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Ombudsmen help seniors who cannot help themselves
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Published: September 14, 2009
The North Carolina Ombudsman Program, established in 1976 in response to the Older Americans Act of 1965, advocates and protects the rights of nursing home and adult care home residents.
An ombudsman, which is the Scandinavian word for advocate, works with nursing home residents, their family members, and facilities to enhance the quality of life for residents in long term care facilities. They help maintain the essence of the Nursing Home Resident's Bill of Rights, which is given to each resident upon admission into the facility.
The Resident Bill of Rights provides the bases for the provision of care in nursing facilities, and is the law.
The program is run by regional government, but is a federal program, and the money comes from federal funds and the state.
Each state has an ombudsman program, and in each state, the program runs differently.
In North Carolina there are a total of 36 ombudsmen around the state of North Carolina.
"One of the things that is different here is the way that the volunteers work with the ombudsman program," Regional Ombudsman Laurie Abounader said. She covers Anson, Cabarrus and Union counties.
"In some states the volunteers call themselves ombudsmen. In North Carolina, they don't. Here they are called the Community Advisory Committee," Abounader said.
Volunteers, after applying to the program, are appointed by the county commissioners to the commission. The commission members visit facilities, interact with the residents, and advocate for their care.
"They visit the facilities, and there is a report form they fill out where they ask about food, smoking, and 'Do your needs get answered?' They interview residents. That is their primary job," Abounader said.
Members of the committee must be residents of the county they serve, and are volunteers on the committee from one to three years. Most will work six to eight hours a month. but in that time, the advisory committee must visit all the nursing homes in the county every three months. Volunteers receive an initial 15 hours of training, and then must fulfill 10 more hours of training annually.
There are other agencies that go out to visit the facilities — the health department, the fire marshal, and the State of North Carolina — but there is no single entity that goes out to talk with residents about how their care is provided, and if their needs are being met. That's what the ombudsman program does.
"They have the ability to pursue cases or complaints, but they typically leave those for the ombudsman. So if they get a complaint they'll refer it to the ombudsman," Abounader said.
They try to find out what the residents like and dislike about their care, and when they finish with their visit, they talk with the administration or supervisor in charge of the facility, and share what they found during their visit.
There is no regulatory power behind the commission, or behind ombudsmen. Most facilities want to do a good job, and provide a good service to the resident.
"The ombudsman program is powerful, and effective, and plays a very important role in the long-term care setting," Abounader said. "Our power lies in what we give others: education, information, and advocacy skills. Educating residents about the Resident's [Bill of] Rights that protect them, training facility staff about treating residents respectfully, and teaching family members the most effective way to handle problems.
"It's the right thing to do. Our only power lies in the art of persuasion, being able to mediate, to be able to say to folks 'Do it because it's the right thing, and do it because it's going to make your life easier, and the residents life better.' "
"Confidentiality is paramount in what we do. I have had many cases where the facility calls and asks 'what do we do in this case'?" Abounader said.
What Abounader said she will always remind the facility is that, as the legal caregivers, facilities are ultimately responsible for the safety of all of the residents in the building.
The ombudsmen program also does educational presentations to facilities on a very regular basis.
"The idea that if I'm able to get 30 staff members in front of me, and talk to them about the rights of residents, or talk to them about how to work with challenging behavior, that I'm able to help those 30 people work with all of their residents," Abounader said.
Abounader said that the nursing home of the 1960s, where the patients are in beds and restrained physically and chemically, don't exist anymore. Those conditions have improved dramatically.
"There are improvements made everyday, and I think things are getting better for long term facilities," Abounader said.
As Baby Boomers age, they are going to demand better choices in their care, Abounader said. They will want more than starch white sheets and starch white walls.
Facilities in our area have done some renovations to make things more comforting and more like home.
"Officially we call that 'culture change'," Abounader said.
It's a relatively new term in the world of long-term health care. It's a new way to approach care where it is no longer institutional, but there are more efforts to engage residents in the decisions of how things will affect them.
"When human beings take care of human beings, mistakes are inevitable — no amount of power will help prevent this, but the ombudsman works in a variety of ways to help the resident achieve a resolution," Abounader said.
• Contact reporter Robin L. Gardner: 704-789-9140
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