My siblings and I suspect abuse by facility staff to my father with Alzheimer's. Can we put a nanny cam in his room?

I am glad that you had a Care Conference with the facility and were able to voice your concerns and to make some changes regarding your Dad's care.  I think that the room change is a good idea as noise can be a trigger for some Alzheimer's patients. 

Has your Dad's behavior gotten worse or better since the Ativan was started? Sometimes Ativan causes an elderly person to become MORE agitated and MORE anxious instead of less agitated and anxious.

Is your Aunt related to your Dad?   I am wondering if the Alzheimer's behavior problem is familial or hereditary?

Having your Dad evaluated at one of the geriatric psychiatry programs is a good idea as it will give you a educated evaluation by a "third party".  Please let us know what their recommendations are for your Dad. 

Has your Dad's behavior gotten worse or better since the Ativan was started?  Sometimes Ativan causes an elderly person to become MORE agitated and anxious instead of less agitated and anxious.

I would consult an attorney in your state; explain the circumstances of the need to install a recording device. As the facility will undoubtedly claim they follow state guidelines and do all they can for their patients... An easy statement to make to cover liability, but not always true.
I recall reading about a family who captured their loved one dying of breathing problems, with 2 "nurses" standing over him laughing as he feebly said he couldn't breath. They, the nurses, then lied on the written description of events and claimed they attempted to resuscitate. The recording of the event was then made known and turned over to the prosecutor. The case is still pending.
As this is such a horrible situation and so easily applied anywhere, I would find out what your jurisdiction allows and do all you can to silent guard/monitor your loved one.

Hello all -

Thank you again for your thoughtful and informative comments. Here's where we are today:

Have had a very long care conference with facility. It seems that my dad has been having incidents, they have a log. But no one contacted our family. We are furious about this, have requested follow- up documentation. Some of the documents we requested for the care conf are still outstanding. It was very disappointing the facility seemed to be scrambling during our conf. However, what's important is that my dad's behavior has, in fact, been changing as his ALZHEIMER'S disease progresses. We are discussing having him evaluated at one of two hospitals in our city where there are robust geriatric psychiatry programs. I think this will happen soon. We actually are well- informed about this because we explored this option for my aunt, who has terrible dementia with behaviors, late last year.

Our complaints about some staff are being followed up on. We are going to move my dad's room to an area farther away from the common areas. This may reduce triggers for him, i.e. the two patients that constantly howl, the loud tv.

I did not contact Ombudsman; the website link to find a contact didn't work (?!). But the facility filed a notice with them of one of the incidents. They gave us a copy. Only problem is, the report states that patient family was notified. So the new facility director filed a false report based on what her staff told her, and they lied. So my sister POA filed a response to that report to set the record straight.

The medical staff had suggested to my sister POA several weeks back that they would like to try ativan gel and/or tabs as a prn intervention when dad is agitated. My sister denied that request, in writing, because the facility had not communicated with her in response to questions she had sent the md. She told them, in writing, that she will not approve until she hears from the md's office. At the time of our conf, she had not heard anything. But guess what, medical staff had in fact administered both ativan gel and tabs to my dad. Another furious response from us.

We are scheduled to meet again in three weeks, at which time facility is expected to be able to cross every t and dot every i.

Breaking my heart every day..

This is a reply to MsRandall, who has posted many replies saying that camcorders are against the law, that the family member could be sent to jail, etc. First of all, whether it's legal to install a camera depends NOT ON the policy of management but on the state law, and these laws do vary from state to state.

Second: there is a hierarchy of rights involve here: Possibly (depending on state law) the right of aides to privacy as they work; the privacy of other residents who might be seen on the recorder; and the rights of residents to quality care, free of abuse and neglect. Every time, I would prioritize the rights of residents to good care, which means they feel valued, respected, physically and emotionally comfortable and safe. I venture that MsRandall may represent management in some capacity? If so she should be even more concerned to protect the rights of residents to be free from abuse, not to be neglected, to have person-centered care. CMS mandates all these things.

Please: if you think there is a reason to suspect that your family member is suffering in his/her care home, but in your presence the aides are angelic, do try to get evidence, one way or the other.

I am a Director of Nursing in a AL community, you have the right to remain and see what care is being given to your loved one, I will say that my care givers will call out if they are giving private care if someone knocks on the door, however that is a dignity issue to protect our residents. That being said at no time can they ban you, if they pull the curtain, pull it back again. This is YOUR loved one not theirs and you have the right to make sure they receive proper care at any time.
I have had to report to family members several times about their loved one having violent episodes however I do it every time and let them know what I feel may be triggering them. Transparent care giving and communication is the very key to getting and giving the best possible care we can. It truly takes a village but it is the least our loved one deserves.
I wish you the best of luck!

Call the state hotline immediately! Report your concerns to them and they will have a professional team handle it. The facilities are scared to death of state inspection.They can be fined hundreds of thousands of dollars, lose licensing and be shut down for non compliance. I've worked in nursing homes and saw things change for the better when the state got involved. The state is like a god in the healthcare world. So call them!( If you believe your loved one is immediate danger of physical are sexual assult also call the local police. )It will be the safest for your loved one and your self.

The more vulnerable the resident is, the more you need a cam in the room. It is not surprising that there will be one individual who may be heavy handed when handling a frail elderly person, whether to change their diapers or feeding a resident with aspiration risk. I have seen footages of residents being abused by nursing aides on TV that made me sick to my stomach. Without the cam, no one will ever know what can happen to their loved ones and the culprit(s) will be left unpunished. Unfortunately the cam is only limited to when the resident is in the room. Negligence such as not administering medication correctly, or whether food is properly fed to resident with swallowing difficulties may not necessarily be caught on cam. I have witnessed a resident's hands shaking violently and the nurse at the computer just told me he was just cold.

My mom is in a living assisted home and we put two iBaby monitors we had used in her apartment before she went to this home.
No one has said anything at that place.
It helps us to see how she’s doing. Or if she’s asleep. It’s been helpful

I would check the laws in your state, especially if your dad has a roommate. If he does, there might be some serious legal implications for you, even if you have the camera trained just on your dad. Privacy laws and HIPPA laws do come into play with roommates.

Did you notify the Ombudsman?

Legally I could not answer the question for you but I will say that I wish I had thought about it when my dad was in rehab.nursing home. everyday I was given some piss poor excuse why my dad was black and blue. why he got a cut on his arm. why he fell out of the bed. why he had to sleep on the floor for the night. why he had to go to the hospital during the night and I never got a call about it. and the stories went on and on.
After the excuses that I was given from the staff, I decided to talk to his roommate.
He told me terrible things they did to my dad late at night when I was not there. I confronted the staff and was told the room mate was mentally unstable and made up stories all the time.
the last straw was when I got there one morning as I did every day for about a month and they were just taking dad down to therapy . I told them I would take him down and when the woman in therapy took him inside I waited outside for him to be done. a few minutes later the head therapist came out and said they couldn't work on my dad due to the marks on his neck. I looked down and my dad had hand marks completely around his neck as if some one tried to strangle him. no lie. he was real red, bruised up and yellowish completely around his neck.
I went crazy. my dad was crying begging me to take him home. and that is just what I did. I packed his bag and called the medical van and out of there we went. I filled a complaint with the medical board the next day..
no one knows what goes on when family and friends are not there to defend the patient. think twice before you put them in a place without some type of security that they are and will be safe. video is the best. legal or not that is the only way I would ever allow anyone from my family to stay there.

Please don't advise people to commit a criminal act. It will not help their love one if they go to jail -- which can be the penalty for video taping someone without permission. Many people are giving emotional responses - but those responses could end up sending someone to jail.

Yes, you can place a nanny cam inside his room, consider sitting it up high to view exits and entrances. If he has a roommate, consider editing out his roommate if he is captured in the footage. If your dad is being abused then likely others are being abused. Amazon has lots of hidden nanny cams available. Hidden in picture frames, stuffed animals, clocks. find an all inclusive camera, if possible.

We took an old unused cellphone and installed an ap called "Alfred". The ap uses the camera on the phone and it's free if you don't mind ads once in a while (or $10 if you want ad-free and the ability to zoom in). We could check in from our cellphone at any time and no one knew the phone was there (except Mom of course). Since it's a cell phone, it doesn't look like a nanny cam. You can also have multiple devices linked to the one ap. I think there's a way to record and take pictures but we never had to do that. Good luck, I'm sure this is very stressful for you.

Some of the staff in the nursing homes are there physically but just do the minimum to get the job done. Some are pressed for time, others simply hate their jobs and would rather goof off than work; I've seen both kinds where my mother is living.

If you catch a person in a criminal act, the courts will allow it to be submitted, even if your state does not allow nanny cams.

If you see no criminal activity, then simply do not present the video to anyone.

Please ensure that it is a hidden camera, and it is only pointed at your mother, not any roommates.

Laws vary from state to state. Some states do allow camera's in residents room as long as certain guidelines are followed. Check to see what the law's are in your state.

In SNFs, family members are not allowed to be in shower or bedroom when getting washed, changed...they supposed to wait outside until Aides are finished. He should require 2 aides & under no circumstances should this happen again...speak to Social Worker.

Yes! Yes you can!

You can if it is your own home; however, a private facility not owned by you can bring legal action against you due to privacy and HIPPA law issues. I am no lawyer but I also imagine different States have different laws regarding this.

Your best means to keep your loved one safe is VISIT OFTEN and DAILY and do routine skin inspections.

https://www.elderlawanswers.com/can-you-put-a-surveillance-camera-in-a-nursing-home-room-16956

I wonder to what extent the contract your family signed with the facility and the rules of the facility would control whether you can place a Cam. Also, the law of the state you are in, may also impact your right to record others without their consent.

Generally, speaking it would be safer (legally) to assume that you CANNOT place secret cameras in a room without permission or consent of the facility. The health care facility is not your property. Depending on the sate, their can be very tough legal consequences including jail time.

If you suspect abuse your best option is to talk directly with management who can use their authority to put hidden cameras in common areas or in your family members room to catch abuse happening.

No idea about camera or not, but about abuse and aggressiveness in AL/NH situations ...

We had a patient once, with mid-stage Alzheimers', who had spent 40 years working the midnight shift. Family told us he continued to sleep days, get up about 10 pm and putter around the house until going to bed at some random time between 8 am and noon, even through 15 years of retirement when he might have made a change.

Night shift aides didn't know how to cope -- it meant they weren't just babysitting the mostly-sleeping folks, but needed to be watchful and maybe keeping company all night. Didn't help much that we were routinely shorter-staffed overnight because it generally took about half the number of staff to cover nights than to do dayshift with all its bathing and cooking and socializing.

But after awhile, and some retraining of folks who wanted to insist he 'stay up' so he could get 'back' to what they thought of as a regular schedule ... eventually he was okay. Eventually aides learned to deal successfully with his eating schedule and so on.

But he was pretty aggressive during the period when people would wake him up 20 minutes after he'd gone to sleep, or try to prevent him going to bed, or try to put him back to bed when he'd just got up for the night.

Another way that patients get labeled 'aggressive' is when a staff member tells them to do something, and they don't do it fast enough, so the staff member takes their arm to guide or coach or hurry them 'just a little.' Quite often folks with arthritis don't like to be touched or grabbed (I mean, it hurts them, so they like it even less than most people) and will yank their arm away ... which causes bruising to elderly paper thin skin.

Then staff get labeled 'abusive' and they retaliate by labeling the resident 'aggressive.' Gets to be a vicious cycle.

Also there are situations in the NH that tend to create this kind of interaction. Nobody wants to be told they have to take their shower 'now', but one person delaying will throw off the whole day for staff. Bathrooms are necessarily shiny, highly reflective, and often slick with water -- which makes falls more likely and more dangerous. Bright reflective rooms are hard for elders to see in, because our eyes accommodate much more slowly, so the first several steps in the facility bathroom the person can feel almost blind. Rushing them just leads to falls. Chief result is that many NH residents are afraid of bathrooms. Which of course leads to more incontinence. (sigh)

You Can put the Cam, But an Aide who is Cleaning the Room may See the Zoom...Stay on Top of this Tough Topic, I believe YOU.....

I did. Made sure it was focused mainly on our mother and not the roommate. (Just in case I did get caught) I purchased a clock/temperature/camera. $350. camouflaged it. Of course, I had to retrieve it because it had to be downloaded onto a puter.
we didn’t see anything the short period I used it because we lived out of town. Difficult to do this type in a regular basis. The others are pricey.
beat to find out though.. somehow.

It's entirely possible that the staff is at the very least neglecting your dad--and this can amount to abuse just as physical assault would be. I don't care what the facility (or eve the law) says, I'd get a nanny cam in there. If it shows neglect or abuse or violation of your instructions, let the home sue you after you've sued them! This place is probably short-staffed (they ALL are) with underpaid aides. You and your siblings are doing the very best thing, you are visiting often and monitoring and advocating for your father.

Best of luck to you.

1. If you want to put in a camera check the laws in the state. Most will allow cameras but focused only on the resident, not a room mate and not in the bathroom. And audio may not be permitted at all unless you have permission, and that would be from anyone that might be recorded.
2. If your discussion withe the Ombudsman is not successful I would begin to look for another facility.
3. Even if the discussion with the ombudsman is successful you might want to look for another facility, you never know how staff may react. (OK I might be a little paranoid on this)

Thank you all for your thoughtful responses. What we are experiencing is that the facility is saying my dad is aggressive and has assaulted staff. We heard NOTHING about this. Until last night when they called my sister Judy who is poa and said it was a courtesy call to let us know they were sending him to the hospital for a psych eval. Judy stopped them! They said it was a fourth incident in two weeks. They had the police there! But we have not been advised of any of this. Judy got the administrator on the phone and it turns out that there is no one staff who can say what exactly has been happening. But they all say that someone else notified us, though the administrator could find no record of such in my dad's chart.

When we moved my dad in, we instructed facility that he sleeps long during the day and that they should allow him. They should try to get him up of course but not to insist if he refuses. Just leave him a meal tray. What we have heard from another resident's husband is that they have been insisting that he get up to go to meals and he told them to get out. I know if they try to manhandle him he will push back.

I visit 2-3 times a week during the evening and have observed staff ignoring patients. There are two patients who constantly holler, loudly, yet they are kept in the public living room with the other patients. This yelling really affects my dad and agitates him. He had also begun having pooping episodes that are quite messy. This seems to aggravate the staff. At least three times I've been there and cleaned him up. Once I actually got in the shower with him and cleaned him head to toe while an aide stood around not knowing what to do next. How could this be?

All in all, we (my 7 siblings and I) feel this is a staff issue, lack of training combined with lack of oversight and supervision. They are pretty much sitting at a table on the side of the community living room and not doing much.

Everyone on yhis forim have given great answers / suggestions, but I would start looking for another place.

Is someone there every day. What kind of abuse are you seeing? The first thing I would do is take him to his PCP and have him examined head to toe. Has he lost alot of weight. Moms AL checked residents weight all the time. If they lost more than five pounds they started them on Boost or something like it.

I would do what you need to do.  If he's being abused you need to catch it so they can be held accountable.  There are so many ways to hide a camera, picture frame, stuffed animal.  Illegal?  I don't know.  Consequences from the facility if they find out, maybe.  Your dads safety biggest concern, absolutely!