Imagine doing the research to place your elderly father in a nursing home.  You look at the ratings online, you talk to neighbors, and you think you’ve found a good placement.

Everything seems to be going well.  Then you get a phone call from the nursing home administrator, reporting something shocking.  A nursing home worker has taken a humiliating photo of your father, partially undressed and covered in excrement, and shared it on the social media application Snapchat or Instagram with a crude caption.

The photo is taken for the worker’s amusement.  She sends it to her fellow workers.  If all goes well, they follow their obligations and report the incident to their boss, who takes action and reports the incident to law enforcement.  

Generally, such abuse and invasion of privacy is illegal in every state.  Even so, a particular set of facts and circumstances might not fit the laws on the books in any given state because something is so new.  In many areas involving new technologies, governments -- local, state, and federal -- need to catch up to innovation.

Not so long ago, Snapchat, Facebook, Instagram and Twitter weren’t as widely used as they are today.  It would have been hard for anyone to anticipate that a smart phone would be in everyone’s pocket, including those of the nurse’s aides caring for a vulnerable elderly population.  

I learned of the social media exploitation of nursing home residents through the investigative news outlet, ProPublica.  Its reporters have documented 44 incidents across the country since 2012 in which nursing home workers posted photos of nursing home residents on social media.  Three of the incidents were in Iowa – in Johnston, Ames and Hubbard.  A TV station in Wisconsin detailed the incidents in that state.

There are a few points of good news, despite the grimness of the problem.  By all accounts, the vast majority of nursing home workers do their jobs well with respect for the people in their care.  Many of them are drawn to the work because they love providing care and have a warm humanitarian spirit.

Public awareness is growing, and so is preventive action.  Since I began inquiring, several entities have taken steps to prevent the problem.  
The leading nursing home industry association responded to my letter and put out detailed guidance to its members about the social media abuse problem.

The inspector general of the federal Department of Health and Human Services alerted 50 State Medicaid Fraud Control Units to be increasingly aware of the problem and investigate allegations accordingly.  Most nursing home care is funded through Medicaid, a state-federal program, and nursing home inspections also are a state-federal venture.  

Patient privacy is protected through a strict federal law.
The Justice Department expressed concern, noting that protecting seniors from abuse is one of its highest priorities.  
Facebook, Instagram and Snapchat also expressed concern.  
I’m continuing to follow up.  In its latest response to me, Snapchat said it’s technically unfeasible to routinely monitor user posts for problematic content.

Also, it’s unclear how many users Snapchat has terminated for problematic content and how easy it is for users to report troubling content.  Even if reporting is easy, reporting after the fact is not a preventive measure.  
So if you’re a caregiver who needs to place an elderly parent in a nursing home, what steps should you take on social media concerns?
--Ask the nursing home about its policies for cell phone use during work and use of social media by employees.  If employees are allowed to have their phones with them while caring for residents, have they been trained about resident privacy involving social media and the consequences of violating such policies?
--Use ProPublica’s reporting to see whether social media exploitation of nursing home residents has been reported in your area.  Keep in mind that the available data is not comprehensive.  The reporters did their best to compile the information using nursing home inspection reports and news reports but there’s no single source on the problem.
--Ask to see the nursing home’s last several inspection reports.  Nursing homes are obligated to report all abuse, including social media abuse.  If they have experienced the problem, it should be reflected in an inspection report.  And use the online reporting tool,, to see how the nursing homes in your area stack up.
Social media is a tremendous force for good, but when misuse is a concern, especially in the case of vulnerable people, we all must work to right the ship.