Editorial: Nursing home residents need volunteer advocates

Published 1:30 am Thursday, March 10, 2022

By The Herald Editorial Board

The skilled nursing facilities, adult family homes and assisted-living centers that provide long-term care to seniors and other vulnerable people were among the first and hardest hit by the covid-19 pandemic when it struck early in 2020.

The measures taken to lock down those facilities to prevent the spread of covid-19 among those most at risk further isolated an already vulnerable population, with family, friends and others prevented from visiting for much of the last two years.

Among those who lost in-person access to facility residents were volunteers with the state’s Long-Term Care Ombuds Program, which sends volunteers to the state’s long-term care facilities to meet personally with residents, check on their health and well-being and act as advocates to resolve problems.

In Washington state, the federal- and state-supported program works to send volunteers and paid staff to more than 4,300 long-term care facilities in the state, acting as advocates for the more than 78,000 residents in those facilities.

It’s fulfilling work, said Patricia Hunter, head of the state’s Long-Term Care Ombuds Program, “but it’s not a cupcake-baking, friendly visitor kind of gig.”

“This is really meaningful stuff,” Hunter said. “You’re meeting people and going into their ‘homes’ and sometimes you’re hearing some very emotional and heavy stuff.”

And right now, there are not enough people to provide the outreach and advocacy that the program should offer.

During the pandemic the program’s volunteer corps fell from about 400 ombuds volunteers to as few as 135; it has since rebounded a bit to about 150 volunteers. But the lack of volunteers and pandemic restrictions, in 2020 and 2021, curtailed consultations with residents and family members to 13,000 visits from a pre-pandemic level of 41,000 and halved the number of cases and complaints filed.

In Snohomish County, there are 758 long-term care facilities serving 8,900 residents. Heidi Le’Esperance, a long-term care ombuds manager in the county said she currently has 10 certified volunteers working with 2.5 FTE paid staff, a daunting ombuds-to-resident ratio.

The program is hoping to rebuild its ranks by adding 200 ombuds volunteers by June. The program is looking for volunteers who can commit at least four-and-a-half hours a week to visits at a local facility of their choice. Volunteers are asked to complete 36 hours of online training, in-person job shadowing with a trained volunteer and certification that covers issues of aging, common mental and physical diseases and disabilities, interview and problem-solving methods, regulations and ombuds policies.

The work is serious but vital, Hunter said.

“It’s also joyful,” she said. “There are lots of amazing moments where you see independent self-growth where people are learning to advocate for themselves or you’re helping them move out of nursing homes to a less-restrictive setting or back to their own homes.”

Along with depleting the program’s ranks of volunteers and complicating their work, the pandemic deepened the isolation of residents and allowed issues to go unresolved, Hunter said. Until vaccinations and more protective gear were available, even the state’s own long-term care regulators were barred entry from many facilities.

Residents’ isolation meant increased problems with dementia, anxiety and concerns over care, diet, medication and socialization.

While the state has its own auditors reviewing care at facilities, those facilities are only visited once every 12 to 18 months, and the state is now working through a backlog of reviews caused by the pandemic.

The ombuds volunteers are residents’ first line of protection and a vital part of the oversight system, Le’Esperance said.

The work is one of advocacy, Le’Esperance said, and involves conversations with residents and family. In most cases, resolving complaints involves working with the facility’s staff and administration. A big part of the responsibility is education, sharing information with the resident, the facility and family, she said.

Jo Balanger, an ombuds volunteer with the Snohomish County program who worked in long-term care before retirement, says the work also involves convincing residents they can speak up for themselves.

The volunteers quickly build trust with residents, but also with facilities’ staff and management who in most cases recognize the volunteers’ role in assuring good care, Balanger said.

“I go in every week and meet new residents,” Ballanger said. “In no time they recognize me and seek me out when they see me in the building. It’s a good feeling. I’ve been told many times, ‘Oh, I’m so glad you’re here.’ Even if I’m not doing a whole lot in my mind, they just like seeing me. They do trust you.”

Long-term care facilities, even before the pandemic, faced a crisis in staffing and funding as prospective and existing workers left the profession and went to other less-demanding but better paying jobs. Those concerns will only grow as the baby boom generation ages and requires an increasing level of care.

The state Legislature, as it wraps up its session today, is expected to pass a supplemental budget that will increase Medicaid reimbursements that will allow the state’s adult family homes to increase pay for those providing care to those with developmental disabilities.

Likewise, President Biden, during last week’s State of the Union address, announced a package of reforms, assistance and $500 million in funding to improve care and oversight of the nation’s nursing homes.

That funding and commitment to improved care is significant, but it still requires the eyes and ears of volunteers working directly with residents.

Jenny Heard, another ombuds volunteer in Snohomish County, works with one resident who has lived in a nursing home for 13 years.

“It is her home,” Heard said. “It’s not perfect; no home is, but she’s entitled to have her concerns listened to. We gather together and go over the problems. And some of those things can be fixed, and some can’t. But it can always be monitored. I’m there as her support person. I can’t change everything, but I can make the communication happen.”

Become an LTC ombuds volunteer

To learn more about the state Long-Term Care Ombuds Program and how to volunteer go to waombudsman.org or call 800-562-6028.