Ombudsman volunteers bring support and connection to nursing home residents
An ombudsman, by definition, is someone who investigates complaints and mediates fair settlements between two parties, according to the online version of the American Heritage Dictionary.
Yet, while the description fits those in Coastline’s Ombudsmen program — people who mediate disputes between nursing home residents and administrators — volunteers in the program say it’s more accurate to say they are a friendly face who listen to residents, get to know them, and then, when asked, help solve the problems and issues that come up during daily life in a nursing home.
Amy DiPietro, Dartmouth Council on Aging director and a Coastline Ombudsman volunteer, for example, says her volunteer role goes beyond resident advocacy.
“Residents are just happy to see somebody from the outside world,” she said. “I’ll pop in, knock on doors, say hello, and chat with some of the residents in the hallways and activity rooms.”
“A friendly face is always welcome,” she added.
Volunteer Howie Galitsky describes his ombudsman role by telling the story of a man he saw alone in his room every time he visited the New Bedford nursing home he’d been assigned to. The resident was 100 years old and nearly deaf and blind, so Galitsky struggled to connect or learn about any issues he might be having.
That bothered him, he said. So, he went to Ombudsman Program Direc-tor Anna Dougherty and requested a pocket talker – a hearing assistance device that amplifies the voice.
“He just sat there all day,” Galitsky said about the resident. “Anna let me borrow one of those machines and I brought it to him and we had conversations. It was really nice. I learned he had 12 medals from World War II…I learned so much about this man.”
At its heart, the Ombudsman program at Coastline exists to support the dignity and empowerment of the long-term care resident to live quality lives. Volunteers are crucial to that mission, Dougherty, the program’s director for the past three years, said.
As program volunteers, DiPietro and Galitsky are assigned to one or two specific local nursing homes where they can form relationships with residents and staff members.
Volunteers receive training and become certified by the state Ombudsman office, part of the Executive Office of Elder Affairs. They volunteer at least an hour a week for two weeks a month and are recertified every two years.
When she visits, DiPietro identifies herself as an ombudsman and tells residents she’s available to talk if they have any concerns. One woman, for example, told her she was having trouble sleeping and asked for help.
“She was concerned she was being woken up in the middle of the night to be given her meds,” DiPietro said.
When DiPietro inquired, she got support from the unit manager, who put visible notes on the resident’s door and room saying, ‘Please don’t wake me up.’
It can seem obvious, DiPietro noted, but staff tasked with giving medications on a set schedule, may not be aware of the disruption they’re causing. Likewise, she said, a resident who speaks up for themselves can be written down as irritable or disruptive, causing staff to be less receptive to their requests.
“But for me,” she said, “I’m coming in with fresh eyes and I can help.”
What volunteers and Dougherty emphasize is that residents have the right to make decisions about their needs and preferences. Not every conflict is resolved to everyone’s satisfaction, but the persistent attention of an ombudsman volunteer helps.
The program is also overseen and backed at the state level by the state ombudsman office which sets staffing and administrative policies that are consistent with state and federal laws. The relationship isn’t designed to be adversarial, but can help cut through layers of administration to solve a problem.
“We’re a reminder for residents that they do have rights,” Dougherty said.
Facilities take their input seriously, DiPietro added, knowing that the program must report back to state.
“Residents just want some control over how they’re going to live their lives,” she said.
Nursing homes also have internal mechanisms to support residents’ rights including Resident Councils, led by and made up of residents, whose meeting minutes are filed by the nursing home and can become part the state’s annual review.
Councils give residents “an opportunity to voice what they’ve been experiencing and come up with the change they’d like to see, like new activities,” Dougherty said.
“We always remind (residents) that if they have any concerns, we can address them but that there is a Resident Council too,” she said, suggesting that sometimes an issue is better addressed by the council. “We always want them to participate if they’re able to because they may not be the only one who is having those issues and it also gives them a time to meet other residents.”
Nursing homes also hold regular presentations to remind residents of their rights and hold individual care plan meetings with each resident, where daily routines such as meal or shower times can be tailored to a resident’s needs. The Ombudsman Program steps in when a resident request isn’t met or gets lost in a busy environment. Requests must always come directly from residents, although legal guardians or activated health care agents can stand in for a resident who is unable to communicate.
One woman, for example, simply wanted a cupholder for her wheelchair which Galitsky helped make happen.
Another woman had been placed on a pureed diet but wanted to eat solid foods again.
“I asked her, ‘Do you want me to address it?’ and she said yes,” Galitsky said. “So I went back to my (nursing home) contact person and she had someone check with the doctor and they said yes, she didn’t have to eat (pureed food) anymore.”
Galitsky is always looking for ways to get to know residents better. One opening topic is his age, he said. At 83, he often gets asked how long he’s been in the nursing home by people who think he’s a fellow resident.
“Oh, I’ve been here about a year,” he answers casually, intentionally misinterpreting the question as asking how long he’s been a volunteer at the home.
“I’m not lying,” he says with a grin. As a retired aging professional, who worked for Bristol Elders in Fall River for 25 years, Galitsky understands more than most how important his role is to resident well-being. That still doesn’t mean he’s there to police anyone, he said.
“I can look at it from both standpoints,” he said, referring to staff and residents. “I am there to bring joy to people and to be available, and if I have a problem, I’m going to call my supervisor.”
DiPietro too said she refers the more difficult situations to Dougherty. It’s why the role is a good one, she said, for anyone who cares about people.
“Neither of us like conflict, but when you know that you’re advocating for somebody who may not have a loud enough voice of their own, it comes pretty naturally,” she said, speaking of herself and Galitsky. “Anyone with empathy could do this.”