may compromise a roommate's privacy. On the staff side, caregivers might feel resentment that families do not trust them to care for seniors properly. None of these criticisms should be show-stoppers!
Those are valid concerns, but each can be mitigated with a common-sense solution. Cams or audio equipment can be thoughtfully placed to avoid personal privacy concerns. If there's a roommate in the picture, a signed consent from the roommate or their responsible party can set out the terms to preserve roommate privacy. Workers have no expectation of privacy in the workplace - including caregivers. In fact, there are already many jobs that are under constant video surveillance (i.e. cashiers, department store employees, and police officers to name a few).
What there is no argument about is that California Health and Safety Code still has a ways to go to give families the unequivocal, unambiguous and indisputable right to place privately-owned electronic monitoring equipment inside the room or apartment being rented from the assisted living facility.
|
|
|
|
Video chatting is being touted as a great replacement for in-person visits with residents living in congregate care settings, but anyone who has tried it knows that the technology doesn’t always meet expectations. Standard problems include the audio randomly cutting out, multiple screen freezes even with a direct internet connection, along with bad lighting or glare, and all are big limitations on the video chat experience. And scheduling a time with loved ones can be difficult even without the issues that cognitive challenges and unfamiliarity with technology pose.
While in-person visits might not have needed much or any assistance from facility staff, in this COVID-era staff are essential for video chats. If the facility is fortunate enough to have devices available for residents, staff are required to sanitize and distribute devices and help set up calls with family. Because of the limited number of devices in most facilities, and the need for staff assistance, several facilities we've heard of have a designated video chat scheduler. The need to schedule a video chat, while understandable, requires a lot more logistics management than just dropping in to visit with your loved one.
In my own personal experience, video chatting with my 96-year-old grandmother was difficult, even with my mother at her side facilitating the call. Being able to see her was wonderful, but our call was short as her hearing issues and the video-chat audio function kept us from being able to hold a conversation that allowed me to explain why I couldn't visit her in person.
I know she was happy to see me, but I imagine our video-chat experience is close to the best-case scenario in an assisted living facility. Even though the call wasn't optimum, it was better to see her than not see her at all.
Many families having relatives living in care facilities likely have similar sentiments. In these difficult times, when our ability to adapt contributes to resilience, being able to video-chat (even with its imperfections) with loved ones, in assisted living or not, is a means to stay connected and to help make someone's day.
|
|
|
|
|
|
|
