Sunday, 16 January 2005 - 8:45 AM

This presentation is part of: Community Health Care of Older Adults

Experiences and Challenges of Local Long Term Care Ombudsman Programs in New York State & California: A Qualitative Inquiry

Purpose: Mandated under the federal Older Americans Act, Long Term Care Ombudsman Programs (LTCOP) play an important role in the quality of care in institutionalized LTC settings (including: nursing homes and board and care facilities) by advocating to protect the health, safety, welfare and rights of elderly and other residents. LTCOPs operate in every state and locally. While state level ombudsman programs function largely at the policy and oversight level, local ombudsmen visit LTC settings to observe and resolve complaints on behalf of residents or intervene in problem situations involving service providers. Especially at the local level, these programs serve as a voice for some of society’s most vulnerable persons. The purpose of this study was to gain insight from local ombudsmen, themselves, concerning successful programmatic approaches and barriers to program operation. To date, comprehensive efforts to utilize qualitative research methods to examine local LTCOPs has been sparse.

Method: Data are drawn from telephone interviews with 50 local LCOP coordinators in New York and 35 in California (representing all local LTCOPs in each state). As a part of a larger on-going research effort, semi-structured interview items were used to elicit respondent experiences as a local LTCOP coordinator. All data were transcribed and AtlasTi was used to aid in the analysis. The investigators used a grounded theory and a multistage iterative coding process to identify thematic elements and emergent patterns in each interview and across programs.

Results: Results of this study provide insight regarding the challenges and issues faced by local ombudsmen advocating for residents of nursing home and board and care facilities. Specific exploration of key issues and programmatic challenges included the following domain areas: conflicts between federal mandates and program duties; relationships with other aging service agencies and organizations; challenges and obstacles concerning issues of elder abuse, end-of-life care and post-acute & rehabilitative care; challenges and needs related to program cultural competency; as well as general challenges to quality of care within LTC facilities.

Implications for Practice & Policy: The findings of this study have direct implications at both the practice and policy level, affording rich detail regarding the experiences and challenges concerning local LTCOPs. At the practice level, the data delineate critical needs and obstacles faced by local ombudsmen and underscore areas for program development and staff training. In connection with the larger study, the findings herein are to be disseminated to local ombudsmen in order to develop a set of recommendations and a best practices tool kit. On the broader level, Ombudsman Summits are to be held in both states in which policymakers, local ombudsmen, and other critical stakeholders will meet to develop a framework for initiating ideas for program and policy improvement. With recognition of the increasing numbers of individuals who will reside in LTC facilities and changes in the ethnic and cultural diversity of our society, improved understanding the issues faced by local LTCOPs is timely, representing an important issue for professionals, policy makers as well as for residents of LTC facilities and their families.

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