Department of Family Services – Older Adults

CONTACT INFORMATION: Monday–Friday 8 a.m.–4:30 p.m.
703-324-7948 TTY 711
12011 Government Center Parkway, Suite 708
Fairfax, VA 22035
Trina Mayhan-Webb

Northern Virginia Long-Term Care Ombudsman Program Tips for Advocates


The Resident's Condition

  • Is the resident's hair clean and combed?
  • Are men shaven? Are women free of facial hair?
  • Are nails trimmed and clean?
  • Do residents' teeth look clean (free of plaque)?
  • Does the resident's skin look cracked and dry? Do lips appear chapped? 
  • Are residents wearing clean and appropriate clothing, suited for the temperature?
  • Are the resident's glasses clean?
  • Is the resident's hearing aid in?
  • Is the wheelchair, walker or cane in good repair and clean?
  • Is there use of physical restraints? If a resident is in some form of restraint (lap cushion, bedside rails, waist belt), does the resident seem anxious or upset about it?
  • Are residents sitting comfortably in their chairs? (Special wedged cushions can help prevent sliding out of chairs.)
  • Are residents being helped to walk (if help is needed) in order to get regular exercise?
  • Are individuals who are unable to leave their beds being turned every two hours?
  • Is there evidence that measures are being taken for them to avoid contractures of knees and hands (e.g., a rubber device gripped in one’s fist)?

The Resident's Room

  • Are call buttons accessible to the residents, wherever they are in their rooms?
  • Are call lights on for long periods of time?
  • Are needed items (eyeglasses, telephone, and books) within reach?
  • Is there fresh (cool or cold) water within reach?
  • Are the resident's bedroom and bathroom floors free of spills, grime, and trash?
  • Is there a comfortable chair for each resident or a visitor to use?
  • Are the places for storage (closet, dresser, and nightstand) in good repair?
  • Are the bed linens in good condition (no holes, stains, or worn plastic covers on pillows)?
  • Does the resident's toilet and bathtub or shower have grab bars for safety?

Environmental Conditions

  • Is the lighting adequate and soft?
  • Is there a clear, unimpeded path that ambulatory residents can take down a given hall, with sturdy handrails?
  • Are benches or chairs strategically placed in long hallways for brief rests?
  • Is the room temperature comfortable, free of drafts?

The Dining Room(s)

  • Is the atmosphere pleasant and relaxed?
  • Is the seating comfortable?
  • Are many residents present? If a significant number are eating in their rooms, why is that?
  • Are appropriate utensils provided (i.e., large-handled/easy-grip forks and spoons, or plates with a plate guard) if needed?
  • Is staff providing needed assistance, such as opening milk cartons, or telling visually impaired people what and where food items are on their plates?
  • Are residents who need assistance to eat waiting in the dining room for long periods while others eat (whether the food is or is not in front of them)?
  • Is there enough staff to assist those who need to be fed?
  • Does the staff sit down beside individuals who need to be hand-fed and take their time in feeding them?
  • Do the residents consume most of the food served to them?

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  • Are residents constantly hollering out? Are they being ignored?
  • Is the public address system overused, causing unsettling noise?
  • Is a TV or radio blaring with the resident absent from the room?
  • Is staff speaking or laughing too loudly?
  • If music is playing, is it a type that would appeal to the residents?
  • Do you hear staff discussing a resident's personal care or medical condition in a way that violates the person's privacy?
  • Is staff speaking in English when providing care for a resident?

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  • Do you notice urine, fecal, or other odors that persist?
  • Are odorous diaper and laundry bins not being emptied?
  • Does the food served smell good, as well as look good?

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  • Is the menu posted?
  • Is there variety in the menu?
  • Are the residents served what is shown on the menu?
  • Are fresh (versus canned) fruits and vegetables served regularly?
  • Are the meals nutritionally balanced?

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  • Are residents' hands sticky, dry, or chapped?
  • Are residents' possessions or the furniture (e.g., overbed table) sticky to the touch?

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  • Are a significant number of residents present at a given activity? If not, why not?
  • Are staff or volunteers available to assist in bringing residents to an event?
  • Are residents aware of the scheduled activities?
  • Is the calendar of events (whether posted or in the newsletter) written in large, legible print?
  • Are the activities appropriate for the residents?
  • Is the activity leader audible to the participants?
  • Are there a variety of opportunities to suit different tastes?
  • Do residents say that they enjoy the activities?
  • Are activities offered on weekends or in the evenings?
  • Are any activities held outdoors?
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