Friday, December 28, 2012

Ten New Year's Resolutions for the Caregiver

1.      I will remember to take care of myself.  
Eat healthy, sleep well, exercise regularly…whew, that might seem daunting when you’re in the midst of caregiving, but taking care of yourself makes you a better caregiver. Maintaining your emotional and physical health is vital. Make and keep preventive care appointments. If the stress of caregiving becomes overwhelming, seek professional help. Remember, if you are not feeling well, you will be unable to take care or visit your loved one.
2.      I will allow myself time to recharge and de-stress.
Don't become a victim of caregiver stress. Remember that the world will keep spinning even if you are not there. Maintain your “me” time. Commit to doing at least one thing you enjoy or need every day. This can be as simple as keeping a journal, having dinner with friends, watching your favorite television show, or reading a good book. If you make plans to go on vacation, give nursing staff a heads up and inform them of anything they need to be mindful of when you’re not there.
3.      I will seek and accept help.
Lean on friends and family. Take them up on their offers to help. Whether you need someone to keep an eye on a loved one at home, or you’re afraid he or she is lonely in a nursing facility, your “helpers” can be that “friendly visitor” that can check in on your loved one when you’re unable to. Other tasks may include running errands like grocery shopping that will allow you more time to be with your loved one. Take advantage of online care team calendars where “helpers” can sign up for specific tasks, like this one provided by the Alzheimer’s Association.
4.      I will seek local resources.
Ready and willing support may be available around the corner. Contact your local Area Agency on Aging, NJ EASE at 1-888-747-1122 (for resources for older adults and caregivers), a local chapter of a national disease-specific organization, or the nearest senior center.
5.      I will find support.
Do not walk this road alone. Connecting with someone who is going through a similar caregiving experience can be cathartic and helpful. Support groups provide an opportunity to share advice, vent frustrations and learn from others who have the same concerns, stresses and challenges. Support groups are available in a variety of formats from group meetings moderated by a professional, to online support groups to social networking groups. You might even find someone in the same nursing facility as your family member that you can connect with.
6.      I will have the "tough talk" with my loved one.
Dying is a part of life and it can be difficult to talk about, but it’s one of the most loving things you can do. Have an honest discussion with your family member about end-of-life issues and last wishes. Where would he or she like to be laid to rest? What about funeral arrangements? Discuss how he or she would like to receive medical treatment, if any, and then document those wishes using an advance care directive. Work with your loved one to establish a healthcare proxy, providing copies to all healthcare providers.
  1. I will work in partnership with the professionals who are caring for my loved one.
Always advocate for your loved one, but try not to let your passion for good care come across in a negative manner. Speak up and ask how the situation can be resolved. Friendly, open communication with nursing staff will help keep problems from becoming serious.
If you do believe your loved one’s rights are being violated, please refer to our residents’ rights brochure or contact the Elder Ombudsman’s office if you have concerns regarding your loved one’s care.
8.      I will not feel guilty if I seek help from professionals.
  Sometimes loved ones need more assistance than you can adequately provide. If you’ve sought in-home care agencies, assisted living centers, and nursing homes to help you take care of your loved one, remember that you are still a caregiver. You are still needed by your loved one.
9.      I will give my loved ones a "break."
  We know things may get tough to deal with sometimes. You didn't voluntarily come into this caregiver role, but this also was not the life your loved one imagined. He or she may feel trapped in a body that is not cooperating. Their inability do what once came so easily can be a source of their aggravation. Remember to keep calm and remain patient during these frustrating times. Also, leave the situation if you need to cool off.

10.      will remember my loved ones for who they really are. 
Remember your loved one for who they really are. If things have become more difficult because your loved one is in serious physical decline, mentally rehearse the memories of his or her best years. If your loved one lives in the past and repeats the same story over and over again, use it to your advantage. Ask them about that era – who were the movie stars or the athletes of that time? You might end up hearing a brand new story that your loved one is more than willing to share.

Monday, December 24, 2012

2012 Year In Review

Clinical Ethicist Helen Blank speaks
at OOIE Ethics Training in March 2012.

Ombudsman McCracken presents
outstanding leadership award to
Jane Knapp on behalf of the
Tri-County Regional Ethics Committee.

OOIE staff promote Ombudsman services at the
New Jersey State Fair in Augusta, in August.

Volunteers from the southern region of the state
participate in volunteer training in Trenton.

Assemblywoman Donna Simon
greets residents during an October
Residents’ Rights Bingo
event at Acorn Glen in Princeton.

OOIE staff Nikiah Nixon at the OOIE booth at the
AARP Consumer Expo in Mercer County in August.

Ombudsman McCracken speaks to residents during an October
Residents’ Rights Month event at Hamilton Continuing Care in Hamilton.

Ombudsman McCracken greets a resident during a June “Elder
Abuse Awareness Day” event at Bristol Glen Retirement Community in Newton.

OOIE Attorney Amy Brown speaks with a
resident at House of the Good Shepherd in Hackettstown during
an April “National Health-care Decisions Day” event.

OOIE Policy Director Elizabeth Speidel with Mary Luby of Mon-mouth
County Office on Aging, Disabilities and Veterans’ Services,
attend event at Luftman Towers in Lincroft.

Wednesday, December 12, 2012

Help Nursing Home Residents Enjoy the Holidays

When the hustle and bustle of the holidays is fast approaching, it is important to remember our loved ones who are in area nursing homes. This can be a depressing time for them. They are separated from the normal routine and for many of them, this may be their first time away from home during the holidays. Family members should realize the importance of reaching out to their family and friends living in nursing homes.

Try to include your residents in the holiday festivities in some way. Investing in your loved one can be key to a happier holiday for both you and your loved one. Here are some ideas:

Visit Often
Visits from family and friends are always welcomed around the holidays. It can help their day go a little faster and make it a little more special because of the visit from you.
Many treasure visits with children and grandchildren as well. Children, adequately chaperoned, can be a real source of enjoyment and happiness for an older adult. 

Taking a loved one home, if possible, while you are preparing for the holiday festivities, will make them feel they are still a part of the celebration. They can smell the cookies in the oven, watch the "hustle and bustle" in kitchen, see the lights on the Christmas tree or participate in the lighting of the Menorah. Another plus is that once you have them home, their enthusiasm is contagious!
And don’t rule out visits from pets as well. Many nursing home residents love to have visits from pets. Quite a few nursing homes have volunteers certified to do friendly pet visits. If this is the case, request a furry visitor the next time they come into the facility.

Spirituality and the Holidays
Getting your loved one in touch with their spirituality during the holidays can be especially helpful as
well. The holidays are a time when many older adults reminisce of days gone by. While this is usually a pleasant experience, it can be a little sad because of the many losses we experience by the time we are older adults. A resident’s spirituality can be a comfort and a source of strength for them during the holiday season. Getting your loved one in touch with a counselor or person from the clergy can be helpful in addressing the loneliness and spiritual concerns that they may have in their lives. Most nursing homes are good at having an area priest or pastor available to visit with residents. Speaking with the nursing home social worker or administrator and setting up a visit for your loved one can be a source of personal strength and encouragement for them during the holidays.

The Importance of Involvement
Try to get your loved one involved in a project that allows them to reach out to someone else. Most residents love to be productive and involved in other people’s lives. You never lose the urge to make a difference to someone less fortunate than yourself. There are all types of projects that older adults can get involved in.
  • Making holiday cards is one activity that does not require a lot of energy and can be done at a resident’s leisure, when they are feeling up to it. They can either make cards for their friends and family or they can make cards for other people in the community who could use a friendly reminder that they are being thought of.
  • Create a "Holiday Diary" with the assistance of a family member or friend. Have the resident document a holiday remembrance so that it can be saved as a keepsake. For this project, the loved one recalls a special holiday memory, a story, a gift received and/ or given or special holiday song that meant so much to him or her. The resident can have a diary entry for each of the Twelve Days of Christmas, or the Eight Days of Hanukkah. This is a great way to find out about holiday traditions and special times that happened long ago. Keeping a written journal of these special moments can be a treasure in years to come.
Bonnie Camp, a certified volunteer advocate with the Office of the Ombudsman for the Institutionalized Elderly and a hospice volunteer, received her MSW and Gerontology Certificate in 2011 from Rutgers University School of Social Work. She graduated from Stockton State College with a Bachelor’s degree in social work and minors in gerontology and writing. She is currently employed as a nephrology social worker with South Jersey Healthcare at dialysis units in Bridgeton and Millville.

Thursday, December 6, 2012

Tips and Gift Ideas for Long-Term Care Residents

It is the time of year to start thinking about what to buy for the person on your list who lives in a nursing home, assisted living, or residential care facility. Most items appropriate for retirement community residents are inexpensive gifts, and they’re easy to select if you know a little about the recipient’s hobbies and preferences.

Consider some of these practical and appropriate gifts for a nursing home resident:
  1. Warm bathrobe
  2. Soft nightgown or pajama set
  3. Cozy enclosed slippers or firm shoes with rubber soles
  4. Clothing items that are easy to wear, such as jogging suits and cardigan sweaters with large buttons
  5. Hand lotion and facial tissues
  6. Comb or brush
  7. Large print edition books, magazines, or puzzles
  8. A deck of playing cards or board game
  9. A soft pillow and pillowcase
  10. A quilt, blanket or comforter for the bed
  11. A CD player and some CDs
  12. Photographs or photo collages
  13. Stationery, note cards, greeting cards, pens, and stamps
  14. Calendar for 2013 with dates marked on it for upcoming birthdays, anniversaries, etc. For birthdays, mark down how old the person will be on that day; for anniversaries, the number of years together
  15. Address book with addresses written in for family and friends
Be aware that there are many gifts that are not appropriate for nursing home residents, like huge televisions and fancy clothes. Also, due to possible swallowing difficulties and restrictive diets, sending food items such as candy, cookies and fruit is not advised. If a nursing home resident has Alzheimer’s or a related dementia, do not send liquid items such as perfume, cologne, after shave or lotion, as these may end up being swallowed.  Gifts like scented candles are dangerous, since many residents require oxygen as part of their care regimen.

Here are few tips to remember when choosing a holiday gift:

  • Remember that residents in nursing homes have limited space for personal belongings
  • Check with the administration about their policy on items families and friends can bring to residents
  • Permanently label any gift with resident’s name
  • If you’re giving clothing, make sure it’s wash-and-wear, unless you’ll be responsible for the dry cleaning
  • Understand that off-site laundry is the rule in many nursing homes. Clothing can easily be lost during this process.
  • Know that, even if someone is in a “private” room, it’s still accessible to staff and other residents
  • Keep safety in mind at all times: glass or ceramic items are breakable and can cause injury
  • Find out about the administration’s policies on pointed or sharp objects such as scissors, pins or needles – including plastic flatware and knitting needles
  • Give the resident money directly, unless it’s pocket change for phone calls.  Deposit money in the resident’s  “patient personal account”
  • Bring food or candy if the resident is on a special diet, UNLESS you check with the nursing staff and have their OK
  • Bring visiting pets the nursing home administration hasn’t cleared .  That can be traumatic for both the animal and the resident
The holidays can be a very lonely time for nursing home residents. Remember that your time is best gift you can give.  Nothing can take the place of visiting your friend or family member in the nursing home. This is a very enriching and appropriate gift for nursing home residents. Spending half an hour, or even just a few moments, can be a great experience for all. Offer to read a holiday story, talk to your loved ones about their favorite holidays, or ask them to tell you about a gift they received and treasured as a child.  Find out their favorite holiday song and sing it to them, or find a recording of it and play it for them.  Senior citizens are valuable members of society and spending time in their company is beneficial to all, so bring the kids.  Younger grandchildren will have a better understanding of the stages of life when they experience visits to the nursing home, and  their youthful presence will delight many.

Seasons Greetings

I hope that you are all enjoying a happy and healthy holiday season. This year, in the aftermath of the one of the greatest natural disasters in our state’s history, I know that many of us are very thankful for our state’s excellent response to Hurricane Sandy and all the devastation that the storm left in its wake.

Unfortunately, studies show that vulnerable elderly citizens suffer inordinately in natural disasters and that mortality rates in long term care tend to increase following widespread evacuations. While the long-term effect of Hurricane Sandy on the state’s senior population cannot be known at this time,  government agencies in New Jersey in partnership with the senior-serving provider community were incredibly well prepared for this devastating event.

In the days and weeks following the disaster, OOIE staff and volunteers checked on conditions in facilities that had lost power or that had been forced to evacuate residents. Our staff found that long-term care facilities did everything they could to ensure quality care and continuity of services during those critical days and nights after the storm hit.

Now we must be vigilant about another unfortunate Sandy after-effect:  the prevalence of disaster-related scams. According to the New Jersey Division of Consumer Affairs, it is not uncommon for unscrupulous home improvement contractors to try to take advantage of people seeking home repairs following a disaster. In addition, fraudulent charities sometimes pop up seeking donations, never to be seen or heard from again.

Vulnerable senior citizens are very often easy targets for these scammers. They don’t have to be: information about how to avoid disaster scams is available at the New Jersey Consumer Affairs Division website or by calling the Division at 800-242-5846.

Warm wishes for a wonderful holiday season and a happy New Year.

- James W. McCracken, LTC Ombudsman

Friday, October 19, 2012

Fall Greetings from NJ's Long-Term Care Ombudsman

The fall is a busy time for those of us in the elder advocacy community. This is especially true because October is Residents' Rights Month, an annual event designated by the National Consumer Voice for Quality Long Term Care to honor residents living in all long-term care communities.

Ombudsman McCracken speaks with residents at a nursing home.
This October, the Ombudsman’s office is travelling to several long-term care communities throughout the state to meet with residents and educate them about their rights as delineated in both the federal and the New Jersey Nursing Home Bill of Rights. In order to make this information both instructive and entertaining, we will be playing “Residents’ Rights Bingo”, which was developed by Mighty Rights Press, a Division of The Legal Center for People with Disabilities and Older People.

We are also committing additional outreach resources to another area of significant concern to the health care community: advance care planning.

Elizabeth Speidel, OOIE Director of Policy and Legislative Affairs, has developed a presentation that provides specific information on advance care planning tools and how important it is for people to have conversations with their loved ones about  end-of-life care or other medical decision-making issues. Elizabeth is available to speak to organizations interested in learning more about this topic. For more information, contact the OOIE outreach office at 609-826-5073.

We also interviewed with leaders of two Regional Ethics Committees, groups of dedicated health care professionals who volunteer their time helping long-term care communities resolve complex bio-medical ethical issues. TREC serves  Burlington, Camden, and Gloucester.  OREC serves Northern Ocean County.  Both of these groups do an amazing job. You can find the interview here.

Volunteer Advocate Jim Vine in his younger years
We also featured a spotlight on one of our stellar volunteers, Jim Vine. Jim, like so many of our volunteers, is extremely dedicated to providing advocacy, friendship and comfort to people living in long-term care. Jim was motivated to become a volunteer because of his late wife, Susie, whom he describes as “the quintessential giver”. Read his story here.

Our volunteers are the definition of “givers”.  They give their time, their patience, their talents and their energies to making life better for elderly people living in long-term care. I am endlessly amazed and awed by their commitment to the people we serve.

Lastly, I hope you enjoy enjoy a happy and healthy autumn.

First Annual OOIE Training Conference Draws 100-plus Volunteers, Special Guests

More than 125 advocates and OOIE staff attended the 1st Annual Volunteer Ombudsman Training
Conference and Volunteer Recognition Luncheon at the Hyatt Regency New Brunswick on May 23, 2012. The event assembled advocates throughout New Jersey’s 21 counties to participate in an interactive, interesting, and informative training.

Volunteer Advocates participate in a role-playing activity.
James W. McCracken, Ombudsman, welcomed the participants and thanked them for their continued support to New Jersey’s vulnerable elderly in long-term care facilities.  Speakers also included Lori Smetanka, Director, and Sara Hunt, Consultant, from the National Ombudsman Resource Center (NORC) in Washington, D.C., who presented on interactive role playing and skills for effective listening.  Paul Greenwood, Esq., from the San Diego District Attorney’s Office, tackled the seriousness of elder abuse in a way that entertained, educated and motivated the audience. Teri Cox, Volunteer Caregiver and Advocacy Consultant, presented on the rewards of volunteering. Special guests included: Lowell Arye, Deputy Commissioner, NJ Department of Human Services, who spoke about Medicare/Medicaid and  provided policy and legislative updates, and Victor Orija, the State of Delaware Long Term Care Ombudsman.

Paul Greenwood recounts some of the more notorious cases he has prosecuted during his career.
On the day before the volunteer training conference and luncheon, OOIE staff participated in an intensive all-day training with Hunt and Smetanka that focused on: the history of ombudsman programs nationally; issues relating to confidentiality and consent; how to advocate for people with dementia; identifying the misuse of anti-psychotic drugs; the re-authorization of the Older American’s Act; the impact of the Affordable Care Act on ombudsman programs; and emerging advocacy trends.  Later in the day,  Hunt and Smetanka reviewed case studies with the staff that focused on common types of problems including: guardianship; residents leaving LTC against medical advice; resident sexuality; transfers and discharges; and behavioral health issues.

In addition, Hilary Meyer, Director of the National Resource Center on LGBT Aging, presented on the challenges of protecting the rights of people who are Lesbian, Gay, Bisexual and/or Transgender living in long-term care communities.  The National Resource Center on LGBT Aging is available to provide trainings on LGBT aging issues and best practices.  Information can be found at

New Documentary Inspires Healthy Aging

The New Jersey Ombudsman invites you to share the award-winning documentary Age of Champions with your community.

Age of Champions is the story of five competitors who sprint, leap, and swim for gold at the National Senior Olympics. You’ll meet a 100-year-old tennis champion, 86-year-old pole vaulter, and rough-and-tumble basketball grandmothers as they triumph over the limitations of age.

Sharing the film with your community is a powerful way to inspire your members, engage your staff, and support your organization’s mission. More than 500 senior residences are already using the film to enrich their programs and promote the message of lifelong health and wellness.

Sign up now to purchase the Age of Champions Screening Kit, which includes the DVD, discussion guide, promotional materials, and fun giveaways for your audience. Enter the discount code “ombudsman” and save 10% on your order.

Watch the trailer and learn more here.

Spotlight on James Vine


James Vine has a significant history of volunteering.  In fact, in 1941, at the age of 16, he volunteered for the National Guard in his home state of California.  It took the Guard 18 months, but they eventually figured out that he was underage and discharged him.

That didn’t slow him down, though. He immediately joined the Navy and was deployed twice to the Central Pacific.

In 1944, while on leave in Camden, NJ, Jim met his love, Susie, on a blind date.  They married, had three sons and eventually six grandchildren and one great-grandson.  They were parted last August when after 65 years of marriage, his beloved wife, Susie passed away.

Jim Vine has been an active volunteer in Gloucester County for the past 13 years. When asked why he became a volunteer with the Office of the Ombudsman back in 1999, Jim credited Susie. “In my declining years, I wanted to live up to the ideals of my wife, who was the quintessential giver.”

Jim says that what has kept him going as a long-term volunteer is that even though volunteering presents constant challenges,  he can  identify plenty of situations that would not have been resolved if it were not for his advocacy.   Incidents range from pushing for a consult for a resident who had a growth on her face (which indeed turned out to be cancer) to empowering residents to speak up for themselves to ensuring that all residents are treated fairly and equitably.

When volunteering, Jim feels closer to Susie, who would have wanted him to continue his role as a volunteer advocate.

Jim’s advice to new volunteers:  “First establish a positive relationship with the staff.  That lets them know that you can relate to them in a way that they can trust you. They will help you do your job.  But, you must always remember, “YOU ARE THERE FOR THE RESIDENT!”

LTC providers urged to utilize clinical assessment and intervention offered by S-COPE (1-855-718-2699)

In September, Ombudsman McCracken wrote a letter to all long-term care communities encouraging them to utilize the Statewide Clinical Outreach Program for the Elderly (S-COPE), a program developed by the NJ Division of Mental Health and Addiction Services (under the NJ Department of Human Services) and implemented by Trinitas Hospital.  S-COPE is a program that has been designed specifically to provide specialized clinical consultation, assessment and intervention for older adults who have primary diagnoses of dementia with behavioral disturbances, and who are at risk of psychiatric hospitalization.

Its purpose is two-fold: to provide individual resident assessment before these situations reach a crisis point, and to provide education for facility staff to better handle these situations in the future.  S-COPE representatives are available to provide assistance to LTC providers 24 hours a day, seven days a week, including holidays.

The Office of the Ombudsman for the Institutionalized Elderly (OOIE) fields many cases where elderly residents with dementia and/or mental illness have behavioral problems.  Often we find that interventions could have occurred much earlier to minimize the serious disruption caused to the elderly resident, other residents of the facility, and facility staff.

S-COPE can be reached at 1-855-718-2699.

Long-Term Care Residents Honored During Residents’ Rights Month, October 2012

My Voice, My Vote, My Right

Residents of Hamilton Continuing Care Center enjoy  
 a game of Residents’ Rights Bingo as OOIE  staff Amy Brown 
and Deirdre Mraw facilitate the game.
Residents' Rights Month is an annual event designated by the National Consumer Voice for Quality Long Term Care.  It is celebrated in October to honor residents living in all long-term care facilities, including nursing homes, sub-acute units, assisted living, and board and care and retirement communities. It is a time for celebration and recognition offering an opportunity for every facility to focus on and celebrate awareness of dignity, respect and the value of each individual resident.

Resident Regina Matyi of Hamilton Continuing 
Care Center smiles after winning a OOIE 
gift basket during Residents’ Rights Bingo.
The theme for this year - “My Voice, My Vote, My Right” - focuses on the right of seniors living in long-term care settings to vote.

The Nursing Home Reform Law, passed in 1987, guarantees nursing home residents their individual rights, including but not limited to: individualized care, respect, dignity, the right to visitation, the right to privacy, the right to complain, and the right to make independent choices. Residents’ Rights Month raises awareness about these rights and pays tribute to the unique contributions of long-term residents.

OOIE will be facilitating Residents’ Rights celebrations in several New Jersey long-term care communities throughout the month.   Events will consist of games and discussions regarding resident-focused topics like knowing their rights, elder abuse, advance care planning and healthy aging.  This month highlights the importance of listening to and empowering New Jersey residents who live in our state’s nursing homes, assisted living and board and care communities.

Ombudsman's Call to Action Results in Surge of Interested Volunteer Advocates

The OOIE Volunteer Advocate Program received close to 150 calls in June after several newspapers published a letter to the editor by Ombudsman James W. McCracken. He urged individuals to get involved in the fight against elder abuse by becoming a volunteer advocate.

(L to R) Regional Coordinators Beth Manè, Sue Rosenkranz, 
Clara Krever, Janet Khanlian, and Volunteer Advocate Program 
State Coordinator Deirdre Mraw 
VAP Trainees participate in cognitive impairment activities. Taped gloves are used to reduce tactile 
sensitivity and manual dexterity.
In response to these inquiries, Regional Coordinator Janet Khanlian put together a revamped group training for interested volunteers at OOIE headquarters in Trenton. Most of the advocate trainees were from the southern New Jersey area, where Khanlian recently became Regional Volunteer Coordinator.  These volunteers were joined by some volunteers from the central and central coastal counties managed by Regional Coordinator Beth Mane, who also contributed to the training.

Education and Outreach on Elder Abuse Awareness

OOIE acknowledges World Elder Abuse Awareness Day 2012

Friday, June 15, was World Elder Abuse Awareness Day, a day created in 2006 to focus attention on elder abuse and exploitation.

In honor of World Elder Abuse Awareness Day, Ombudsman James W. McCracken visited Bristol Glen Continuing Care Retirement Community and attended an event at the Ramada Toms River for residents of the communities of Green Acres  Manor and Magnolia  Gardens. The purpose of these visits was to help raise awareness of elder abuse and provide residents, family members and members of the public with information that they need to combat abuse, neglect and exploitation of vulnerable older adults.

McCracken at Bristol Glen Continuing Care Retirement Community
OOIE is a resident-focused advocacy program that seeks to protect the health, safety, welfare, and civil and human rights of older individuals who live in long-term care facilities. We receive about 6,000 complaints of abuse, neglect or exploitation in long-term care facilities such as nursing homes, assisted living, boarding homes, and residential health care providers.

The message that McCracken delivered at these events and in a letter to the editor published in several major daily newspapers is that, while awareness of an issue is important, action is even more important.

Becoming a volunteer advocate is one way to combat elder abuse and to make a meaningful difference in the lives of elderly residents living in a nursing home. Volunteer advocates receive 32 hours of training and are asked to spend four hours a week at a local nursing home, listening to residents’ concerns and advocating on their behalf.  To become a volunteer, call the OOIE Volunteer Advocate Program at 609-826-5053.

As Ombudsman McCracken always says: The need is clearly there — will you answer the call?