Protecting the rights of low-income nursing home and assisted living facility residents
Abstract
Often low-income nursing home and assisted living facility residents are unable to advocate for themselves in the areas of social, legal, physical, and mental health. Many of these elders do not have any family in close proximity, so they may need someone else to represent them, securing their right to an acceptable quality of life while living in a nursing home or assisted living facility. The North Dakota State Long Term Care Ombudsman Program, under the auspices of the State Office of Aging Services, uses AmeriCorps*VISTA members to recruit volunteers from the community who can assist vulnerable seniors. Additionally, AmeriCorps*VISTA members, trained by the State Office of Aging Services, are charged with instructing ombudsmen in how to recognize potential problems and how best to represent clients, ensuring that the least restricting alternatives provided prevent further abuse or neglect. John Pohlman with the Corporation for National and Community Service, Dakotas' State Office, submitted this effective practice in February 2002.Issue
All too often, aging is accompanied by the inability to make the kinds of decisions that secure an individual's continued good health and quality of life.
Action
AmeriCorps*VISTA members, trained by the State Office of Aging Services, work with the North Dakota State Long Term Care Ombudsman Program to recruit and train Ombudsmen to recognize potential problems and represent elderly and institutionalized clients throughout the state. Effective practices include:
AmeriCorps*VISTA members:
- Revised a training manual for the Ombudsman position
- Develop Long Term Care posters and brochures and disseminate these to newly licensed Assisted Living Facilities
- Facilitate group training at orientations and presentations
- Created training modules for self-study.
Some of these modules include topics such as
- How to detect and correct abuse among elderly institutionalized residents of nursing home and assisted living facilities.
- Common sense nutrition and hydration. (Provides simple tips like making sure each client's water glass is filled throughout the day.)
- Seeking alternatives to chemical and physical restraints. (An alternative to a physical restraint could be the installation of a light that would go on when the patient gets out of bed to let the nursing staff know they are needed.)
- Advanced directives in assisting people to get living wills and durable power of attorney for terminal ill patients.
Context
North Dakota has created a statewide Ombudsman Program in the Aging Services Division of the North Dakota Department of Human Services. Currently, three AmeriCorps*VISTA members are actively serving 34 counties in rural North Dakota. One AmeriCorps*VISTA worker serves 18 counties, another serves 10 counties, and the third serves 6 counties.
The Long Term Care Ombudsman Program
- Receives, investigates, and resolves concerns affecting residents
- Answers questions and provides information and referral services
- Encourages residents, family, and community involvement in long-term care facilities
- Promotes community education about long-term care issues
- Coordinates efforts with other agencies and organizations
- Identifies issues and problem areas, and recommends needed changes The program serves
- Residents of nursing facilities, basic care homes, and hospital swing beds, transitional and sub-acute settings
- Families and friends of residents and the general public
- Employees and administrators of long-term care facilities
- Various regulatory, certification, and other agencies
In 2000 the census indicated that 118,985 people aged sixty and older lived in North Dakota. Within that population, there are many seniors who do not have a support system, in part because younger family members may have left the state. According to the Director of Aging Services, North Dakota may have the highest population of institutionalized people in the country. In this setting it is especially important for the elderly to have access to someone who can assist them.
Outcome
Residents in nursing homes and assisted living facilities are utilizing their local Ombudsman to register complaints related to care and living conditions. These are being addressed as they are brought to the institution's attention. In 2000, 743 cases were opened through the Long Term Care Ombudsman Program. A formal media campaign, which corresponds to the enactment of new state licensing laws for assisted living facilities (as of January 2002), will be conducted in April of 2002, to broadly publicize this program of support for the vulnerable elderly in North Dakota. This campaign includes a wide variety of informational literature made available to those in support positions.Evidence
- Fewer complaints are being called in to the Central Office by residents, their families and friends, as issues and problems are being resolved sooner by the AmeriCorps*VISTA members and Volunteer Community Ombudsmen the AmeriCorps*VISTA members helped to recruit.
- More serious systemic problems are identified by AmeriCorps*VISTA members and the Volunteer Community Ombudsmen, and preventative measures can be put in place before a crisis arises.
Posted On
February 22, 2002For More Information
Related Practices
Related sites
North Dakota Department of Human Services