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July 8, 2011

Time for Granny Cams in Singaporean Nursing Homes (SINGAPORE)

Jul 07, 2011

 (The Straits Times - McClatchy-Tribune Information Services via COMTEX)

Last month, an egregious instance of elder abuse in Singapore was revealed.
A camera installed surreptitiously by the son of a resident at Nightingale Nursing Centre in Braddell Road captured videos of three female caregivers abusing and maltreating his very frail mother.

This, however, was not the first documented instance of elder abuse in a nursing home here. Two years ago, the owner of both Serene Nursing Home in Joo Chiat and Irene Nursing Home in Balestier installed closed-circuit television (CCTV) cameras in the homes after allegations of elder abuse surfaced. Five caregivers were then caught on video doing so
Such ad hoc solutions aside, the sector needs more stringent government oversight. In its current review of the sector, which comprises more than 60 nursing homes with 9,300 beds, the Ministry of Health should consider setting forth by statute a Bill of Rights for residents of nursing homes.

These could include the rights to dignity and autonomy in making choices about one's care arrangements. The resident should also have the rights to reasonable attention to her individual needs as well as freedom from physical, sexual, verbal, mental and financial abuse.

Such a statute could also require nursing homes to install video surveillance technology, either CCTV or webcams. If it is the latter, family members can access the footage online in real time, using secure passwords. These digital images, with or without audio, can also be stored in digital video recorders, to be watched at any time and from any location.

Installing such 'granny cams' will restore some trust in these homes. These gadgets can bring to light any abuse or neglect while also deterring potential abusers. The video footage will not only be useful in substantiating allegations of abuse but also help to exonerate staff wrongly accused by senile residents or confrontational kin.

A nursing home resident may sustain cuts and bruises because of an abusive caregiver -- but also if she simply hits the bedrails in her sleep, if it is fitful. Thus granny cams can protect both residents and caregivers. Lastly, a live feed at the staff station would help in the constant monitoring of residents as well.

Yet some in the industry argue that, costs aside, having granny cams around will erode the trust between resident and caregiver. Others worry that some footage might be misinterpreted. For example, the video of a worker tiptoeing around to look for a small item misplaced in a resident's room could be misconstrued as an instance of pilfering.

Or a resident recorded moaning and groaning while being transferred to or from her bed may make some think she was being abused. In fact, many a cognitively impaired patient does moan or groan, even though there is no discomfort suffered. Then there are Alzheimer's patients who may be delusional and may make wild allegations of neglect or abuse.

Moreover, such electronic surveillance can only frighten off good help that is already hard to find for this low-paying but difficult job. Most caregivers in local nursing homes nowadays hail from the Philippines, Myanmar, Sri Lanka and China.

Usually registered nurses in their home countries, these caregivers earn only S$400 (US$325) to S$600 a month. Cultural and language differences may make it more likely that videos are misinterpreted.

Opponents of granny cams also argue that installation is an affront to the dignity of frail or incapacitated residents. These gadgets would also record the intimate details of clothes or nappy changes, medical examinations and nursing care such as sponge baths in bed.

Actually, the best video surveillance systems can be programmed so the resident or her immediate family can turn off the granny cam for private moments.

But most residents share rooms, so the concern is also that other residents may inadvertently be exposed. If so, a granny cam law could require families to obtain the consent of other residents in the room before installation, if the requesting family cannot afford a private room.

Alternatively, the granny cam may be angled for maximum view of the resident's bed without also catching other residents. Today's high resolution cameras can be remotely commanded to pan, tilt, or rotate even 360 degrees, isolate a face and zoom in to scrutinise it closely, or even look at the page of a book.

Ideally, a law should be passed to mandate granny cams. If such a law merely forbade a nursing home from disallowing the installation of a granny cam by concerned families who can afford it, then poorer residents, those without kin or those who have lost their mental capacity to ask for it will not be helped thereby.

Moreover, if nursing homes are merely prevented from prohibiting granny cams, those who choose to install one may face caregiver hostility and recrimination.

By contrast, if the law mandated it, then all residents would benefit equally from the technology, regardless of financial wherewithal, family status or mental capacity. In fact, mandating it will cater to those who need it most.

But given industry resistance, perhaps granny cams may be mandated at first only in those nursing homes where abuse and neglect have been documented. As their benefits become evident, hopefully homes will install granny cams, whether mandated by law or not.

To see more of the Asia News Network, go to http://www.asianewsnet.net/home/Copyright (c) 2011, The Straits Times, Singapore / Asia News Network Distributed by McClatchy-Tribune Information Services. For more information about the content services offered by McClatchy-Tribune Information Services (MCT), visit www.mctinfoservices.com



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