RALEIGH Laura Winslow is 76 and still doing just fine at home, but she figures shes always one major illness or broken hip away from needing to move into a long-term care facility.
Thats one reason shes willing to serve on a hard-to-staff citizens advisory committee that monitors family- and adult-care homes in Wake County. Its counterpart provides the same oversight for nursing homes.
Both committees are chronically under-filled, running with about half the number of people they need to make visits to dozens of facilities, check for problems and fill out reports that help ensure residents are safe and their rights are being protected.
Its important work, but its time-consuming and can be emotionally difficult when compared to some of the 65 other citizen committees that advise the Wake County Board of Commissioners.
Its not easy to go into a nursing home or assisted-living facility and see people with memory issues or physical disabilities that limit them, said Jennifer Link, who is responsible for Wake County nursing homes in the Triangle J Council of Governments Regional Long Term Care Ombudsman Program.
As you grow older, thats hitting a little too close to home. I think some people see that and think, Oh, thats my future, and theyd rather work with children or do something else.
Where would I go?
Some volunteers have the opposite reaction; having a close friend or relative in a facility, or facing the likelihood of someday moving to one themselves, motivates them to be more involved.
Im a diabetic and I have arthritis, Winslow said. You never know when it might get to the point that I cant do everything I need to do, and then where would I go? What if I need one of these facilities?
This is one way to make sure theyre working right.
To serve, volunteers have to be willing to spend from eight to 24 hours every three months on physical visits to the facilities their committee monitors. The state law that created the committees requires that larger facilities be visited once per quarter, and smaller ones at least once a year.
Wake County has about 75 family- and adult-care homes, and about two dozen nursing homes. Together, they have about 5,500 beds.
For Winslow, the committee feels like a natural extension of the work she did before retiring from a career in child mental health. Much of her working life was dedicated to making sure that programs set up to help children were providing the services they were supposed to. She visited facilities at all hours of the day and night, observed residents, talked to them and their families.
Similarly, when her mother moved into a nursing home, Winslow would visit every day but never on a regular schedule. She might come in the mornings, at lunch, or after work, so that she could see the place under different conditions and with different staff on duty.
Some family members fear reprisals
While Winslow would not have been timid about mentioning problems she saw, she knows that some family members wont complain to the staff or management at long-term care homes because they fear retribution.
At a recent monthly meeting of the Family/Adult Care Homes Committee, group members gave updates on visits they had made or were planning. The committee is divided into teams of two or three people, who make their visits in pairs.
Lately, the committee has been checking specifically to see if homes are equipped with call bells electronic buzzers or even hand-held bells with clappers and if so, whether theyre within reach of the residents and how long it takes an attendant to respond if the resident rings. In some of their checks, the volunteers said, no one answered the call. In others, staff came eventually and said they were slow because they were too busy.
When Winslow visits a home, she knocks on a patients door, introduces herself, and asks if its OK to come in and sit down for a few minutes. Once at eye level, she can see whether the resident is being kept clean and well groomed, and she can ask them questions.
Is the staff responsive to your needs? Do they respect your privacy? Are there activities for you to engage in? Is your food hot when you get it, and is it good? How is the housekeeping?
Facilities usually responsive
Most of the homes she has visited in her eight years on the committee have had only minor problems, Winslow said, and when the visiting team meets with the manager before leaving a facility, Theyre usually open to suggestions.
Link said that even the best facilities sometimes have trouble related to high staff turnover or a change in management, which can cause cause routines to fall apart and important tasks to go undone.
Winslow has been in homes where residents were left sitting in a chair, alone in their room, for hours. She occasionally finds residents who are not getting bathed regularly. She visited one family care home in which all the residents had been settled together in a basement TV room with no way to exit quickly if fire broke out.
In that last case, Winslow said, I went out to my car, got my cellphone and called the department of social services.
Aimee Kepler, regional ombudsman for long-term care who works with nursing homes, has only 18 people on her committee, when shes allowed to have up to 25. When the committees are short-handed, she said, each team of volunteers has to take on a larger share of visits. If a team member falls ill, other teams will pick up those visits as well.
Wake County staff have looked for ways to get more people to serve, but the committees almost never have a full roster. Kepler would like talk to community groups about what the committees do, in case some of their members would like to serve.
Somehow, we make it work, with the number of people willing to serve, she said. I dont know what Id do without them.