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Florida Time Union

May 28, 2008

Watchdogs for the elderly

The Times-Union

Connie Bend Colebrooke, executive director of the Park Ridge Nursing Center in Jacksonville, confers with volunteer ombudsman Don Braverman in one of the physical therapy rooms. Braverman and other volunteers advocate on behalf of residents of long-term care homes.In his gig inspecting nursing homes, Don Braverman has been through the doors of many of Jacksonville's best and worst.

Some days, Braverman has to steel himself as he pulls up in the parking lot, clipboard in hand.

"There are some that you walk into and you cringe," he said.

But today is not one of those days.

When he walks into Park Ridge Nursing Center unannounced, there's no frantic scramble. The director, Connie Bend Colebrooke, has a warm handshake for Braverman, a six-year volunteer with Florida's Long-Term Care Ombudsman Program.

That's because the halls smell of air- conditioning, not urine. The rooms are clean and sunny, and as Braverman runs his hand over a windowsill in the dining room, jokes are cracked about the white glove test.

Don Braverman, a volunteer ombudsman on behalf of residents of long-term care facilities, looks at the expiration dates on medications at the nursing station at Park Ridge Nursing Center."This is a good one," Braverman said. "Usually, when we walk in, they panic."

Panic-inducing inspections aren't the fodder for most volunteer jobs. But Braverman and the 14 other active ombudsmen in Northeast Florida don't see it that way, anyway. They have a singular focus: championing the rights of the thousands of residents - just the residents, no one else - who live in the five-county region's nursing homes and residential facilities.

The ombudsman program exists by order of federal and state law. But Florida, while home to the biggest population of seniors in the 50 states and one of the highest numbers of nursing home beds in the nation, has few paid staff. It's the second-worst ratio, according to a 2006 national review of the ombudsman program. Statewide, the 22 paid staff and 355 volunteer ombudsmen investigated nearly 8,000 complaints that year, according to the review.

So it falls to volunteer ombudsmen to conduct surprise annual checks on every long-term care facility - there are 178 in the five-county area - plus investigate all complaints that come into the hot line. They mediate eviction disputes, look into allegations of falls and physical and verbal abuse, argue on behalf of a patient whose medication doesn't come on time or whose money is mismanaged by staff.

Too often, it's a call of last resort when residents reach out, said Mary Domask, a retired nurse and now an ombudsman. She thought of the case of a woman who broke her leg because of a worker's mistake.

"There are so many people who do not have advocates," she said.
And even family members casting a watchful eye over their loved ones need a little backup. Eve Syler wasn't sure what to do when her mother, 99, wasn't getting her medication.

"It made her suffer for quite a while because of it, and no one could figure out what was wrong," Syler said.

After some staff turnover, thefts and other little things also started to add up. She couldn't get the response she wanted from the administration. She called the hot line.

The ombudsman representative appeared unannounced, and went back for several days.

"She talked to my mother endlessly," Syler said. "My mom just fell in love with her."

The problems were resolved, and they negotiated so that Syler's mother and others wouldn't have to go down to the dining room at the crack of dawn. "Now my mom is a happy little camper about breakfast time. Breakfast is her favorite meal," Syler said.

By law, long-term care facilities must allow the ombudsmen entry, but the program doesn't have the power to shut down any facilities or revoke their license. If problems can't be resolved through their efforts or the violations are serious enough, the ombudsmen get law enforcement, the state Agency for Health Care Administration (which licenses such homes) or other authorities involved.

They can also follow up after disaster strikes. After the fatal fire at Governors Creek Nursing Home in Green Cove Springs, the Northeast Florida district director, Mike Milliken, interviewed each survivor.

They don't always win. If a family member complains, but the patient doesn't want to follow through, the ombudsmen must leave. Other times, they don't get the follow-through they want from agencies with the power to censure or shut down facilities that don't make the cut.

Sometimes, though, it's as simple as working with staff to enlarge the print on the menu so frail eyes can read it, or solving a stolen-item caper. "Any win is a win," Milliken said. "Anything you can get for them is something they didn't have before.", (904) 359-4504

By the numbers
Northeast Florida long-term care facilities
13,331 - Number of residents
178 - Number of facilities
15 - Number of volunteer ombudsmen

Source: Long-Term Care Ombudsman, Northeast Florida district

IF YOU NEED HELP If you or a loved one needs help, the ombudsmen investigate complaints for free and confidentially. Call (888) 831-0404.

TO VOLUNTEER The ombudsman program is seeking volunteers. Call (904) 391-3942 or visit