HJNO Sep/Oct 2022

HEALTHCARE JOURNAL OF NEW ORLEANS I  SEP / OCT 2022 11 WHAT IS AN OMBUDSMAN? People often ask, “An om what? Bud who?” Long-term care ombudsmen are trained and certified to respond to the problems and needs of residents of assisted living and nursing facilities. Their services are free and are strictly confidential. Ombuds- men work with residents, their families, and facilities to address concerns affecting residents’ lives and to protect and promote their rights. They listen, provide informa- tion, assist residents in handling chal- lenges, and encourage self-advocacy. Ombudsmen also help families identify long-term care facilities for loved ones and point them to community resources. Many people, at one time or another, face these common scenarios and ques- tions: Is a family member considering assisted living? Are there any alterna- tives? Has a physician suggested a nurs- ing home? Is there guidance on selecting the most suitable nursing facility?What should I know before making a move? An ombudsman can help answer these questions and deal with these scenarios. LTCOP In 1978, amendments to the Older AmericansAct required all states to have an ombudsman (citizens’representative) program. In Louisiana, the Long-Term Care Ombudsman Program (LTCOP), federally mandated in every state, operates under the aegis of the Governor’s Office of Elderly Affairs. The Capital Area Agency on Aging (CAAA) manages the Program in the Greater Baton Rouge/NewOrleans regions. Twenty-three ombudsmen are assigned to 400 assisted living and nursing facili- ties in Louisiana that provide homes to 35,000 residents. At some point, each of these residents will encounter concerns of varying degrees with their facility. Ombuds- men advocate for residents in areas such as residents’ need for information, loss of personal items, food service complaints, financial issues and billing questions, qual- ity of care, respect for privacy, lack of dig- nity, right to make one’s own decisions, visitation and access, involuntary discharge, and psych evaluations. These are often com- plex issues that require investigation and follow-through, which takes time. According to the Louisiana Long-Term Care Ombudsman Program FFY 2020 Annual Report, ombudsmen investigated 1,342 complaints ranging from dietary needs to physical or chemical restraints. Of those complaints, only 42% were received from residents themselves. Because residents of long-term care facil- ities range in decision-making and self-care capacity, ombudsmen focus on ensuring the individual’s needs and desires are met while maintaining as much autonomy and dig- nity as possible. They focus on capacity as a spectrum, and regardless of capacity, an individual can still make decisions about how to spend their day-to-day time. While someone with dementia may no longer remember a loved one’s name, they’ll likely remember a favorite song, and they’ll know when they’re uncomfortable. Ombudsmen’s goals are to ensure that individuals in long- term care remain involved in the decisions that affect their daily lives in as significant a way as they’re capable. Obviously, there are too few ombudsmen for so many residents. How is the Louisi- ana program trying to shift this enormous imbalance? One answer is to empower resi- dents to exert their rights and let their col- lective voice make a difference in their qual- ity of life at their home facility. LA PEER In 2002, a bold trio of nursing home residents in Cambria County, Pennsylva- nia, approached the Pennsylvania Long- Term Care Ombudsman Office to under- take ombudsman training. Conflicts of interest, unfortunately, prevented them from taking the training, but the state’s long-term care ombudsman office had a novel idea: train these residents to assist other residents in understanding their rights and the mechanisms avail- able for self-resolution of the residents’ concerns. As a result of these actions, Pennsylvania’s Empowered Expert Resi- dents (PEER) program began and is now established in approximately 900 nurs- ing facilities in the state. PEER spread to Colorado in 2020, and CO-PEER is now firmly established. Louisiana is the third state in the nation to establish this “train-the-res- idents-to-self-advocate” program. LA PEER began in June 2022 as the Loui- siana Program for Empowering Every Resident. Louisiana’s first LA PEER graduating class received certificates of training on June 30 at St. Jude’s Health and Wellness, New Orleans — the first facility in Louisiana to embrace LAPEER. LA PEER is a series of interactive train- ing sessions for long-term care residents. The program trains individuals in long-term care facilities to advocate for themselves through a six-part empowerment pro- gram and teaches them to help their fellow residents improve day-to-day life in their home facility. The residents, or LA PEERs, are trained to think in terms of advocacy and to act as problem solvers through criti- cal thinking. LA PEERs are instructed on the three steps to problem-solving: intake, analysis and planning; resolution; and follow-up. “Ombudsmen work with residents, their families, and facilities to address concerns affecting residents’ lives and to protect and promote their rights. They listen, provide information, assist residents in handling challenges, and encourage self-advocacy.”