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Legal Aid Justice Center's Elder Law Initiative addresses the legal needs of the low-income elderly population living in the Thomas Jefferson Planning District using a combination of direct legal services, community education and outreach, and advocacy for reform.  The Elder Law Initiative has established an interdisciplinary, community-based approach to improving the care of elderly residents in local nursing homes and long-term care facilities.  The Elder Law Initiative is staffed by Claire Curry (top photo) and Kathleen Caldwell (lower photo.)

Background

The Virginia Department for Aging has reported that the number of elderly Virginians will grow five times faster than the state’s total population’s growth between 1990 and 2025, and that the number of people needing long-term care could more than triple.  In our Planning District, there are currently over 2,000 residents in nursing or assisted care facilities, and many more who need quality care.

At the same time, the long term care industry -- including both nursing homes and assisted care living facilities -- is in crisis.   Understaffing is a major problem.  A 1998 survey conducted by the Virginia Department of Medical Assistance Services revealed that 16% of nursing assistant positions in the Region Ten Planning District were vacant.   

Long term care providers face many other problems.   Workers are often underpaid, overworked, under-trained, stressed, and demoralized.  This poor work environment has led to high rates of staff turnover, with the average turnover rate for nursing assistants  estimated to be 130% per year.  This ultimately leads to decreased quality of care for residents.  State budget cuts in recent years have translated into reduced care reimbursement for nursing homes, leading to lower staff salaries, additional staff turnover, and insufficient regulatory oversight.

Many residents suffer from pressure ulcers, falls, weight loss, dehydration, depression and other physical complaints. Families trying to protect a loved one are often unfamiliar with their right to participate and receive information, and with their loved one’s rights to receive a personalized, consistent, and professional level of care.  For example, they may not be given an opportunity to participate in care planning or to look at the medical record.  As relationships deteriorate among caregivers, patients, and family members, so does the care given to the patient.

The Community Partnership for Improved Long-Term Care 

The Partnership was one of the co-sponsors of the first annual Charlottesville-area conference on geriatrics held on February 26-27, 2008.  We were happy to have the opportunity to recognize all of the many volunteers who have helped make our Pressure Ulcer Prevention (PUP) project such a success.  To see photos from the luncheon honoring volunteers.   

Legal Aid Justice Center launched the Community Partnership for Improved Long-Term Care (“Partnership”) in collaboration with the Jefferson Area Board for Aging (JABA) and others.  From the beginning the Partnership has included the key voices needed to properly advocate improved care: family members who have experienced difficulties in obtaining adequate care for loved ones in nursing facilities, concerned health-care professionals including staff from local facilities, senior care ombudsmen from local agencies, members of the local bar, and professors from the University of Virginia Schools of Medicine and Law.  The Partnership has worked since 2004 to determine the problems most prevalent within long-term care in the Thomas Jefferson Planning District, heighten public awareness, build up Family Councils within care facilities, and to be the voice for the residents and their families to effect meaningful change in quality of care.

 The Partnership helps improve conditions for local elders by:  

• educating families and patients about their rights and how to exercise them;

• working with Long Term Care facility staff to improve working conditions so that there is less turnover and the quality of care can improve;

• mobilizing and empowering facility-based family councils to use their collective power to seek reforms within individual facilities;

• educating the local medical and Long Term Care community about issues of key importance, e.g., pressure ulcers; and,

• conducting collaborative research with Social Services and UVa physicians on abuse and neglect that leads to enhanced ability by caregivers, family, staff and patients’ advocates to identify instances of mistreatment and intervene quickly to protect elders.

Together with the Alzheimer Association and the Jefferson Board on Aging (JABA), the Partnership held the "Working Together" Third Annual Conference on Improving Senior Care" on February 16-17th, 2010. The two-day conference's purpose was to encourage communication, the exchange of information, and adoption of best practices among all those involved in senior care. It also recognized the challenges and celebrated the accomplishments of long-term care workers, in order to support the goals of enhancing professionalism, leadership, and teamwork.

Elder Law Documents You Can Use

The Elder Law Initiative has put together a collection of useful documents for persons interested in becoming involved in nursing home advocacy.  

• Fact Sheet on Access and Visitation
• Fact Sheet on Residents Rights
• Key Components of Family Councils
• Rights of Family Councils
• The Community Partnership for Improved Long-term Care
• The Piedmont Area Regional Family Council -- Why is it Worth Your Time
• Ways for Families to Overcome Obstacles to Family Council Development
• Why Family-led Family Councils Benefit Families, Residents and Facility Personnel