Oklahoma House of Representatives
Media Division
January 26, 2004

OKLAHOMA CITY - A state lawmaker is trying to protect Oklahoma's senior citizens by introducing legislation that would authorize video monitoring in nursing home rooms and require a doctor to view a deceased person before he signs a death certificate.

State Rep. Rebecca Hamilton recently led a legislative study at the state Capitol into nursing home reform and community services for the frail elderly.

Kevin Motes, a reference librarian for the U.S. Government Information Division of the Oklahoma Department of Libraries, said statistics indicate Oklahoma's senior citizen population is on the rise.

According to the 2000 census, which are the latest 'hard figures' on the issue, Oklahoma has 455,950 seniors age 65 and up. The latest 2002 census estimation shows an increase to 460,459 residents 65 and older.

Hamilton said she is interested in improving the quality of life and reducing verbal, physical and sexual abuse for residents in nursing homes. Among the measures the Oklahoma City Democrat has filed is House Bill 2309 to protect vulnerable seniors.

"Legislation that would come out of this study has already been partly formulated, but it is still a work in progress," she said.

Hamilton said her House Bill 2309 would permit electronic audio or video monitoring in the rooms of nursing home residents. The measure also would require a physician to personally view and examine anyone who dies in a nursing home before that doctor signs a death certificate.

Esther Houser, a state long-term care ombudsman for the Oklahoma Department of Human Services said families have set up video cameras in their loved ones' nursing home rooms to monitor the quality and quantity of care they receive. In some cases that was the result of reported abuse or neglect, and in other cases it was simply a preventative measure, Houser said.

"On occasion, those video tapes have been used as evidence in criminal actions or lawsuits related to verbal, physical or sexual abuse, or other kinds of violations of residents' rights," she said. "It also involves situations where residents were left for long periods of time, were not turned in their beds, or issues of medication administration were questioned."

Houser said some people in this state have suggested placing cameras in nursing home rooms, but some facilities have resisted the idea. "The issue of residents' rights is a cut and dried issue to me," she said. "Nursing home residents have rights in state law, in federal nursing home law, and they also have constitutional rights, just like any other American."

She said residents have the right to retain and use personal possessions while staying in nursing homes. "If anyone wants to set up video on themselves, it doesn't violate the privacy rights of the other resident in the room, with or without notice to staff members that a video camera will be operating," Houser said.

Hamilton asked if incidents of abuse had been reduced where electronic monitoring was conducted. Houser said she was not aware of any formal studies of using video monitoring in nursing homes. "I believe that most people, if they know they are on camera, won't do things like shoplift from rooms or other inappropriate actions that
people might do when they aren't being watched."

She told the legislative panel that notice to nursing home staff of a monitoring system likely would prevent certain kinds of criminal actions and abuses from occurring. "There are numerous circumstances when residents reportedly suffer abuses, but a suspect may never be identified due to lack of evidence," Houser said.

It may be a surprise that because a nursing home is considered to be a medical setting, a doctor is not required to view someone who is deceased before writing a death certificate, and Hamilton said she wants to change that rule. Currently, a doctor will take a phone call from a nurse at the facility. The cause of death is declared over the telephone and a death certificate is written based on that information.

Most nursing home residents die from a natural progression of illnesses. "But it is also true that some could suffer from neglect, malnutrition and dehydration that could lead to death," Houser said.

She suggested that if the medical director of a nursing facility is the attending physician for an individual who has died, a different doctor would view the body and determine the cause of death.

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Scott Hancock
Media Specialist
Oklahoma House of Representatives
1-800-522-8502 ext 422  ¶ 3:41 PM