Building a trusting rapport with individuals residing in long-term care is an important step for a long-term care “ombuds” (the gender-neutral term many prefer to “ombudsman”). Last summer, an ombudsman approached a female resident residing in a nursing home facility. The ombuds introduced themselves and attempted to explain their role as an advocate for residents of long-term care facilities. The resident appeared disheveled and shared that she was not happy living in the care facility. She wanted to return home. Then she stood up and left the room before the ombuds could hear more and offer advocacy services.
The ombuds continued making rounds in the nursing home, visiting other residents, and checking on complaints. Later, the ombuds decided to re-approach the resident. This time, the ombuds offered a program brochure, a business card and, most importantly, a listening ear.
Trained and authorized to ask residents “probing” questions, the ombuds dug a little deeper to get to know the resident. A bigger picture of what the resident really wanted began to form. The resident expressed her fear of losing independence and felt she was not ready to live in a nursing home. With the resident’s consent, the ombuds worked with the nursing home social worker to discuss the resident’s desire to return home. A care conference involving pertinent facility staff, the resident, and her family members was held to discuss the possibility of her return home.
The resident requested that the ombuds attend the care conference. With everyone’s input about the resident’s safety and medical needs, she was able to return home and maintain her independence. Most importantly, she was able to exercise her legal rights—choice, autonomy, and decision making.
Federal and state standards for care facilities
According to the Nursing Home Reform Act of 1987—the federal standards for nursing homes in the United States—all residents in nursing homes are entitled to receive quality care and live in an environment that improves or maintains the quality of their physical and mental health. This entitlement includes freedom from neglect, abuse, and misappropriation of funds. Neglect and abuse are criminal acts whether they occur inside or outside a nursing home.
Washingtonians can applaud the excellence of our state legislators who, in the mid-1990s, extended these special rights to cover all licensed long-term care settings in our state, including adult family homes and assisted living facilities. Residents do not surrender their rights when they enter a facility.
State ombuds role
The Washington State Long-Term Care Ombudsman is the first line of protection for ensuring the safety and protection of vulnerable adults living in licensed nursing homes, assisted living facilities, and adult family homes. Recently, an ombuds approached a resident who was lying in his bed, looking embarrassed and upset. The ombuds learned that the facility staff were not getting to him quickly enough and he regularly endured lying in his own feces. While there in the room, the ombuds witnessed staff bringing the resident his meal tray before offering to clean the resident up.
With that resident’s permission, the ombuds spoke to the nurse on duty, who immediately removed the resident’s meal tray and cleaned the resident. The family members were pleased that their loved one was getting the attention he needed and deserved. The ombuds added the resident to the weekly visit list in order to keep a watchful eye and build greater trust.
Residents and family members often fear that complaints will lead to retaliation. Our Program’s federal and state mandate and role provides the legal authority to advocate for residents living in licensed long-term care and accepting complaints concerning quality of care and quality of life brought by residents, family members, staff and/or the community. We understand that the fear of retaliation is real, and all services provided by the Long-Term Care Ombudsmen are confidential.
Our primary goal is to resolve complaints quickly, on the lowest level of the facility‘s organization and to the satisfaction of the resident. The ombuds also offer information and education about residents’ rights through one-to-one consultations, care conferences, over the phone, and through presentations to small and large groups. We work closely with protective authorities and licensing oversight whenever needed.
Ombuds volunteer opportunities in King County
The Long-Term Care Ombudsman Program serving King County is currently accepting applications for volunteers to become certified long-term care ombuds. Selected candidates must attend a 32-hour certification training (offered at no cost) and pass a Washington State criminal history and background check. Once certified, the new volunteer commits to spending four hours per week in their assigned facility, meeting with the residents to receive complaints, problem-solve, and work towards complaint resolution. To maintain certification, all ombuds must attend monthly meetings, where they receive technical support, training, and peer support.
Reporting abuse, neglect, and exploitation
For more information about neglect and abuse, see The National Consumer Voice for Quality Long-Term Care’s Fact Sheet on Abuse, Neglect, Exploitation, and Misappropriation of Property. Please report immediately, following the tips in the fact sheet.
You can give your report to the nursing home’s administrator, director of nursing, and social worker. You can also file the complaint with Department of Social and Human Services (DSHS) Complaint Resolution Unit—call 1-800-562-6078, e-mail CRU@dshs.wa.gov, or visit Report Concerns Involving Vulnerable Adults online.
Adult Protective Services (APS) investigates reports of abuse, neglect, and exploitation of elders. The APS contact number is 1-866-END-HARM (1-866-363-4276).
Contributor Pamela Williams is the Regional Long-Term Care Ombudsman for King County.