Reasons for Using Cameras
Cameras can be used to get a visual picture of how the older person is doing -- to pick up on clues that might not be obvious from a phone call, for instance. Cameras are also used to see if home health aides showed up and treated the elderly person appropriately.
Wired or wireless
Wired cameras require running wires from the camera to a computer or gateway that will capture pictures, wireless cameras can send information to a wireless access point or computer. Wired cameras are cheaper, but more difficult to install and harder to move. Wireless cameras are more expensive, and may be vulnerable to "hacking" over the Internet if not properly encrypted, but are easy to install and move.
Power Issues
Cameras need power to run and must be located near an electric outlet, limiting their placement options. If the power goes out, the camera will obviously quit working, perhaps just at the time when the elderly person is at most risk.
Fixed or movable
Some cameras are fixed in place and can only view whatever is in front of them, others can be controlled remotely to scan the room on demand. Those that can scan the room make it possible to see more areas with a single camera, but are more expensive.
Computer Systems
Something has to control the cameras. In many cases cameras are controlled by a computer located in the elderly person's home. If the computer loses power, shuts down, gets a virus, or otherwise is put out of commission, the system won't work. The occupant of the home, or perhaps a visitor like a grandchild, could deliberately or accidentally destroy the system by shutting down or changing the configuration of the computer. In some systems the computer is put in an out-of-the-way place like an attic. Other systems bypass a local computer by using a gateway to send pictures directly to a computer located somewhere else, like a central web server.
Number of Cameras
A system with lots of cameras is more expensive, but make it less likely that something important will happen that the camera cannot "see". A system with numerous cameras leaves the occupant literally living in a fishbowl, a life that few of us would choose for ourselves. Most systems that use cameras try to place them in a few strategic spots that are most likely to allow a remote viewer to know if something is wrong. For instance, one system places a camera in the kitchen and one in front of the occupant's favorite chair. Placement of a camera in a bathroom is a touchy issue, but an important consideration since falls often occur in the bathroom. One system places a camera in the bathroom, but pointed at the floor. The idea is that this placement will protect privacy but make it easy to see if the person has fallen. Other systems avoid cameras in the bathroom entirely.
Control of Cameras
One issue not well resolved is whether or not the occupant can control the cameras, or turn them off. Privacy concerns would dictate that the occupant should be able to easily turn them on and off, but that would also eliminate the benefit of installing them. If the elderly person falls right after turning off the camera, how would anyone know, and whose responsibility is it? That being the case, is the camera of any benefit anyway? An occupant who most needs to be monitored might be the most likely to turn cameras off -- for instance, someone with Alzheimers might react with paranoia to the cameras and keep them off all the time. In at least one case, an elderly person being monitored by cameras took things into her own hands and cut the wires to the camera.
Access to Pictures
Systems vary in the way they handle access to the images on the cameras. One system requires users to install proprietary software on their own computers, then dial into a computer in the recipient's home which has been set up to allow access only from specific sources. They tout that as a way to keep "hackers" from seeing the information, but it also ties up a phone line and limits the ways the system can be accessed. With this system, the caregiver cannot access the cameras if they are away from the computer that has the proprietary software installed on it. Most systems upload pictures to a central web site, which can be accessed by anyone with Internet access and the right id and password.
Storage of Pictures
Video files are huge files, and it takes a lot of storage space to archive them. No system is big enough to store all pictures indefinitely, so tradeoffs have to be made on what to keep. No one can possibly look at every picture from every minute of every day, so the possibility exists that important pictures might be destroyed or overlooked.
Relevance
Most of the pictures will show nothing of importance most of the time, and no caregiver will be watching them continuously. Having a camera will allow a remote caregiver to "look in on" their loved one, but will not guarantee they will see something going wrong as it happens. If something does happen, the camera may have captured pictures of it which can be reviewed later, but because of the storage issue mentioned early, this will be useful only if someone checks soon afterward and makes a decision to save the relevant pictures.