HJAR Sep/Oct 2022

Q&A 22 SEP / OCT 2022 I  HEALTHCARE JOURNAL OF ARKANSAS  Will you please go into more detail about the calls you get about elderly caught in an unwanted guardianship trap? While I cannot go into great detail because ombudsman advocacy is confi- dential so as to protect the integrity of our program, we do encounter this situation. This can occur if, for example, a resident gets sick with a UTI, becomes confused, goes to the emergency room, and ends up with a delirium diagnosis. A guardian is needed to temporarily make decisions, but it shouldn’t be permanent. However, some- times the resident doesn’t show up for the hearing because they are still hospitalized, or another issue comes up, and the guard- ianship does become permanent after 90 days. The guardian is then able to put the resident in a long-term care facility even though this is not necessary, and it falls on the resident to prove they are not incapaci- tated and should return home. How common is UTI mental delirium in the elderly? Studies have shown up to 1/3 of elderly patients admitted with UTIs experience confusion.¹ So, there are cases of UTI mental delirium, where a guardianship was, perhaps, prematurely invoked by the healthcare system while the patient was in the height of crisis to clear a bed for insurance purposes? I can’t speak about clearing a bed for insurance purposes or being invoked by the healthcare system. Sometimes it’s family who panic because mom or dad has never been sick, and they act prematurely. I know this next question is a bit outside your role as the state’s ombudsman, but I understand you were part of setting the policy for the “No Patient Left Behind Act.” Tell us the genius of that act, how you feel it benefits patients, and if you feel like it is being interpreted correctly. I was not part of the “No Patient Left Alone Act,” though I would have loved to have been. Knowing how many residents went so long without seeing family or friends during the COVID pandemic is dis- heartening. Hearing the stories of so many who struggled with the hardship of social isolation and the impact on their quality of life is why this Act is so beneficial to those living in skilled facilities. Many states have enacted similar laws. When and how do ombudsmen typically get involved in a case? If folks need to reach out to you or your team, what is the best way to do so? Ombudsmen are required to make quar- terly unannounced visits to facilities. Typ- ically, on these visits, they meet residents who have concerns. We encourage those residents to speak for themselves, how- ever not everyone is comfortable doing so. That’s when the ombudsman representee assists. We also get calls from the facility. Social workers, directors of nursing, and administrators will utilize the ombudsman for those who don’t feel they have an advo- cate or a voice. You have the ear of the healthcare industry in Arkansas. What do you wish they all knew that could help their patients? The ombudsman program has been in Arkansas since 1978 advocating for our vulnerable population for 44 years. Within the Area Agencies on Aging, there are 13 regional ombudsmen, three volunteer ombudsman coordinators, and 125 volunteer ombudsmen. At the Arkansas Office of the State Long-Term Care Ombudsman, our program coordinator and myself, as the state ombudsman, offer free advocacy for your loved one. I have two words — utilize us. You can find information, including phone numbers and emails, on our website: arombudsman.com. In your job as a problem solver, you hear a lot of woes and must hit a lot of roadblocks. How do you decompress at the end of the day, and do you have any tips that you have learned about how to handle these often difficult and sometimes delicate situations? I sit by a pond with my best friend, my husband. We fish, reflect on the beauty sur- rounding us, and our blessings. This is my coping mechanism for difficult days and for those situations where there seems to be no positive solution. I refuse to let these days overtake my compassion and empathy for others. I strive with my whole heart to make a difference to those our program serves, my team (what a great team I am blessed to work with daily), family, those I love, and my faith. If I can provide 0.01% of the advocacy Christ did for me, I have abundantly accom- plished being a servant. Charlotte, it is nice that there are dreamcatchers like you and your team out there who can help us prevent and awaken from nightmares. Thank you for taking the time to share with us what you do. n REFERENCES 1. Cedars-Sinai Medical Center.“Unlocking the cause of UTI-induced delirium.” Science Daily (Dec. 2, 2021). https://www.sciencedaily.com/ releases/2021/12/211202141507.htm The ombudsman advocates for quality of life, quality of care, and residents’ rights. Our primary goal is to empower the resident to speak for themselves. When they are not comfortable in doing so, we speak for them, giving them a voice.”