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Factors Affecting Nursing Home Patient Participation in a Volunteer Grievance Resolution Service

Critical preconditions for effective program performance with vulnerable popula tions are service visibility and staff commitment. These factors may be especially important for patient representative programs serving the elderly in long term care institutions. Data collected from 210 residents in 14 skilled nursing and health- related facilities and 24 volunteer providers of nursing home ombudsman services suggest factors that may influence patient utilization of a mechanism for grievance resolution. Significant associations were found between both patient variables (age, education, sex, race) and facility variables (auspice, level of care, quality of care) and program awareness, service utilization, awareness of personal rights, and fear of retaliation. Patient representatives displayed intense altruisitc impulses, frustration with staff apathy in institutions and altered outlooks toward old people and institu tional care. Findings point to the value of personal advocacy with institutionalized aged populations, volunteer incentives and advocate career ladders, focused exper tise in selected health problem situations and flexible role behaviors in nursing home settings.