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Interfering in family care

jones

Dee Childers and her two sisters love their Dad and want to make sure he has the best care possible. As he descended into dementia, needing more intensive care, they became his legal guardians and found a good quality residential facility where he could live out his final years in safety and dignity.

The sisters wanted to be able to check in on Dad when they could not be present in person to make sure that all was going well. And, although they trusted the people at the facility, they thought it wise to ensure that his care was up to standards. So, they decided to install a Dad Cam in his room, which they could access with their tablets whenever they wished–much like the cameras that are popular with parents to monitor their kids.

They, of course, notified the facility and were given the green light to install the monitor. It had to be a touchy decision for the facility because it might be opening itself up to liability in the event an employee failed to act appropriately and was recorded doing so on camera. To its credit, the facility agreed to the arrangement, despite this potential downside.

The sisters thought it would be a good idea for the facility to have access to the Dad Cam, because Dad liked to have his door closed, making it more difficult for staff to peek in frequently to make sure that all was well. They gave the facility a tablet and asked that it be used to keep an eye on Dad. The sisters certainly had a legal right to make that decision on Dad’s behalf as his legal guardians.

Things were going well for Dad, the sisters and the facility until a facility visit by Idaho Department of Health and Welfare (IDHW) inspectors in early July. Upon learning of the Dad Cam, the inspectors issued a serious violation of IDHW regulations for the facility’s purported invasion of Dad’s privacy.

IDHW noted in its exit report that Dad “had a video camera in their bedroom and staff were able to view the activities of the resident via a tablet in the nursing station.” Actually, that was the precise purpose of the Dad Cam. That purpose was specifically authorized by the sisters who were appointed by a court of law as the persons to make such decisions on the part of this mentally disabled resident.

IDHW privacy regulations do not appear to specifically prohibit the use of authorized video monitors and it is not clear why that would be good public policy. With the growing incidence of elder abuse, why would it not be a good idea to have more eyes upon the manner in which dementia patients are treated in residential care facilities, especially when the facilities are specifically authorized to do so by residents or their legally appointed guardian(s)?

IDHW responds that the facility has a policy saying it does not use security cameras in residents’ rooms and that Dad’s privacy is jeopardized because the tablet at the nursing station can be seen by other residents and visitors. Yet, the sisters gave the facility a tablet and specifically requested that it be used to keep an eye on Dad. They have the legal authority to make that call on Dad’s behalf. They dispute that the Dad Cam compromises Dad’s privacy.

If this facility is punished for the use of the Dad Cam, the sisters will also be punished by losing a monitoring tool that gave them additional comfort their Dad was receiving the best care possible. It is not clear who wins in this situation. Perhaps this is one of those rules that the Governor’s office should scrutinize for governmental overreach.

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