MAKING A DIFFERENCE : One Agency’s Approach: Advocate for Seniors in Long-Term Care Facilities

California has more residents 65 years and older than any other state, according to the U.S. Census Bureau. The figure is likely to rise as baby boomers age. Many will come to rely on long-term care from nursing or retirement homes and residential board and care facilities. To protect residents’ interests in these licensed facilities, federal law mandates that each state provide advocacy services for them. In California that translates to a Long-Term Care Ombudsman Program in each county, with the largest two programs in Southern California. These programs, WISE Senior Services in Los Angeles County and the Orange County Council on Aging recruit, train and supervise volunteers to serve as advocates for residents of long-term care facilities. They become long-term care ombudsmen after completing 36 hours of instruction about the aging process, long-term care laws and regulations and complaint documentation, mediation and resolution. Ombudsmen are certified by the state and spend about 20 hours each month visiting facilities in an assigned area to meet with residents and to investigate and follow-up on concerns about everything from cold food to stolen property to the worst kinds of physical abuse and neglect. Some facility administrators and staff bridle at their unannounced visits and recommendations for change, but as a Los Angeles ombudsman explained, “A few don’t like us much, but the smartest ones say they want us to mingle with the residents. They see us as an asset. If I bring something to their attention it can help make them more responsive to their residents’ real needs.”

INTERVENTIONS

Ombudsmen are trained to respond to residents’ expressed wishes or complaints and, in certain cases even if concerns are not directly expressed, to act in the best interests of a resident. They act as a liaison between residents and facility administrators, care providers and family members and provide an on-going social contact for a group of people who often live in isolation. While they have no enforcement powers they may report their findings to government enforcement agencies. Examples of ombudsmen responses include:

--Working with nursing home staff to incorporate ethnic foods into facility menu

--Informing a facility administrator that residents have the right to have drapes drawn in rooms before having their clothes changed

--Reminding staff that urine bags must be changed regularly

--Confirming and reporting that family members are withholding a resident’s Social Security check

THE NEED FOR OMBUDSMEN

Los Angeles County

Number of long-term care beds: 80,000

Number of ombudsmen: 249

Orange County

Number of long-term care beds: 19,470

Number of ombudsmen: 50

Source: WISE Senior Services, Orange County Council on Aging

“Volunteering as a senior ombudsman is not for the faint-hearted, but it is for the big-hearted. It’s demanding and sometimes sad, but there’s a tremendous reward in helping people who often have no one else there for them.”

--Mary Chandler, Irvine, coordinator of volunteers, Orange County Council on Aging

RESIDENTS’ RIGHTS

Residents of long-term care facilities have state and federal-mandated rights within several broad categories:

Self-determination--including the right to choose a personal physician and to participate in planning and making changes in their own care and treatment

Privacy--including the right to have private medical treatment, personal visits, written and telephone communications and confidential personal and clinical records

Freedom from abuse --including the right to be free from physical or mental abuse or threats, corporal punishment, involuntary seclusion, restraints or use of drugs for discipline

Information--including the right to receive written information at admission and throughout their stay about services and charges at a facility

Visits--including the right to receive visits by relatives, friends, clergy, ombudsmen

Protection of personal funds--including right to written record of all transactions if facility is responsible for resident’s funds

TO GET INVOLVED

WISE Senior Services administers, Los Angeles County’s Senior Ombudsman Program. Call (800) 334-9473 or (310) 394-9871. Bilingual ombudsmen are always in need, and there is an urgent need for ombudsmen in the East San Gabriel Valley and in Central, South-Central and East Los Angeles.

The Orange County Council on Aging Senior administers that county’s ombudsman program. Call (714) 863-0323.