A voice for the voiceless

From chewy bacon and hard-to-cut biscuits to encouraging a family to put their mother in a memory care unit, Michal Rosenberger has done it all in her year as a volunteer long-term care ombudsman.

Several times a week, Rosenberger, a retired teacher and school counselor, visits residents at Brookdale Place at NorthPointe, the 120-bed assisted living facility around the corner from her house in north Spokane.

She advocates for the residents, often on small problems – like the unsatisfactory breakfast – before they become large issues for both the resident and the facility. In this case, the kitchen staff was notified about the food and the resident was reminded to ask for help cutting her biscuit.

“I’m an extra voice, an extra pair of ears,” Rosenberger said.

She is one of about 40 volunteers for the Eastern Washington Long-Term Care Ombudsman Program run by SNAP. Volunteers spend at least four hours a week in the 27 nursing homes, 71 assisted living facilities and 195 adult family homes in Spokane and the four adjoining counties. The program is funded by federal and state dollars in addition to grants and donations.

With a total of 7,124 long-term care beds, 40 volunteers aren’t nearly enough. In 2014, volunteer ombudsmen provided 2,377 facility visits and 1,500 consultations while tallying 4,993 volunteer hours. There were 372 closed complaints with 73 percent resolved.

Linda Petrie, the regional long-term care ombudsman, said she is always looking for more volunteers, especially in the Spokane Valley. Facilities want ombudsmen but there aren’t enough. She encourages people to sign up for the four-day volunteer training that starts April 21. All potential volunteers are interviewed and screened before the trainings.

Even if a facility doesn’t have an assigned ombudsman, residents can request a visit. Petrie said there is a lack of awareness about the ombudsman program and how it gives residents a voice and ability to maintain dignity outside their own home.

The ombudsman program is mandated by the 1978 Older American Act largely to help prevent elder abuse and neglect. The mission is large, but the work is mostly joyful. Volunteers don’t consider themselves defensive watchdogs. Instead they build relationships with residents, families and staff.

They don’t spy and they don’t pry. The goal is to have residents approach them with concerns, everything from being cold at night to fearing they aren’t getting the correct dosage of medication. Often staff will call an ombudsman if a dispute arises. If needed, the ombudsman can contact Adult Protective Services and Residential Care Services for further intervention.

“You become attached,” said volunteer ombudsman Dorothy Webster, a former city of Spokane manager. “Many of the residents have not had a social visit in a long time. “You learn a lot just sitting, talking and interacting.”

Webster spends about 30 hours a month at Franklin Hills Health and Rehabilitation Center, where she has volunteered for about a year.

Petrie said Franklin Hills is an example of how the presence of an ombudsman can help improve care.

In 2006, Franklin Hills had the county’s worst record for resident care. In 2011, the state issued fines and a “stop-placement” order on new patients after a man died when staff failed to provide him the level of fluids his physician recommended. According to the state’s compliance website, there are fewer problems now. A 2014 survey showed investigations into two medication errors but no fines or citations.

Petrie said Franklin Hills didn’t have an assigned volunteer ombudsman in 2006 but the program did respond to several complaints. There was an ombudsman in 2011, but there wasn’t any way they would have known about specifics such as hydration levels.

She said the goal of the program isn’t to report facilities to the state but to work to advocate for residents and ensure they are getting the best care and have a voice.

“We do good work and often times will prevent citations by addressing a complaint,” she said.

Although, she added, unless residents tell the ombudsman of problems such as with medications or bed sores, they often won’t know.

Elise Biviano is the executive director of Northpointe, where Rosenberger volunteers. She said ombudsman volunteers make a large difference and help support residents.

“Michal has been instrumental in restoring trust,” Biviano said.

She recalls having a resident who was smoking in her room even though she had signed a no-smoking contract. Biviano and the ombudsman mediated a solution where staff is willing to walk the woman, who has dementia, to the designated smoking area.

Rosenberger volunteers because she has a brother in a nursing home in Canada. She’s too far away to help him but she wants to ensure other people like him are getting good care.

“It’s enlightened self-interest,” Rosenberger said. “I’m going to need care eventually.”