Greg Hartzell

There are 1 million licensed beds in 30,200 assisted living communities across the United States, according to the National Center for Assisted Living.

With so many lives and so much property at stake, securing assisted living communities today requires a complex, multifaceted approach. For the purpose of this article, however, we are going to look only at the role IP (internet protocol) video surveillance cameras play as a means of deterring, detecting and investigating incidences at assisted living and other residential settings for older adults and disabled individuals. Cameras are a proven way to keep residents, patients and staff safe from theft, violence or, in the case of memory care units, the dangerous wandering of residents off facility grounds.

Another serious issue threatening the safety of residents is abuse. It has been estimated that between 4% and 5% of assisted living community residents have been subject to some form of mistreatment or physical abuse by the very people entrusted to serve them.

Over the years, videos surfacing of elder abuse or thefts have prompted families to take protection into their own hands. Many families of residents have taken the extreme measure of hiding video surveillance technology in loved ones’ rooms as protection against maltreatment and neglect. That said, it should be noted that several states now explicitly permit residents in long-term care facilities to maintain surveillance cameras in their rooms.

Utah and Texas have laws that allow the installation of cameras in assisted living communities on residents’ requests, and a camera-loaning program in New Jersey enables families of senior living residents to secretly record the care of their loved ones. Illinois, New Mexico, Oklahoma, Texas and Washington allow nursing homes to install electronic recording equipment in private rooms.

Arguably, the presence of video cameras makes an assisted living community or nursing home safer. By conveying a strong security presence with indoor and outdoor cameras, a facility shows it won’t be an easy target. Frequently, that alone is enough to stop a criminal act.

Do assisted living communities need video surveillance?

As the security technology landscape has evolved, so has the array of video surveillance cameras available to managers of assisted living communities and nursing homes. We will discuss those options later, but first we need to answer a more basic question: “Why do these facilities need video surveillance systems?”

First, security cameras can deter abuse and substandard care. Many experts believe that installing video cameras could singlehandedly restore public confidence in residential care settings because they give family members instant access to recently stored footage. On the flip side, families concerned about abuse would be able to observe the wonderful care that many staff members provide.

For operators, video surveillance can minimize legal responsibility should an employee or resident be found guilty of abusive behavior. By having digitally captured evidence on hand, owners can reduce unnecessary and groundless litigation.

Second, installing cameras let staff members better care for agitated or restless elders who may try to get out of bed or a chair without needed assistance. This could prevent falls, hip injuries or, at the very least, could speed help should a fall occur.

Oxygen tubes and other medical equipment that is easily dislodged could be more closely watched. If something goes wrong, the staff can rush to the room and fix the problem.

In addition, a properly placed indoor camera in a memory unit will help prevent confused or wandering residents from entering unsupervised areas. Exits and entrances being monitored by cameras also will help protect staff and residents from possible intruders.

Third, employee theft is a problem in many residential care facilities, and assisted living is no exception. Unfortunately, it is not unheard of for residents to have their possessions stolen.

Facilities have supplies stolen as well, including medications meant for residents. Having a camera in place can give operators information related to the thefts that, frankly, there’s no other way to get.

Opponents of video surveillance claim it makes it more difficult to recruit staff in an already low-wage, high-stress work environment. They say employees will not be able to make decisions without fear of being challenged by a resident’s family, or that it takes away from their professionalism. This perspective fails to take into account that there are already numerous careers where employees are under constant surveillance, including bank tellers, bus drivers, and police officers. Video surveillance does not impede healthcare workers, rather it aides them in making the best decisions and avoiding any compromising situations.  

The rise of IP cameras

Security cameras have evolved over the past 10 years, moving from traditional analog CCTV technology to IP networking. Analog cameras once were the only choice for security, but more healthcare facilities are discarding their outdated hardware — time-lapse recorders, CCTV monitors and switching units — and replacing it with IP cameras, network video recorders, mobile apps and cloud-based storage.

There are several reasons for this migration. For one, IP cameras offer sharper, crisper images, with resolutions up to 20 times higher than analog systems, ranging all the way to 4K ultra-HD cameras. Higher resolutions translate into fewer cameras covering larger areas, and lower total cost of system ownership.

Also, IP cameras let facilities use their existing CAT5 or CAT6 Ethernet cabling instead of running all new cables. Beside reducing installation costs, this makes it easy to add or move cameras as needs change.

In addition, software-based IP cameras can offer intelligent video features that improve surveillance system performance. Facial recognition, motion detection, audio detection and people-counting are some of the video analytics available on high-end IP cameras.

Finally, because they are a product of the Internet age, IP cameras let authorized users remotely view live video or search recorded images on nearly any PC, tablet or iPhone/Android smartphone. For example, if the camera detects motion, it can send an email to a smartphone along with live video at any hour, anywhere. (Note that some state laws prohibit the use of cameras by resident families if they transmit the images to a remote location.)

The takeaway: IP cameras are a plus in any security system today, no matter how large or small.

With their rise in popularity and advancing technology, however, the myriad of IP camera choices can feel overwhelming. Here are a few features you’ll want to know about to navigate the options and make the best choice for your community:

  • Camera types. There are three basic designs when it comes to IP cameras. Bullet cameras are named for their streamlined, bullet shape and are ideal for one directional monitoring since they typically do not have the capability to move or zoom in. Dome cameras are, naturally, dome-shaped. Unlike the bullet camera, it’s difficult to tell where a dome camera is pointed, increasing its purpose as a deterrent. “Speed domes” are a variation that spin quickly to capture a broader range of images. At the high end of the chain is the PTZ (Pan, Tilt, Zoom) camera. Designed for coverage of large areas, a PTZ has the ability to move and capture different angles, making it the performance equivalent of several fixed-sight cameras. A PTZ security camera can be pre-programmed to scan an area or controlled by an operator in a remote location.
  • Resolution. Resolution defines the amount of visual data that an IP camera is able to capture. IP camera resolution is measured in megapixels or “millions of pixels” and is given in horizontal and vertical pixel dimensions. For instance, if a camera is 1280 x 1024 resolution, then the camera is 1.3MP (1280 x 1024 = 1,310,720 or 1.3MP). The higher the resolution is, the more data the camera can capture, resulting in better clarity of the video.
  • Power over Ethernet. Instead of running a separate power cable to each camera, along with an Ethernet cable, Power over Ethernet or “PoE” lets you transmit power over the data cable itself, saving up to $300 per camera and freeing up installation limitations since an Ethernet cable can run up to 100 feet. The PoE standard 802.3af supports higher power ratings needed for motorized cameras.
  • Wide dynamic range. When viewing an area with challenging lighting conditions, it’s best to select a camera that provides good wide dynamic range. For example, when you view an entryway with a large window, a camera provides backlight control or WDR to remove shadows.
  • IR LED. Infrared (IR) LED lighting enables IP cameras to capture clear footage in low light or even no light conditions. Unlike humans, an IP camera can see infrared light, so when those wavelengths reflect back, it’s as if the camera is shooting footage in an illuminated room. The more IR LEDs that a camera has, and the longer their range, the better it is able to see at night.
  • Weather/Vandal resistance. If you plan to use cameras outside, then make sure you purchase models that are weatherproof, which is often referenced as being IP66 rated. Otherwise, water or dirt might interfere with the quality of your video feeds or, worse yet, damage the camera’s sensitive electronics. Cameras are available with thermostatic controls, which allow them to heat or cool to prevent condensation from forming over the lens and obscuring its sight. Cameras that are “vandal resistant” are referred to as being IK10 rated.

When properly installed, IP cameras create a safer, more secure environment for assisted living and nursing homes and the people they serve.

Greg Hartzell is director of Toshiba surveillance and IP video products.

McKnight’s Senior Living welcomes marketplace columns on subjects of value to the industry. Please see our submission guidelines for more information.