Northern Virginia Long-Term Care Ombudsman Program UPDATE Newsletter
Volume 7 Issue 3 June 2013
In this issue:
Long-Term Care Considerations for LGBT Adults
Older Adults and Oral Health
NPR Broadcast Interview by the NVLTCOP Director
Enhancing Nursing Home Preparedness
World Elder Abuse Awareness Day
Spotlight: Terri Lynch Retires
Long-Term Care Considerations for Lesbian, Gay, Bisexual, and Transgender Adults
The Long Term Care.gov website is a division of the Administration for
Community Living (ACL) under the U.S. Department of Health and Human
Services. It has a lot of information on Lesbian, Gay, Bisexual, and
Transgender (LGBT) issues related to long-term care. This website covers
the unique needs and special considerations for LGBT adults, including
laws, programs and services that might impact individuals and couples.
One area covered is “Health Disparities Impacting Long-term Care.”
One category of health disparity is that there are barriers to health care access for individuals. These barriers could result in less accessibility to health insurance coverage, fewer visits to the doctor, and delay in getting needed prescription medications, screenings, diagnoses and treatment.
Once in a nursing facility, the Lesbian, Gay, Bisexual, or Transgender older adult can sometimes face hostility from staff and other residents. This results in distress for the individual. Added to this, there can be denial of visits from their partners and their family of choice, as well as not allowing same-sex partners to room together.
Another category of health disparity is the negative impact on physical and mental health from the distress that Lesbian, Gay, Bisexual, and Transgender older adults feel. LGBT older adults are more likely to require medication for emotional issues and are more likely to be overweight or obese. The isolation that results from not wanting to be “outed” is also a contributing factor for stress whether the Lesbian, Gay, Bisexual, or Transgender older adult is in a facility or staying at home to receive long-term care services.
For additional information on the Administration for Community Living website, see www.acl.gov or the Long-Term Care website, http://longtermcare.gov.
“Advocating for LGBT Long-Term Care Consumers”
“Advocating for LGBT Long-Term Care Consumers” is a presentation given
by Eric Carlson, an attorney specializing in long-term care with the
National Senior Citizens Law Center. In it he states that the need for
promoting cultural competency in long-term care must be emphasized so
that providers and staff make an effort to create an atmosphere in
facilities that is more welcoming to LGBT residents. This would involve
affirmative training of staff to reduce harassment, and to ensure that
care will be provided.
Some residents have had providers refuse to accept their medical power of attorney, were denied visitation by people they designate, and had wrongful discharge. Residents are advised to consider asking for an individual accommodation to work around these issues.
Mr. Carlson summarized a report released in 2011 that surveyed LGBT older adults and mentions:
78% have a fear of being “outed” and would not reveal their sexual orientation to staff
Fear of harassment by residents and staff
Facility refusal to accept medical power of attorney when LGBT partner is named
Refusal to provide care, which is in violation of the Nursing Home Reform Law
In 2010, hospital regulations were revised to include informing residents of visitation rights and their right to receive designated visitors. It’s important that residents put their wishes for a medical decision-maker in a power of attorney document, even if the state provides for LGBT marriage.
For additional advocacy efforts, please see: "Inclusive Services for LGBT Older Adults: A Practical Guide to Creating Welcoming Agencies", by Services and Advocacy for GLBT Elders (SAGE) and the National Resource on LGBT Aging at http://www.lgbtagingcenter.org/resources.
Enhancing Nursing Home Preparedness
Northern Virginia Emergency Response System
Natural disasters can occur at any time, and can have a devastating
impact on our most vulnerable populations, including those residing in
nursing homes. The Derecho storm that impacted our region in June of 2012
showed us how harsh nature can be, taking out power and 9-1-1 service in
the region for several days. While Hurricane Sandy largely spared our
region, it certainly could have been worse.
It was with this in mind that the Northern Virginia Emergency Response System (NVERS), the regional emergency preparedness coalition, working with the Northern Virginia Hospital Alliance (NVHA), formed the NVERS Extended Care Working Group in July of 2012. This group brought together local emergency managers, public health preparedness leaders, nursing home leadership, and other stakeholders to look at how best to enhance the preparedness of our region’s nursing homes.
Several key gaps were identified by the group’s members. Using funding available from the US Department of Health and Human Services Hospital Preparedness Program , a number of critical projects were launched that will exponentially increase the preparedness of Northern Virginia’s nursing homes. The projects will fill gaps in planning for evacuation and surge, communications and information sharing, and electrical resilience.
The first project evaluates the resources required to evacuate each nursing home in the region. It factored in the total number of patients, how many need ambulance transport, etc. The surveyors also looked at how many patients each nursing home can absorb if another facility, or facilities, in the region needed to evacuate. This evaluation is critical in helping plan for the need to evacuate patients from nursing homes in the region during an emergency.
Determining the back-up power capabilities and identifying ways to enhance power resilience was the purpose of the second regional project. An assessment was done to determine the capacity of the emergency generator in each facility in the region and looked at what it would take to provide emergency power to these facilities should their systems fail. The data from the electrical assessment and surge/evacuation study were provided to the nursing homes, local emergency management, local and state public health preparedness, and other stakeholders.
The third critical project is to provide emergency communications capability since normal communication systems failed during the 2012 Derecho storm. This will be in the form of 800 MHz radios assigned to every nursing home in the region. These radios, similar to the ones installed in every hospital in the region, will connect the nursing homes with each other, with local emergency operations centers (EOCs), and with the Regional Hospital Coordination Center (RHCC). This connectivity will allow them to communicate during emergencies when other methods fail; and, to ensure these radios always work, they will be hard-wired into their generator-backed power system. Each nursing home also now has access to the regional emergency alerting system and information-sharing platform, the Virginia Healthcare Alerting and Status System (VHASS). This web-based system will allow nursing homes to share critical information, like bed status, with local emergency managers and public health preparedness teams during
These projects, and the work of the NVERS Extended Care Working Group, will continue as we collaborate on additional preparedness activities, like developing plans and agreements for patient movement during emergencies, and conducting exercises to enhance our ability to respond to emergencies.
June 15 is World Elder Abuse Awareness Day
According to the Administration on Aging, World Elder Abuse Awareness
Day was first started by the World Health Organization at the United
Nations and the International Network for the Prevention of Elder Abuse.
The purpose is to raise awareness of the cultural, social, economic, and
demographic issues that affect elder abuse and neglect. Elder abuse is
significant as both a public health and a human rights issue.
It is estimated that $2.6 billion is lost every year by seniors who are victims of elder financial abuse and exploitation. Basic needs such as housing, food, and medical care suffer as a result. No one is immune to this. It can occur in any demographic, from the very poor to the very rich and across cultures.
The National Center on Elder Abuse has information on ways to participate that can be simply visiting an older person who lives alone, or a longer commitment to volunteer in a program addressing elder abuse. Check out what is happening in your community to observe World Elder Abuse Awareness Day on June 15 at: http://ncea.aoa.gov/get_involved/index.aspx.
Need Information or Have a Concern About Nursing or Assisted Living
Northern Virginia Long-Term Care Ombudsman Program
12011 Government Center Parkway, Suite 708
Fairfax, VA 22035
Offices hours are Monday through Friday
from 8:00 a.m. to 4:30 p.m.
Intake Line: 703-324-5861 TTY: 711
Email us at: NVLTCOP@FairfaxCounty.Gov
To view information on the NVLTCOP
website and to see the Investigation and Complaint Log, please go to:
What an Ombudsman does:
Advocates for improving the quality of life for persons receiving long-term care services
Resolves complaints against long-term care providers through counseling, negotiation, and investigation
Provides information about long-term care providers to help make an informed decision
Educates the community about long-term care issues
Visits residents of long-term care facilities on a weekly basis through our volunteer program
Trains long-term care staff on long-term care related information
Consults with providers
NVLTCOP Director Interviewed for National Public Radio
Laura Nichols, Director of the Northern Virginia Long-Term Care
Ombudsman Program, recently conducted an interview with NPR affiliate,
WAMU (American University Radio). Laura discusses the Ombudsman Program
and some of the larger issues related to nursing home care, such as the
power of negotiation, assistance with finding a long-term care facility,
types of complaints from residents, and the major causes of neglect and
One section of the interview is about the meaning of the term “Ombudsman.” Laura: It's originally a Swedish term for "citizen's advocate." Usually an ombudsman is an impartial person, but obviously we are not impartial. We do try to be nonjudgmental, as best as anyone can be. But we are obviously working on the side of the resident or their decision maker. So we do take everything into consideration. We don't just go storming in and say, ‘You're neglecting this person.’ We would interview all the pertinent staff. We would do a records review, and then with all that information pulled together, we would say whether it was verified or not verified, and then work toward the resolution.”
Laura’s interview can be found at: http://wamu.org/news/13/05/07/managing_nursing_home_complaints.
The interview on the Northern Virginia Long-Term Care Ombudsman Program is part of a five-part series on aging and abuse that can be found at: http://wamu.org/aging_and_abuse.
Older Adults and Oral Health
A Cross-Federal Initiative on Expanding Oral Health Access for Older
Adults was started by the Department of Health and Human Services (HHS)
in 2010. The need for this initiative is based on the disparities seen in
access to services due to age, race, income, and education. There is
concern that there will be a “tsunami of need” with the increase in the
aging population since there is no routine coverage for dental needs
Since oral disease is preventable, the efforts of this initiative will focus on health literacy to counteract how little professional dental care is currently used. In addition to HHS, other agencies involved include the Center for Disease Control and the Administration for Community Living.
Poor oral health affects a person’s quality of life and causes poor general health. Gum disease is linked with diabetes, heart disease, and stroke. Adults over the age of 75 have the highest amount of tooth loss. Tooth loss can cause weight loss in some cases, and weight gain in others. Both of these weight issues have negative affects on older adults.
The Health Community Study’s objective is to build partnerships with resources in the community and to recruit dentists to participate. Community health centers would play a key role in connecting with community services.
The Eldercare Locator connects people to Aging Network to find services in their community and can be found at: www.eldercare.gov. The goal is to help seniors stay at home through low cost home and community based services.
Terri Lynch, Advocate and Mentor, is Retiring
Terri Lynch, the Director of the Arlington Area Agency on Aging, a
co-sponsoring agency of the Northern Virginia Long-Term Care Ombudsman
Program, will be retiring on June 28 after more than 30 years
serving the older adults in our community, as well as being a leader in
the field of Aging at the State and National levels. Terri was
promoted to Arlington’s Area Agency on Aging Director in 1982. She has
served more than 30 years in this role providing expertise, guidance and
direction to the Commissions on Aging and Long Term Care
Residences. She also helped establish a network of services and
programs in the Aging & Disability Services Division.
Terri has received more than 20 distinguished honors, letters of appreciation and superior performance awards. She has been honored multiple times by elected officials, state leaders, community advocates and colleagues. She received an Elder Service Award and the prestigious Winston Award, which recognizes members of the Northern Virginia community who have promoted democratic ideals and the advancement of the rule of law. She is a founding member of NVAN, the Northern Virginia Aging Network, comprised of the agencies on aging and commissions on aging, as well as aging service and advocacy groups, throughout Northern Virginia. NVAN has produced a state legislative platform every year since 1982, which has made differences in aging services, accessibility, housing, mental health and more. It is clear that Terri has really made a difference.
Terri was president of the Virginia Association of Area Agencies on Aging most recently from 2000-2002, ensuring that our local programs receive needed funding from the Older Americans Act and the state legislature, including funds for the NVLTCOP, community based services, and meals programs. She served both as a member of the NVLTCOP policy board and the state Long-Term Care Ombudsman Advisory Committee, offering perspectives based on her extensive experience and her unwavering concern that the ombudsman program be strong and independent. As if all that is not enough, Terri also has served on the board of the Virginia Elder Rights Coalition.
"Terri is an amazing mentor. Terri offered, and followed through on, always being available to give me perspective on decisions made in the past, as well as being willing to brainstorm new ideas. We worked together on numerous projects together. Terri has made a difference in the lives of so many older adults." said Grace Starbird, retired Fairfax AAA Director and retired Director of the NVLTCOP.
“I first knew Terri over 25 years ago when she was vigorously advocating to save a position in senior employment,” remarked Erica Wood, member of the Arlington Commission on Aging. “I soon found that this was so typical of her! Over the years, I have seen literally hundreds of instances in which Terri has advocated for elders in Arlington and throughout Virginia. She has created unique services in Arlington to fill unmet needs. She is always innovative, ahead of the curve, and consistently makes ties and connections that get things done! But what’s really special is her enduring ‘sense of injustice’ that imbues all of her work.”
The Northern Virginia Long-Term Care Ombudsman Program is committed to a policy of nondiscrimination in all programs and services. To request reasonable accommodations or alternate formats, call 703-324-5861 (voice); 711 (TTY).
This publication has been created or produced by Fairfax County with financial assistance, in whole or in part, from the Administration on Aging and/or the Virginia Department for the Aging.
A Fairfax County, Va. publication. June 2013