Our last article focused on the availability of Ombudsman services to empower and assist residents in identifying and exercising their rights in long-term care settings. Ombudsman services are federally mandated, however the Pennsylvania Department of Aging has taken an additional step in supporting long-term care residents by developing a program in which residents are trained to advocate for themselves and other residents. This program is called PEER – Pennsylvania Empowered Expert Residents.
The PEER program is facility based and requires collaboration between residents, the facility administrative staff, and the local Ombudsman. PEER programs are not present in all long-term care facilities. While participation in this program is open to all residents of a facility, it requires energy and commitment to become a PEER. The training program involves one two-hour class per week for five weeks followed by a graduation ceremony. Learning is accomplished through reading, videos, PowerPoint presentations, group discussion, and testing. Once training is completed, PEERS meet regularly (once every 1-3 months) with a local Ombudsman and also may participate in quarterly conference calls with other PEERS from around the state. A compassionate personality and ability to communicate effectively with staff members and other residents are qualities that are beneficial for an individual to become a successful PEER.
Forest Park Nursing and Rehabilitation Center in Carlisle has had a successful PEER program for the last four years. Diane and Cora, two of the original PEERs, continue to work hard to improve the quality of life for Forest Park’s residents. Diane initially heard about the program from a newspaper article about the graduation ceremony of PEERs from another local facility. Believing that “a lot of people are not aware of their legal rights,” she approached the administration and received its support to begin the program. Cora decided to participate because “once in a while, a situation comes up when you need to ask for help.”
They reported that initially, it took some time to earn the trust of other residents. In addition, because all conversations are confidential, many residents were and are not aware of what the PEERs are doing. PEERs are taught how to address issues with specific departments in the facility and to work their way up the chain of command. Diane has discovered that “a patient may be afraid to say something [which may] hurt someone’s feelings. Sometimes we just listen, and that’s all they need.”
The administration at Forest Park continues to support the PEER program. In October, as part of its observance of Residents’ Rights month, the facility scheduled three presentations for staff members (one for each shift) about this topic. They required staff members to attend but also took the unusual step of having the PEERS present a portion of the inservice. Usually, the local Ombudsman assumes full responsibility for the presentation. Nancy Nemoyer, one of Cumberland County’s Ombudsman, believes that the presentation had more of an impact because of the presence and participation of the PEERs.
Elmcroft of Shippensburg, a personal care home, is another local facility that has an active PEER program. Their former administrator was instrumental in bringing the program to the facility about two years ago. Three residents are currently qualified as PEERs. Vern, a resident of Elmcroft for a number of years and one of the original PEERs, believes the program is an important way to help people. He has assumed the responsibility of greeting all new residents and explaining the program to them. Current staff members are supportive of the program and appreciate the extra sets of eyes and ears that the PEERs provide to help ensure that the facility is running smoothly and that residents’ needs are met. They do screen residents who express interest in participating in the program to be sure that they have the skills necessary to be effective advocates for themselves and other residents. They look for residents like Louise, a current PEER who is able to discern whether an issue is general in nature and can be brought before the resident council for discussion or if it needs to be addressed privately with an appropriate staff member.
To meet these PEERs and witness their desire to have a positive impact on the quality of life for all of the individuals with whom they share a home should demonstrate to our society that older adults can remain active and engaged in life even when they can no longer remain in a private residence. Living in a long-term care facility requires adjustments to daily routines and ways of thinking, but these PEERS are ready to take on the challenges and help create a sense of home and community in which all residents will be respected and their needs fully supported.
Karen Kaslow, RN