The Silent Saviors: Advocating for Long-Term Care Residents in Texas

As I reflect on the state of long-term care in Texas, I can’t help but feel a sense of urgency surrounding the advocacy efforts that are absolutely vital for the residents of our nursing homes and assisted living facilities. The stories of individuals like Tonya Jackson, a local ombudsman, underscore both the necessity and the challenges of these roles amidst an increasing population of residents needing assistance.

In one notable instance, Jackson managed to intervene on behalf of an elderly woman facing eviction from her nursing home due to poor communication between her family and the facility management. It’s tales like this that illuminate the importance of having dedicated advocates who are ready to step in where others may falter. Jackson states, > “We do not enter a nursing facility to wreak havoc. We are there to help mend the broken bridge.” This sentiment resonates deeply not just within the walls of care facilities but also in the hearts of the families who silently navigate these often-turbulent waters.

Advocacy can truly change lives in long-term care environments.

However, the gravity of the situation becomes glaringly apparent when we look at the statistics: Texas ranked 42nd in safety and quality on a scorecard from AARP. This dismal ranking emphasizes a statewide issue that requires immediate attention, particularly in regions like Deep East Texas where the need for a voice in these facilities is most dire. It’s alarming to think that just five people—two paid staff and three volunteers—are responsible for over 48 long-term care facilities across three different counties.

The Need for More Advocates

The urgency for more ombudsmen is highlighted by Andrea Earl from AARP, who expresses the sentiment of many: > “We would be lost in the long-term care community without them, but they definitely need more support across the board.” Indeed, volunteers are often the unsung heroes, with the potential to bridge the gaps where permanent staff are stretched too thin. Jackson emphasizes that having an extra set of eyes and ears can significantly enhance the quality of care: > “Volunteers can usually catch things that we can’t, being that our time is so limited going to each of the facilities.”

As Texas lawmakers prepare to reconvene, there’s a glimmer of hope on the horizon. Patty Ducayet, the state’s lead ombudsman, is pushing for greater funding and support for the program. In an ideal scenario, increasing the number of full-time positions could allow advocates to extend their reach and develop a more comprehensive understanding of the conditions within facilities. Furthermore, it could assist in resolving one of the most pressing complaints: involuntary discharges.

Challenges Within the System

One of the major hurdles faced by the program is a staggering 25% turnover rate among paid staff, which jumped to the highest level recorded in 2024. This high turnover exacerbates the issue of limited availability and resources. Ideally, we should have one ombudsman for every 2,000 licensed care facility beds, but currently, that ratio is alarmingly skewed with one ombudsman for every 2,514 beds.

If we had a properly staffed ombudsman program, these advocates could focus on recruiting and training volunteers. As reported, however, more than 100 active volunteers have disappeared since 2019, leaving a mere 300 advocates to cover the vast landscape of Texas’ long-term care facilities.

Community support can tremendously benefit long-term care residents.

Earl notes, > “Those are hard things. It takes resilience and grit, like most hard things do.” Resilience is indeed key in this battle for dignity and support in nursing homes. The emotional toll on residents and their families is immense, often leading to stress and helplessness.

Legislative Gains and Future Goals

Ducayet’s upcoming legislative goals include pushing for an additional $3 million in funding for the ombudsman program, aiming to hire more personnel and implement crucial oversight roles. Additionally, emphasizing compliance with state and federal discharge regulations is essential, particularly given that involuntary discharges have emerged as the No. 1 complaint.

Rounding out these efforts, Ducayet and AARP also advocate for states to require nursing homes to allocate at least 85% of Medicaid reimbursements towards payroll. While these legislative goals may not single-handedly resolve the broader issues within long-term care in Texas, they are steps in the right direction for accountability and improved standards. And to think, amidst all of this, Jackson continues her quest to find more local volunteers to help elevate the voice of residents.

As I ponder these issues, it is apparent that the system bears the responsibility of ensuring the dignity of its most vulnerable members. While the Texas ombudsman program is crucial, it also represents just a piece of the larger puzzle. Only through continued advocacy, community support, and legislative action can we hope to create an atmosphere in which long-term care residents feel valued, respected, and, most importantly, heard.

Finding local advocates is not just essential; it is a lifeline for countless residents who quietly endure daily challenges without a second thought. As we delve deeper into our collective duty, let us be reminded that every resident deserves not just care, but a voice.