Alzheimer's Foundation of America

Foundation of America

The Ombudsman—An Advocate for Families

Advocating for a loved one can sometimes be difficult. Many people are reluctant to “make waves” or create conflict especially with a health care setting because they fear negatively affecting their loved one’s quality of care. Navigating a complex bureaucratic system can also be confusing and intimidating.

That’s where the support of a Long-Term Care (LTC) Ombudsman can be helpful—someone who advocates for the health, safety, and rights of individuals in long-term facilities, and ensures residents are protected by the standards required under the Nursing Home Reform Law of 1987 (in most states, this law also covers assisted living and small board and care homes). Each state has an office headed by a full-time State LTC Ombudsman.

What can an Ombudsman help with?

Your loved one is entitled to the best possible quality of life and care. The Ombudsman program is one of the avenues created to ensure they receive both. Ombudsmen help by:

  • Educating individuals about their rights
  • Addressing concerns about quality of care
  • Discussing and resolving grievances/issues with facility staff and family members
  • Investigating suspected neglect or abuse (physical, emotional, mental, or financial)
  • Reviewing inadequate staffing or training for the level of residents’ care needs

“Residents’ concerns often relate to their specific preferences, such as bathing times or food choices—things not directly attached to a regulation but should be honored by a facility,” said New York State Ombudsman Charlotte Royal. “Concerns like these often require mediation by the Ombudsman with the facility to work together to meet the resident’s desire and ensure that a resident-centered plan of care is in place.”

Ombudsmen also coordinate with other agencies to solve problems on both individual and systemic levels, along with analyzing and recommending changes in laws, regulations, and policies.

Contacting an Ombudsman

If you cannot resolve your concerns or issues directly with the facility on your own, or don’t feel comfortable doing so, you can make a confidential report with the Ombudsman. With your permission, the Ombudsman then investigates and moves to resolve the issues presented.

“Federal and state law requires facilities to allow residents access to the LTC Ombudsman and to also work with the program to resolve issues and concerns. Most facilities do work with the Ombudsman program effectively,” Royal said. “If a facility denies access or refuses to work with the program to resolve issues, the Department of Health is notified; however, this is always a last resort.”

Residential care communities must post the area’s Ombudsman program contact information and responsibilities. You can also search by state, visit the Elder Care Locator website (, or contact the AFA Helpline (866-232-8484).

This article originally appeared in Alzheimer’s TODAY, Volume 16, Number 2, published by AFA. View the entire issue here.