Sometimes, they may have to decide whether to provide life support, such as a ventilator or feeding tube, to keep a loved one alive. Or, they may have to decide whether to remove life support, if it becomes apparent that the likelihood for recovery is slim. Family members may even disagree over the best course of action.

As the overseer of end-of-life decision making in long-term care facilities, the Office of the Ombudsman for the Institutionalized Elderly helps inform people who are making these difficult decisions. The Ombudsman’s role is as a source of impartial information and to make recommendations on a particular course of action.

The Ombudsman also encourages long-term care facilities to call upon the expertise of the Long-Term Care Ethics Committees. The Ombudsman worked to develop these committees, with financial and technical help from the Robert Wood Johnson Foundation and Cooper Hospital University Medical Center. These committees can conduct a more thorough investigation of a particular situation, as well as offer recommendations to the decision-maker.

Facilities are encouraged to tap this resource when confronted with end-of-life issues or even day-to-day ethical issues that often arise.

With the assistance of a grant from the Healthcare Foundation of New Jersey, and also in cooperation with a nationally-recognized palliative care team from Cooper Hospital University Medical Center, the Ombudsman has also coordinated training for facility staff in the provision of palliative care to assist those at the end of their lives to spend their final days in dignity and comfort.