A proposal from the Illinois attorney general's office to allow camera monitoring in nursing homes is drawing cautious support from elder care advocates, who have raised concerns about the privacy of seniors.

Attorney General Lisa Madigan's proposal, announced Monday, would allow video cameras and audio recording devices in nursing homes if residents consent and if they or their family members cover the costs.

The cameras could help deter abuse or neglect at nursing homes, and in cases where abuse does occur they could help hold accountable the people responsible, Madigan said.

"The work that I have done … as attorney general has unfortunately proven that too often when our loved ones are in a nursing home, they are not always safe and they are not always well cared for," Madigan said in announcing the proposal.

Under current Illinois law, nursing home residents are not allowed to have cameras installed in their rooms, according to the attorney general's office.

Cameras can be helpful in cases where the resident consents, but consent can be difficult to determine among some seniors in long-term care, such as those whose mental capacity has been impaired by a stroke, said Kathy Swanson, regional ombudsman for suburban Cook County for the Legal Assistance Foundation, a senior advocacy organization.

"In a lot of cases nobody knows what the person who is impacted by this law wants," Swanson said.

She questioned how many seniors would want to be recorded in their rooms, especially those who require help getting dressed or changing a diaper.

Madigan and other supporters of the measure said the growing presence of cameras — such as those monitoring pets, traffic, police officers and public transit vehicles — makes it logical to allow them in nursing homes.

The proposal would allow recordings from the devices to be used in court and would include penalties for anyone who tries to hamper or obstruct the devices.

The Illinois Department of Public Health receives 19,000 calls per year alleging abuse or neglect and responds to about 5,000, according to a news release from the attorney general's office.

State Sen. Terry Link, D-Waukegan, said he sponsored a bill in 2007 that would have allowed cameras, but the bill failed. Link said an assessment by the state found the "need wasn't there" for the cameras — a determination with which he disagreed.

Link said he anticipates little opposition to a bill that would require residents to consent to cameras and pay for them. "There is no reason that a loved one cannot have that camera in there if they want to supply it," he said.

The attorney general's office is drafting language for the new bill, an effort Link said he supports.

A spokesman for the Health Care Council of Illinois, the state's largest nursing care industry association, said the organization first learned of the proposal after Monday's announcement. Potential costs and effects are not yet clear, spokesman Nathan Brown said.

"We look forward to working with our elected officials in reviewing data on this issue and making sure our residents are protected. The safety of all our residents is of the highest priority," council Executive Director Pat Comstock said in a statement.

"Privacy remains a serious concern, especially as it relates to HIPAA," the statement said, referring to the federal law that governs patient privacy and other matters.

Five states — Texas, Oklahoma, New Mexico, Maryland and Washington — allow cameras in nursing homes, said Lori Smetanka, director of the National Long-Term Care Ombudsman Resource Center, which promotes quality care services for seniors.

"You have to think about what the privacy issues are, who gives consent, and then what happens with the recordings that are being captured," Smetanka said.

The privacy rights of visitors, staff and roommates of the resident also need to be considered, she said. Even if a camera is pointed only at the resident who owns it, it could capture a roommate's conversations, she said.

Smetanka said she did not know how widespread the use of cameras is. A recent conference call with 10 consumers from around the country showed people were divided on the issue, she said. Those who supported cameras in rooms often had some experience with elder abuse or neglect, she said.

Oklahoma started allowing camera monitoring in nursing homes last year, said Esther Houser, the long-term care ombudsman for that state. The law requires nursing homes with cameras inside to notify visitors at the main entrance that they could be under surveillance. The notices are optional in patients' rooms, Houser said.

No data is available on how many residents use the cameras in the state, she said.

"I suspect that in many, many facilities there will be at least one person with a camera, but I don't know of many facilities where there are many people with a camera," Houser said.

Houser praised Oklahoma's law for giving residents the choice whether to have the cameras in their rooms rather than leaving it up to the nursing homes or family members.

"It's a question you should ask yourself — do you want a camera in your room?" Houser said. "Some people might, some people might not."