University of Pittsburgh psychiatry professor Richard Schulz has been one of the nation’s foremost researchers on caregiving stress for
It’s the first Thursday of the month at ManorCare Health Services-Greentree, a day always welcomed by Becky Napierski, a longtime nursing home resident. It’s the morning the Allegheny County Library Association bookmobile arrives with carts of new books, DVDs and other materials.
The wheelchair-bound Ms. Napierski, 65, is an avid reader who has lived in the nursing home since a stroke partially paralyzed her nine years ago. She lobbied for the addition of the bookmobile after graduating from a special program that educates long-term care residents about how to advocate for themselves and other residents.
At her nursing home, it has meant the addition of new DVDs every month so residents in the activity room don’t have to watch the same old movies repeatedly. And as the facility’s most avid reader, Ms. Napierski is able to get through 20 or so new mysteries or romantic suspense novels — something new from Nora Roberts, if she’s lucky — each month.
“It’s very important to keep your mind active, so how better can you do that than reading a book?” Ms. Napierski mused. She learned of the bookmobile more than four years ago and “nagged” — her word — both ManorCare-Greentree’s administration and the Allegheny County ombudsman program to gain access to it.
It’s the kind of outcome sought by the Pennsylvania Empowered Expert Residents program, known commonly as PEERs. Run through counties’ local ombudsman programs, in which both paid staff and volunteers help represent long-term care residents, PEERs has trained 2,200 residents statewide on how to try to address concerns with their facilities instead of either remaining quiet or relying on the ombudsmen.
“Because they’re living there, they see and understand a lot more about the residents’ perspective than we can ever see,” said Dennis Govachini, an Allegheny County staff ombudsman who coordinates the PEERs program locally. “The sad thing is, I have to go train people about rights they didn’t know they have.”
The program is voluntary for facilities as well as residents. Of 62 nursing homes in Allegheny County, six have chosen to participate over the past seven years — four ManorCare facilities plus Seneca Place and West Hills Health and Rehabilitation Center.
About two dozen residents of those facilities — some of them now deceased or no longer active — underwent 10 hours of training about resident rights and how to work with an institution’s chain of command to try to address any problems in cooperative manner. County ombudsmen exist to try to work out problems at facilities where residents or their families are unable to work out conflicts with the administration.
“When concerns or ideas can be handled at the facility level, without relying on a third party, that’s a win for everybody. It’s what we should be moving toward,” said Beth Runser, administrator of ManorCare Health Services-North Hills, where a class of five PEERs was trained last year as the newest group in the county.
So far, that new group succeeded in pushing for a rearrangement of activities rooms so that a long-neglected pool table could be brought into an open space where it’s more likely to be used.
Joe Spagnoletti, 70, a double leg amputee who is president of the residents council at ManorCare-North Hills, said the group there wants to work on arranging more evening activities options for residents. In general, PEERs try to make themselves known to other residents as helpers on various issues with the staff.
“I’m going to go around and greet people, tell them my name, tell them, ‘You can talk to me,’ ” the affable Mr. Spagnoletti explained.
Most nursing homes have residents councils that meet monthly and also try to work on shared issues, but attendance is typically sporadic and the same complaints are often repeated — food quality should be better, call lights need to be answered quicker, etc.
The PEERs training helps some of an institution’s more capable residents focus on ways of helping individuals with their direct concerns, such as pointing them to the right staff person who can address a problem. For a more serious matter, such as a legal issue or question of harm being done to a resident, a PEER may be the one to get the ombudsman involved for someone who wouldn’t know how to do that himself.
Barb Nichols, administrator at ManorCare-Greentree, said the PEERs graduates there brought to her attention the need to adjust staff assignments so people weren’t left sitting idly in the dining room long after completing their meals.
Ms. Napierski, who has a teaching degree and served on the Hopewell school board, said of her role, “There’s things that may happen to me that I don’t like, and if it’s happening to me, I know it’s happening to others, but they may not be able to speak up as well, so I do so. … I need to feel like this is my home.”
Such an attitude isn’t necessarily widespread. An increasing number of nursing home residents are there for short-term rehabilitation and not so interested in ongoing concerns of others at the facility. Some people lack competence to speak up for themselves. In some cases, residents are fearful of retaliation if they complain about conditions.
“Most residents going into a facility, as long as they’re fed and taken care of, they’re not trying to make waves,” Mr. Govachini said.
The PEERs graduates around the state also take part in a bi-monthly conference call to discuss common issues.
Information on starting a PEER program may be obtained by calling 412-350-4074.
Gary Rotstein: firstname.lastname@example.org or 412-263-1255.