Jane Watkins greets the residents at Crescent City Convalescent Rehabilitation by name. She encourages one as he practices with a walker, admires the needlework of another, and wishes happy birthday to a third.

Watkins, 57, is one of 16 volunteers in the Long-term Care Ombudsman Program that advocates for quality care and quality of life in the seven nursing homes and 22 residential care facilities in Humboldt and Del Norte counties.

"And after checking for dietary restrictions, it's not unusual for one of our ombudsmen to mark the birthday with a cupcake and candle to blow out," said Suzi Fregeau, coordinator of the program for the past two years.

Before retiring four years ago, Watkins had been the activity director for Addie Meedem House, Del Norte's only residential care facility.

Earlier this year, she's became the county's lone volunteer in an ombusdman program that is neither regulatory nor enforcement. The volunteer-driven group works closely with the California Department of Public Health, which oversees skilled nursing home operations such as Crescent City Convalescent Rehabilitation, and Community Care Licensing, which regulates assisted living facilities for the elderly such as Addie Meedom House.

"We advocate for the frailest among us who are unable to do it for themselves," Fregeau said. "We respond to complaints of elder abuse and neglect in all of its forms: physical, verbal, emotional, sexual or financial. Then, with permission from the resident or authorized representative, we conduct interviews with family, staff or other residents. We are impartial investigators tasked with reporting abuse or neglect when it is warranted."

They also work to address concerns with unanswered call buttons, roommates, staffing, food and unsanitary conditions.

The goal is to successfully resolve the problem to the satisfaction of all parties.

"We're the ones who look into it when your dad isn't going to meals at his assisted living home and has lost a lot of weight, or when a nursing home says it will discharge your mother because a bill hasn't been paid, or when your spouse can't get along with a roommate despite the best efforts of staff," Fregeau said.

"An interest in residents, and being familiar with the regulations that govern skilled and residential care facilities, make the ombudsman someone who separates fact from fiction and reality from perception to resolve disputes and concerns between residents, families and facilities."

The Ombudsman Program was busy last year. The 18-person crew - Fregeau is one of two part-time paid staff - did the work of 5.55 full-time employees. With a $65,000 annual budget, they made 736 unannounced facility visits, conducted 191 consultations with individuals and staff, and opened 241 cases around alleged elder neglect and abuse.

After adding in the trainings and community presentations, the group performed more than 1,500 activities to support federal and state law that mandates each county to provide ombudsman services.

"Unfortunately, the state budget crisis has reduced the funding for this program the last few years," Fregeau said. "That means many of the complaints and concerns will not be investigated without more volunteers."

Fregeau and Watkins caution: the job is not for everyone. It requires 36 hours of training andndash; four less than the standard required to run an assisted living facility andndash; and a minimum 12-hour per month commitment. Training includes home study with a manual, classroom and field work.

"Anyone who volunteers cares, so it's about more than caring," Fregeau said. "You have to be someone who can listen to people from a variety of backgrounds and lifestyles and not pass judgment on them or the allegations they make. You have to be impartial throughout."

"You've got to be a good listener," Watkins said, "And you need to be able to talk to elderly people, some of whom have problems with memory and communicating."

"Every echelon is different: the director of nurses, the charge nurse, the maintenance staff, the administrator, housekeeping," long-time Eureka volunteer Mary Beth Fitzpatrick said. "And there is an amazing amount of grief for the loss of mobility, independence, the phone, their diet andndash; so many things that have been lost."

Crusaders out to change the culture of a facility or its staff need not apply.

"That kind of agenda:it's not going to happen," Fitzpatrick said. "What we can do is be a very strong presence, someone residents know will show up and who can be called for help."

All three love their work.

"I just cannot bear the thought of people being in a vulnerable state and being in one of these facilities with no one to appeal to except staff," Fitzpatrick said. "For the most part, staff is doing the best it can. But there is so much to do, and sometimes, the nicest people get overlooked because they don't want to bother the busy staff."

"You have to be firm if a resident's rights are being abused," Fregeau said. "But I'd say 90 percent of the time we reach a resolution satisfactory to everyone. It may not be what the resident wanted, but they are satisfied that an impartial investigator listened."

For all three, the job is about building the connections that help people "share their concerns and tell me how they feel about their lives," Fitzpatrick said.

"The more they see you, the more comfortable with you they become," Watkins added.

That human connection, one person to another andndash; even with someone who can't speak, can't move, or is in great pain andndash; creates miracles," Fitzpatrick said.

For more information, or to volunteer as an ombudsman, call 707-269-1330.

Area 1 Agency on Aging paid freelance writer Carol Harrison to produce this piece.


Hints for choosing a long-term care facility:

andbull; Visit the facility two or three times at different times of the day and on the weekend.

andbull; Use and listen to your senses: sight, smell and hearing.

andbull; Notice whether facility and residents are clean.

andbull; Notice how staff interacts with residents. Do they treat them with respect and kindness?

andbull; Review the facility activity calendar to see whether quality activities are provided.

andbull; Ask whether the facility has active family and resident councils, and speak to members about their impressions of the facility.

andbull; Ask to see the most recent DPH or CCL survey findings and ask questions about any finding that concerns you.

andbull; Meet with the facility administrator and other key personnel, including the director of nursing, social work director and activities director.

andbull; Ask to visit living areas. The bedroom you are shown should meet your loved one's needs.

andbull; Ask to see the dining area. Review the menu. Visit during a meal.

andbull; Carefully review the facility admission packet for information on fees and policies.