Ombudsman
An ombudsman is a person who is trained to respond to complaints of elder abuse and neglect that occur in a nursing home. Ombudsmen are either paid for their services or volunteer their time for this important task.
The ombudsman’s assistance is critical as an impartial investigator. Their task isn’t to advocate for the patient; rather, it’s to investigate the complaint to determine whether abuse or neglect has occurred and then report the incident if warranted. Many patients have no family members who visit with any regularity, and no other interested person to assist when abuse or neglect is committed against this “forgotten population”.
Typically, the ombudsman’s office will receive a complaint from a family member who reports that their elderly loved one is being abused or neglected as a nursing home patient. The type of abuse or neglect may arise from a variety of ways.
Often, the complaint is that the patient is suffering from decubitis ulcers, or bed sores, that occur when a non-ambulatory patient is not turned in their bed at regular intervals. This condition can develop within weeks and may result in a deep wound that extends down to the bone.
Other complaints may involve improper feeding. Some patients have hands and arms that are too weak or shaky to allow them to use a fork or spoon. It’s not that they aren’t hungry; rather, their physical limitations simply prevent them from performing the otherwise simple task of eating. Neglectful nursing home personnel bring the patient their food, but leave it entirely to the patient to eat. When the employee comes back to retrieve the food tray, they simply note the patient’s chart as “not hungry”.
When an ombudsman receives a complaint, they then make an unannounced inspection to investigate. During the investigation, they will speak with the nursing home personnel – including the director of nursing and the particular employees responsible for the daily care of the patient. The ombudsman will also review the patient’s medical records to determine whether any notations are made that support or refute the allegations of abuse or neglect.
If the ombudsman finds fault against the nursing home, then a report can be made to the local county or state authorities who monitor and also respond to such cases.
In California, the law requires that all 58 counties provide these ombudsman services. Unfortunately, the state’s budget crisis has forced this program to be severely slashed – reducing state funding by $3.8 million (2008). As a result, ombudsman programs are laying off full-time employees or reducing hours to part-time, and relying more than ever on volunteers.
The Riverside County, California program recently was forced to lay off its three full-time employees, reduce a full-time employee to part-time, and eliminate mileage reimbursement for 20 volunteers.
The bottom line: many complaints against nursing home abuse and neglect will not be investigated and the “forgotten population” of elderly patients will suffer without representation. However, the ombudsman’s role continues to be a valuable tool in combating elder abuse and neglect.
