What is a Long-Term Care Ombudsman

Ombudsman Lee and Terre Ann

[00:00:00] Liz Craven: Hi, this is Liz Craven. Welcome to Sage Aging. This is your podcast for understanding the aging and caregiving journey and connecting to the information and resources that will make your experience better. Before we dive in, let me remind you that you can find all Sage Aging episodes. The Sage Aging ElderCare Guide, and much more at eldercareguide.com.

 In past episodes, we’ve had conversations about transitioning to longterm care today.

We’re going to take that conversation one step further and explore advocacy for older adults in long-term care communities. Being the best advocate possible for your loved one is not a job you have to do alone thanks to the long-term care ombudsman program. If you or a loved one reside in a nursing home, assisted living community or family care home

this podcast episode is exactly the one that you need to hear. I’m happy to have two guests with me today. Terre Anne Lindstamer is the South Central District Ombudsman manager for Florida Ombudsman Program. She’s worked for the Ombudsman Program as staff for more than 12 years. Her favorite part of the job is meeting with residents, hearing their stories and working to enhance their quality of life in any way that she can.

Lee Earl’s is also with us today. Lee has been a volunteer for the Florida Long-term Care Ombudsman Program for more than seven years. He currently serves as the district council, chair and willingly steps up to serve in any capacity when a need arises. I am so thrilled to welcome both of you to the podcast today.

Thanks for taking the time out to chat with me.

[00:01:49] Lee Earls: Thank you very much.

[00:01:50] Terri Anne: It’s our honor.

[00:01:52] Liz Craven: Well, this conversation is long overdue. We’ve been producing this podcast since March of 2020 and this is a conversation that every family should hear and I’m not sure why it took me so long to put this one into place, but here we are Terre Anne and I have known each other for a number of years.

It’s gosh, I think probably. At least 15 years, I would say. When did you come on with the Ombudsman Program?

[00:02:21] Terri Anne: I’m 13 years.

[00:02:22] Liz Craven: 13 years. So, yeah. Yeah. So it’s been a long time and educating the general public seems to have always been an uphill battle for the Long-term Care Ombudsman Program.

Probably most people would say they’ve not ever heard of it. So I hope that today we can really kind of put it all out there in the open and help people to understand what a help and what an amazing program this is and learn more about what you do.

[00:02:48] Terri Anne: Yes. Wonderful.

[00:02:49] Liz Craven: Awesome. So let’s start with just a little bit of background about each of you let’s go first with you Terre Ann.

[00:02:55] Terri Anne: Sure. So I am happily married to my husband, Brian for 36 years now. We have two children, two grown children, and I have four grand babies. So before I actually got involved in where I am now, I was the dental hygienest. My husband and I have also worked in Christian camping and Christian childcare. So we come from that kind of background.

I’ve always been passionate about, elders, had a close relationship with both sides of my grandparents and I’ve always, highly respected elders.

[00:03:30] Liz Craven: And so is that what inspired you to move in the direction of this type of career path?

[00:03:35] Terri Anne: Yes, absolutely.

[00:03:36] Liz Craven: And how did you ever come upon it? How did you find it?

[00:03:40] Terri Anne: I just kind of stumbled into it. A couple of friends of mine from church were working for the program. At the time I was looking for a job as the place that I was working had gone bankrupt. And, they said, well, you know, come try this out. And I’m like, okay. You know, try it for a couple of years and just you know, see. And here I am 13 years later.

[00:04:00] Liz Craven: I love it. And you’re so good at your job too.

[00:04:03] Terri Anne: Thank you.

[00:04:03] Liz Craven: You are a light. All right. How about you Lee? Tell us more about yourself and then how you found this

[00:04:09] Lee Earls: Thank you. Yes, my wife, Janet and I moved here just about eight years ago, following my retirement from a 30 plus year career in retail management.

 Janet had accepted a position here, but I knew that, upon my retirement volunteering was something that I wanted to do. And more specifically, , Long-term Care Ombudsman was something that I was familiar with. My parents are both deceased now, but, at one point in time, each of them lived in an assisted living.

So I was aware of the program and knew about it, but just visiting them and seeing residents and seeing the whole operation just made me want to be a part of the program.

[00:04:49] Liz Craven: Well, what a lucky community we are to have the, both of you working in that capacity. So let’s get into it. And first I think the most important thing that we can address is to define what is a Long-term Care Ombudsman?

[00:05:05] Terri Anne: So ombudsman is a word that means advocate. And it’s not an easy word to say or spell. So I think that’s why a lot of people have never heard of it and aren’t familiar with it. But an ombudsman is a person who advocates for residents. The ombudsman is an advocate for people in long-term care, they can resolve problems and issues that the residents have.

We also do inspections, we call them assessments, and we also do quarterly visits. So that’s something that we do. We want to make sure that the residents know who we are and that they know that they can trust us with whatever they need to share. And so that’s why we’re there so frequently.

[00:05:49] Liz Craven: Those are visits that you arrange directly with each of the communities that you visit? Or do you go by surprise?

[00:05:56] Terri Anne: By surprise, always. Yes. We never let them know ahead of time that we’re coming.

[00:06:01] Liz Craven: And how does the relationship look between the ombudsman and the communities that you serve?

[00:06:08] Terri Anne: I would say 99% of them are good relationships. Every once in a while, we’ll have a community who gives us pushback. But you know, we just try to resolve that issue.

So the majority of the staff understand what we do and we’re on the same page. We all want what’s best for the residents.

[00:06:31] Liz Craven: Absolutely.

[00:06:32] Terri Anne: So we have a good relationship with most of them.

[00:06:36] Liz Craven: How do families typically come by an ombudsman? So maybe they’ve met you within the community and are there programs in place or educational pieces in place that you distribute to families so that they know you’re there and that they know you’re a person that they can reach out to?

[00:06:55] Terri Anne: Yes, we do a lot of community events. We didn’t, of course, during the past two years, but we are starting to do them again. We also have our posters. It’s required. Well, it used to be required. But all of our facilities still do it. They have our posters hanging in their communities. So in the halls

where the residents and their family members can see our information are the resident’s rights and then our name and our phone number and our website.

[00:07:25] Liz Craven: That’s another great thing. The Residents’ Bill of Rights. That’s something I think most people probably are so unfamiliar with.

And I see you’ve got a brochure right there, and I’ll put a link to that in the show notes for this episode. And I’ll forewarn you, there are going to be so many links in the show notes to this episode, because there are a lot of resources that families need to connect to. So as we go and we talk about different resources, do not worry about jotting those down.

I’m going to have them all in one place with live links for you. But that is something, I think when we get to that point in life, we’re typically in crisis. We’re trying to figure it out. What does all of this mean? What does it all look like? Frankly, most families have not prepared in advance and are not well-educated about what’s out there.

And that piece right there, I think serves to put people in a very level space.

[00:08:20] Terri Anne: Yes, absolutely. And it’s written in the language that is understandable. So yes, it’s very important.

[00:08:28] Liz Craven: What are some of the highlights of that document?

[00:08:31] Terri Anne: So mostly we just want residents to realize that they have a right to just have the same life that they had previously.

They think that when they go into a facility or a community that they lose their rights, but they don’t, they actually gain an extra set of rights. So they have the right to, for instance, sleep in and get up when they want, or go to bed when they choose, they have the right to have decisions about what they eat and they have the right to, their own physician.

What pharmacy they would like to use, things like that.

[00:09:12] Liz Craven: Right. It does tend to get a little confusing. I know that from experience when my father-in-law lived in assisted living, and by the way, we had a phenomenal experience with that. We never had any issue that we were not able to resolve with the community itself.

They were very accommodating of his specific needs. I mean, he had to have his oatmeal for breakfast every morning with raisins. And without fail, they had that for him and they were very accommodating of the things that made him happy, uncomfortable. But it’s nice to know that there is an organization and an advocate out there for families who are trying to work through all of those things.

And, you know, sometimes when you have an authority figure or a perceived authority figure, I know the older generation is very hesitant to challenge authority. That’s just the way they were raised. And so it’s good to have somebody on board who can help with that.

[00:10:12] Lee Earls: I’m going to just add the Residents’ Bill of Rights is very specific as she noted.

But you kinda think about it as you mentioned, the transition from living alone, being independent, if you will, to going into long-term care is a very challenging and difficult transition for many. So the best places are the ones that try to make people feel like they are at home, even though they’ve left their previous home.

And so the resident’s rights, while it talks about specific things, I usually just try to say, we’re talking about, as she said, self-determination be able to make the choices that you were able to make at home. Because after all you can eat when you choose to eat. And also with respect to just being treated properly.

I think there’s a stigma perhaps in the past that these places were more institutionalized, and everyone marched to the same orders. And so again, the best communities are the ones that try to serve the individual needs of the resident.

[00:11:17] Liz Craven: I completely agree with that. And I think that most communities have fallen in line and adapted.

It used to be very institutionalized. And I think people are very surprised when they go visit a community and see how resort like it can be depending on the community you go to. And there are communities of all sizes, those that are really big with tons of activities and places to go and things to do.

And then there are those that are small and intimate and feel more like a small neighborhood. So that’s really amazing. So when somebody is in need of an ombudsman, how do you request assistance?

[00:11:57] Terri Anne: So there’s all kinds of ways that you could contact us. You can contact us through the internet. You can contact us by phone. And I’m, I’m sure you’ll provide that number for them.

 Contact us through the mail. We actually have received letters in the past from people. So there’s a multitude of ways that you can contact us. If we’re out in the public doing a presentation or even visiting our communities, you’re welcome to come up to us and express, you know, what your concerns are, your questions, and we’ll be happy to assist.

[00:12:30] Liz Craven: What would you say are some of the most typical scenarios that you help others address?

[00:12:37] Terri Anne: Right now, the biggest complaint we have is that communities are raising their rent. So we’ve had a lot of calls in the last couple of weeks with concerns from family and residents that their rent is being raised. And of course we can all understand why, right?

So that’s a concern. We have the typical ones are lost clothing, the food isn’t quite right. Staff attitudes, medications not being delivered on time or ordered. Those are our foremost frequent.

[00:13:14] Liz Craven: So what does that process look like? A family reaches out to you. What happens next?

[00:13:20] Terri Anne: So we do an intake and it’s entered into the computer.

Our ombudsman are assigned facilities, and so whoever is assigned that facility, we can contact the volunteer and we ask them if, you know, give them a chance, if you would like to take this case. They’re welcome to say, it’s not a good time for me. I’m going on vacation. I have family coming in, but we give them opportunity if it’s their assigned facility.

And then. The majority of the time they always accept it. So they accept their case and then they begin and all that lead take over from there. Okay.

[00:13:54] Lee Earls: Well, as she mentioned, depending upon how they contact the ombudsman program in a number of different ways, and then Terri Ann and her assistant, Samantha do a great job of gathering the kind of specific information that’s needed.

So most typically at five been assigned a case, the first thing I would try to do is contact the resident by phone and a number of conversations take place, but just to get a little more background, even though we’d been provided some notes with what the concerns are, I like to maybe take that opportunity to dig a little bit deeper and find out what I can maybe have a little more of a personal conversation with the resident.

And of course we identify who we are and why we’re doing that. We also want to get their consent because that’s first and sometimes we’ll receive a verbal consent over the phone. Sometimes it’s necessary for us to gather consent. When we do visit the facility, if that’s needed, sometimes we’re able to resolve something via the phone, and sometimes we do need to make a visit, but once we have their consent, Have a little bit of background information on what it is they’re asking for what they’re requesting.

We kind of do an analysis of what we need to do. Typically interview other residents to see, are they having the same kind of issues? Like for example, Terri Ann mentioned, personal property is a big, is one. That’s a common complaint. And we hear things like they’ve lost my hearing aids. They’ve lost my dentures.

They’re lost my glasses or another frequent one is long. My clothes are missing. And you can imagine, you know, if they’re taking care of 60, 70, 80, that can happen. So we’d like to then let’s say for sample, uh, on the case of laundry, ask other residents, have you had these kind of problems? Let’s see, is this a widespread problem?

Is there some, a process problem in the facility or is this isolated to a particular resident? And then, you know, whatever path we need to go.

[00:15:54] Liz Craven: So it’s a pretty easy process. And it’s interesting to note that a lot of the people who families will encounter are volunteers. So tell me about that. The staff to volunteer ratio in the area.

[00:16:09] Terri Ann: So the majority of our program is volunteers and without our volunteers, we would not be able to function. Absolutely. So each office has one or two staff members. There’s a few larger districts throughout the state who might have, two regions. And so they might have two secretaries, but the staff is very small, but our volunteers are more. So right now we have around 200 volunteers across the whole state. We need about 800. Wow. So we’ve got some ways,

[00:16:44] Liz Craven: some

[00:16:48] Terri Anne: we have some, um, yeah, we have some openings for volunteers. A volunteer is a very unique person and I do absolutely want to talk about that. So first of all, they have to have an incredible heart to help others. And they also need to be problem solvers because that’s what we do. We try to work things out, to the satisfaction of the resident.

So they do that. They give a huge commitment to us because, the work is not easy. And I call it work. They don’t get paid, but I call it work. It’s not easy. Sometimes it can be very emotional because, you know, we hear, stories that are heartbreaking often. And so, you know, you have to be strong that way.

 It is very gratifying to be able to assist a family or their residents. It’s very rewarding. To be able to get someone what they’ve needed, or if you’ve seen a bad situation to get that, you know, rectified and, better for everyone. So it’s very, very rewarding. I like to have at least a couple of year commitment from someone because the training is very intense.

It takes about four months to train a volunteer, but the average, I think is like less than two years that a volunteer stays. I’ve been very fortunate and blessed to have my volunteers long-term for instance, Lee is going on eight years. It’ll be eight years this summer. Actually,

[00:18:21] Liz Craven: That’s amazing. That’s a really amazing commitment.

[00:18:25] Terri Anne: And I have some others who have done just almost that long as well. And there’s a huge learning curve to what we do, because we need to be familiar with the rules and regulations and the statutes. And we have the federal as well as the state. So it’s a lot to wrap your brain around.

[00:18:42] Liz Craven: Absolutely. And I’m glad you mentioned federal, because I do want to note for those that are listening from outside of Florida. You have an ombudsman program in your state as well. And again, in the show notes, I’m going to provide you a link so that you can find your local office, but definitely learn more and connect.

And would you say that the programs are fairly standard across the board? Nationally?

We do have a lot of the same guidelines from the National Ombudsman Resource Center. So yes. Every state has different rules and regulations for their office. Some of the smaller states might only have like one state ombudsman, but yeah, we were blessed to have what we have in the state of Florida.

Yeah. So one that would be a big job for that one person. Wouldn’t it? Well, what do you think as it relates to who should consider being an ombudsman? Do you need a special skillset or is that something pretty much any person could walk into after the training?

[00:19:50] Terri Anne: We have had such a wide variety of people. We’ve had school teachers.

We’ve had doctors, nurses, executives. We’ve had basically anyone who has a heart and is willing to learn because we’re constantly educating ourselves. Ombudsmen are actually required to have 18 hours of continuing ed each year. And we, we get more than that. Lee always does three times that much.

So we do a lot more than that, but it just needs to be someone who has compassion. You do have to, if you don’t have it already, you need to acquire a little bit of, being able to do some confrontations. And occasionally, that was one thing I had to develop because I, I don’t really, I don’t know a lot of people that do like confrontation.

Right. But I did have to develop that it wasn’t part of my personality, but I’ve gotten pretty strong about it. When, you know, when you see something that you think is injustice or isn’t quite right, there’s something inside of you that kind of wells up and says, you know, I’m going to try to fix this. Yes,

[00:20:58] Liz Craven: Absolutely. Well, that’s what advocacy is, isn’t it? I think we’ve all got it within us. Well, Lee, why don’t you tell me about one of your favorites encounters during your time as an ombudsman, what’s one of your favorite ones.

[00:21:13] Lee Earls: You know I was thinking about that, as we were coming in and I’ve had so many joyful experiences, just the interactions with many of the residents are so good.

And Terri Anne mentioned the different ways that we’re contacted, but we’re also proactive. We try to be involved when we know about facilities that might be closing. For example, today’s paper container article about the possibility of a nursing home in, in Bartow closing. We’ll try to be involved if there’s like a storm damage, something that has anything to do with, uh, the building.

But the point is we’d like to do a follow through making sure that these residents will find their next home where one particular. Instance that stands out to me was a community that had suffered some major damage. And, it was putting quite a strain on the residents that were at this, facility.

They had not at that point, moved them to another place, but this couple did have to move. And there was an article about them in the paper about their transition from one to the other. And so I read that and I. I gave that to Terri Ann and said, I wonder if this is one that we should proactively reach out to because she had difficulty in this transition.

So we did, we contacted them and, the two of them were together at one point. But because of the challenges of the other place, they were forced to move. But the husband I think was on dialysis or whatever, but once we contacted them and tried to help them resolve some of the issues that they had publicly stated in the paper, you know, like we need some financial, compensation for the move that we had to make and charging us rent.

Cause we don’t think it was fair that. The problems that they had , they are being charged for them. So we reached out to them, contacted them and then subsequently got back with the community that had left. We worked it all out and eventually they ended up getting a recompense for their expense or moving.

So that was very rewarding.

[00:23:15] Liz Craven: That has to feel good when you can make that kind of a difference for people because the transition part that is stressful for everyone, that’s stressful for the caregivers. It’s stressful for the residents. It’s stressful for the entire family. So it’s nice to know that there are things in place that can help people through those transitions.

Terri Ann, what would you say is your favorite part of your job?

[00:23:41] Terri Anne: Well, I, I love to visit the residents, but I also love to educate residents, their family members and the public about the program and about their rights when I was a kid, my favorite game to play with school. So I’d make my sisters and all my friends play school all the time.

So I do love to teach. Occasionally we get invited to actually do some training inside the facility. So we can train about residents rights and we can also train about our program. AHCA recognizes our resident rights training, for staff so they can count it toward their continuing ed requirements, which is a great honor, I think, for us to be able to do that.

So we’re hoping to be able to get back into that kind of arena now that things are opening up a little bit more.

[00:24:29] Liz Craven: Isn’t that nice. I’m thrilled that I’m sitting face to face with all of you. Seriously I’ve been behind the mic by myself for two years, and this is really nice to be face-to-face with these beautiful people.

All right. So two more questions. The first one, are there any resources, websites, books, movies. Anything that you can think of, that you would direct families to, as it relates to getting good information during this time of life?

[00:25:01] Lee Earls: Well, there’s a number of different one. First of all, I know this is going to sound very, self promoting, but I do want to talk about your book..

Oh, the elder guide I’m actually, and that’s, I carried that book. I’ve always carried that book with me on visits. And very often, you know, somebody will bring up a situation and I say, here’s some resources for you. So I want to thank you and congratulate you for providing that. And that’s my pleasure. And.

In addition to that, obviously the state has a number of different websites to go to. I’d like to call out Senior Connections as one that’s often very helpful. SHINE is another one that helps people working through the, medical insurance process. Obviously there’s hospice, there’s a number of different resources.

Alzheimer’s depending upon, you know, what, what you’re dealing with, but one of our favorites among the ombudsman is Tepa snow, teepasnow.com and her positive approach to the way that she provides care for those who are suffering from dementia and written and given in such a way that it really makes it very easy for the caregiver to understand, you know, what is it that this person is

going through the different phases because we know it can be very progressive and why aren’t they responding to certain things and trying to help you understand? And, and so she’s got a lot of valuable resources and when she does come to Lakeland to speak, which she does, you know,

[00:26:30] Liz Craven: She’ll be here in November

[00:26:31] Lee Earls: very soon.

Yes. That’s something that we look forward to and many times I have referred caregivers to.

 Well, she is certainly somebody that I will invite to be on the podcast. So if you’re listening Teepa please come be my guest. We would love to host you when you come to town and have a great conversation. She is amazing.

And anyone who has not investigated what she’s putting out there, you really need to, she absolutely knows what she’s talking about. All right. The last question, my favorite, always my favorite one piece of Sage advice from each of you that you’d like to leave our listeners.

[00:27:11] Terri Anne: So I just want people to be sure that they’re aware of their rights and if they don’t know, then ask, you can call us.

We can help. I feel like we are a wealth of information and resource, partly because of what you provide to us, but also just , over 13 years I’ve been able to, be about in the community. And so I have a lot of contact information as well that I share with my volunteers and my staff. And so we want you to feel free to call us your calls are confidential, unless you give us permission to speak with anyone else about that.

So, don’t be fearful of that. Also one thing, a little bit off track, but something I want people to know is when you’re signing a contract to enter a community, be sure that you stipulate, this comes back to the most common, recent complaints. Be sure that you stipulate how much per year they can raise your rent.

So that’s true for the ALFs and the adult family care homes. That’s not really true for the nursing homes, but people just aren’t aware that they don’t realize that they can question things that they can complain about things, especially like you said, that generation, they just, you know, will quietly suffer and we don’t want them to do that.

We want people to reach out. If we can’t help you, we will do everything in our power to find who can help you.

[00:28:45] Liz Craven: So the moral of that story is dot your I’s and cross your T’s.

[00:28:51] Lee Earls: Absolutely. And I was thinking about it in the context that I know that many people that will be listening to this podcast, they’re either family members or they’re caregivers, or perhaps they’re thinking about what lies ahead, what are the next steps?

And I would definitely. People to make those considerations before you’re forced to make something. But having, having said that, once you are inside a community, whether you, again, whether you’re another family member, just a caregiver or you’re part of a group of friends could be a church or whatever, get engaged and get involved with that community.

Find out everything that you can and. Of these, communities conduct what they call a care plan. And that’s just kind of a multi-disciplined approach to get to know the resident of, you know, as well as they can, what are their dietary needs, rehabilitation, whatever the case might be, but, try to help them and assist them and be a part of that.

I think about the analogy of perhaps you have a child in school when you had those parent teacher conferences. And so, you know, everybody has the same objective. The child to succeed the teacher and you as a parent, but what are the unique things about your child or what are some things that work that would make your child succeed?

And so in this case, what are some of the things that can make this person and this resident, as we talked about earlier, feel more at home in this transition. So be engaged, be involved. Don’t be afraid to ask questions, get to know the staff. And I think that would be very good advice.

[00:30:27] Liz Craven: I agree. Very good advice, indeed.

Well, thank you both so much for being with me today. This was fantastic. And I really hope that this serves to guide people to more information and to seek more information as they’re dealing with transitions in life. And thank all of you for listening. You know, we’d love to connect to you outside of the podcast arena.

You can find us on social media. You can find us on Instagram and Facebook and even Pinterest. So come connect with us there and engage with us and let us know what types of episodes you’d like for us to bring to you. You can also find our website, eldercareguide.com. All kinds of great information there.

Everything that Lee was talking about in that little printed guide, you’ll find online and so much more. So definitely make your way over there and connect with us. That’ll do it for today. Thanks for listening friends. We’ll talk real soon. .