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Advocacy in Long-Term Care Part II – Keystone Elder Law – Mechanicsburg, PA

Two weeks ago, we introduced the concept of Residents’ Rights for individuals who receive long-term care services.  Throughout the Commonwealth of PA, Ombudsman services are available to provide support related to these rights for individuals who are receiving care in a nursing home, personal care or assisted living facility, or adult day center.

The term “Ombudsman” is a Swedish word that means “citizen representative.”  In PA, there is a state Ombudsman, as well as local Ombudsmen, who work through county Area Agencies on Aging.  These trained advocates seek to educate residents, families, and service providers about residents’ rights; empower and assist residents and families in the resolution of issues related to long-term care; and connect residents with additional resources when needed.  Services are free and they are client-directed, which means that an Ombudsman must obtain permission from the resident/family in order to investigate a complaint or concern which the resident has been unable to resolve independently with the facility.  The goal of an investigation is to develop a satisfactory resolution for the resident.  The role of an Ombudsman is not to enforce regulations, nor are they trained to handle conflicts that occur between the family members of a long-term care resident.  Ombudsmen may work with licensing agencies to improve a provider’s compliance with specific regulations; however, they do not have the authority to order a provider to take action in a specific situation.  When a resident has dementia or is otherwise unable to speak for him or herself, an Ombudsman may work with family members if a power-of-attorney is present or there are no additional conflicts.

Currently, a two tier training program is in place for Ombudsmen.  Volunteers and staff attend a one day training that covers topics such as confidentiality, listening and problem solving skills, facility structure, and basic long-term care regulations.  In order to investigate concerns and to document specific contacts with individuals, a three day training program is required.

Presently, Cumberland County has two paid Ombudsmen and about 15 volunteers who aim to visit the 44 licensed care facilities in the county, as well as various adult day and LIFE (Living Independence for the Elderly) programs.  Documented facility visits must occur at least four times per year.  During these visits, the Ombudsman will randomly pick about six residents to converse with, and will make general observations about the facility, such as how residents are dressed; the types of activities which are available; the lighting, temperature, and cleanliness on various units; and how staff interact with residents.  When working with a specific resident to address an issue, there is a separate protocol that must be followed.

Nancy Nemoyer, an Ombudsman in Cumberland County since 2008, stated that her office receives about ten calls per week from individuals who have questions or concerns.  She gleans most of her information about the different facilities from her periodic visits.  Common concerns expressed by residents include call bell response time (#1), food choices, finances, details related to discharge, disrespectful attitudes of staff, and sometimes activity related issues.  One memorable concern that she has investigated involved a routine visit to a facility, during which several residents mentioned to her that staff members were microwaving their bath water.  When she met with an administrative staff member, she learned that their hot water heater had malfunctioned, and that repairs had been ordered.  This information helped her reassure the residents that there was a legitimate reason behind this unusual action, and that efforts were underway to fix the underlying issue.

Do you have a question or concern for your local Ombudsman?  Following are numbers for local Ombudsman programs:

Cumberland County:  Phone: 717-240-6110 or 1-888-697-0371, ext. 6110

Dauphin County:  Phone: 717-780-6130 or 1-800-328-0058

Perry County: Phone:  717-582-5128

If you have an interest in visiting with and providing encouragement to long-term care residents, volunteers are always welcome.  Please call the numbers listed above to inquire about opportunities for service.

Part III of our series on Advocacy in Long-Term Care will introduce a program in which residents of long-term care facilities are advocating for themselves and their peers.

Karen Kaslow, RN