Quality Long Term Care: The Role of the Volunteer Ombudsman Part 2: Focus Groups
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The Long-Term Care Ombudsman Program is a federally mandated program to improve the quality of care received by residents of nursing homes throughout the United States. Certified volunteer ombudsmen are specially trained to act as advocates and to help identify and solve problems on behalf of residents in long-term care facilities. Texas relies heavily on volunteers to carry out this important role; the approximate ratio of paid staff to volunteers is 1 :21. The primary aims of this study of certified volunteer ombudsmen in Texas were to (a) gain a better understanding of certified volunteer ombudsmen's experiences; (b) identify barriers to effective job performance; and (c) identify training needs and ongoing needs for education and support. In this qualitative part of the study (Part II), eight focus groups, totaling fifty-one certified volunteer ombudsman participants, were held in various geographic locations throughout the state. Groups were similar in their perception of the program and their role as certified volunteer ombudsmen. Experiences in respective facilities varied, however, and the attitudes of the long-term care facility administrators were a major cause of this variance. The regional staff ombudsmen were generally seen as supportive. Overall, the focus group participants appeared to perform their certified volunteer ombudsman duties effectively. They were most successful in addressing problems at the facility level. Focus group participants were generally satisfied with their training, but there was a strong preference for state-level training. The need for more interactive in-service training was expressed strongly by a majority. Many of the barriers to the certified volunteer ombudsmen's effectiveness were factors outside of their control. Within the facilities, they encountered a lack of trained personnel, as well as other problems inherent in institutionalized settings. Lack of power was identified as a major barrier. In addition to recommendations listed in the quantitative part of the study (Part I), the focus groups produced another set of 28 recommendations for improvement. These include suggestions for legislative changes; volunteer training and communication skills; as well as reimbursement, recruitment, recognition and retention of volunteers.