Academic journal article Social Work

Elder Rights and the Long-Term Care Ombudsman Program

Academic journal article Social Work

Elder Rights and the Long-Term Care Ombudsman Program

Article excerpt

The 1992 amendments (P.L. 102-375) to the Older Americans Act (OAA) of 1965 (P.L. 89-73) merged the ombudsman, legal services, and eider abuse programs into Title VII - Vulnerable Elder Rights Protection Activities. Designed to highlight and combine advocacy functions, Title VII is another federally legislated addition to the patients' or consumers' rights movement.

Mizrahi (1992) provided a historical perspective on the patients' rights movement and an update for the 1990s. Citing social workers as "among the staunchest advocates of patients' rights and patient participation in health care decision making at the individual and collective level" (p. 246), Mizrahi acknowledged the tensions and uncertainties surrounding the rights of consumers. She raised multiple issues and posed several questions for social workers to consider:

With respect to the broader debate, social workers may want to question why there is not as much public outcry about life with dignity as there is about death with dignity? Why aren't quality-of-life issues being raised as often about the conditions under which increasing numbers of people have to live out their lives, such as poverty and homelessness, before life-threatening physical illness or debilitating mental illness overcomes them? Why aren't policymakers exposing the horrendous abuse and neglect in many nursing homes and other residential facilities as part of the quality-of-life discussion? (p. 250)

As a function that has quality assurance and the empowerment of frail elderly people as its goals, the Long-Term Care Ombudsman Program in Title VII of the OAA may be leading the development of a widespread elder rights focus. (We support efforts toward gender-neutral language in the social sciences and prefer to use the term "ombudsperson" instead of "ombudsman." However, program officials decided to keep the original term, which came from Sweden.) Ombudsmen face issues of life with dignity when they encounter older people who are not included in decision making that affects their daily lives. Ombudsmen intervene with people who are being relocated because their poverty status does not allow them to stay in familiar long-term-care settings and also target elder abuse and neglect in nursing homes and other residential settings. In short, ombudsmen around the country are part of the patient-consumer rights movement, and their stories are critical to social work's understanding of aging issues.

In this article we examine the most pressing issues facing the Long-Term Care Ombudsman Program in the 1990s. We highlight the valuable work done in this federally mandated program at the state and substate levels and emphasize the importance of this program to the social work profession.


The ombudsman program was originally targeted to people in nursing homes. Given highly publicized charges of ill-run facilities and possible eider abuse, seven ombudsman demonstration programs were sparked by reaction rather than proaction. Programs began in five states in 1971 following "a conversation that took place between government official Arthur Flemming and President Nixon during a visit to a nursing home in southern Illinois. Aware of a series of exposes about the conditions of nursing homes, the President turned to Arthur Flemming and asked what could be done to improve the situation" (Coleman, 1991, p. 45).

The Long-Term Care Ombudsman Program grew out of these demonstration projects developed by the U.S. Department of Health, Education, and Welfare in 1972 and 1973. Under the 1975 Amendments to the OAA (P.L. 94-135), annual grants were provided to most states for ombudsman program development. The 1978 OAA amendments (P.L. 95-478) mandated that each state establish and operate a statewide ombudsman program. Between November 1979 and December 1981, Monk, Lenard, and Litwin (1984) conducted a two-part study to "ascertain whether the program work[ed] or not and second, to contribute to a model of practice for community-sponsored, volunteer ombudsman programs" (p. …

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