CCTV can be an effective form of assistive technology. However, there are ethical and legal issues around using security cameras to keep an eye on someone with dementia that must be taken into account.
Families, who worry about leaving a person with dementia alone, often ask us if they can install CCTV cameras at home. Loved ones may want to check on a relative when they are not there, but is this ok?
Like so much in dementia, everyone is different, and each person's situation should be considered individually. But there are some clear legal and ethical issues to think about.
We can use assistive technology as a way of enabling someone to remain independent. It can also allow people to be safer in their own home for longer.
Yet this does not automatically justify use of CCTV. So, it's worth asking a few questions when thinking about home security cameras.
Can a person with dementia consent to CCTV?
Being able to decide to have CCTV or not is an example of having the 'mental capacity’ to make a particular decision.
The person needs to understand what is being proposed, the practicalities, weigh up the pros and cons, and communicate a decision. All this is covered in the Mental Capacity Act 2005.
If the person can make this decision themselves then it is theirs to make and must be respected - even if the family disagree.
If the person lacks capacity to make this decision for themselves then the decision can be made for them. This can be done by an attorney or deputy, a professional such as a social worker and in some circumstances, family.
But the decision that's made must be in the person’s 'best interests'. It must also have regard to the 'least restrictive' option. The terms 'best interests' and 'least restrictive' are from the Act and we explain them below.
What if the person with dementia cannot consent to CCTV?
In making a ‘best interests’ decision for someone who lacks capacity, the following should be considered:
- Whether the person will be able to make the decision in the future. (If they have good and bad days, can the decision wait until a time they can make the decision themselves?).
- The person’s own views – it’s important to note that, even if someone cannot make a decision, they may still have an opinion.
- The person’s past and present preferences.
- Whether all appropriate friends, family and professionals have been consulted.
- Whether all the relevant circumstances have been taken into account.
A decision also needs to have regard to the 'least restrictive' option. There needs to be discussion as to what other options are available and if these are more suitable.
For example, other forms of assistive technology may be suitable, including pressure pads. These can also monitor when a person leaves or enters the home and can be less restrictive than filming someone.
If it is decided that there isn’t a less restrictive option, or it wouldn’t work, then the least restrictive way of using the camera must be considered. For example, placing cameras only where needed.
Cameras should not be placed where someone goes to the toilet, washes, or dresses. If cameras are placed in these areas, social services could also become interested as this may raise safeguarding issues.
Does CCTV breach the person with dementia’s human rights?
Finally, there are wider legal issues that we must acknowledge. The use of cameras in this way does go against someone’s human rights. This is because we all have a right to privacy and dignity.
Where absolutely needed, in someone’s best interests, this right can be infringed upon, but it needs to be carefully considered.
Families who are unsure should consult with social services before using CCTV.
If security cameras are being provided by a specialist company for care purposes, then they should also help with these considerations.
If the cameras are recording and storing the information, then it is important to think about:
- how this data is stored
- who will view it.
Any recordings will be very personal to the person and so should not be widely shared. If the recordings do highlight abuse or neglect, then this should be shared with social services.
Any decision made for someone needs to be in their best interests. It must also have regard to the least restrictive option.
Legally, CCTV does infringe upon a person’s right to privacy and dignity. This means the decision needs careful consideration. It may also need consultation with a professional such as social services.
Like so much else in dementia, it needs to be an individual decision taking into account a range of factors.
This article was first published on 27 October 2016 and most recently updated on 14 February 2023.