It can be tough, moving into a nursing home.

It means you can no longer care for yourself at home, and no matter how nice the room or how diligent the staff, adjusting might not come easily.

Maybe breakfast arrives cold, or nursing home staff leave your door open at night. Or maybe it’s something bigger, like trying to get a new wheelchair or the nursing home is trying to kick you out.

From 2015 to 2018, Minnesota’s Office of Ombudsman for Long-Term Care said it saw a 150 percent increase in cases of abuse, neglect and financial exploitation of vulnerable elders.

“Regrettably, Minnesota ranks at the bottom in this country in terms of ombudsmen consumer advocate capacity available to consumers,” wrote state long-term care ombudsman Cheryl Hennen in the office’s 2018 annual report.

However, local volunteers tasked with championing the rights of the elderly in nursing homes have a different take. They praise the care they have witnessed in Alexandria’s nursing homes.

“You've got a great setup in Alexandria, I've just gotta say,” said Jane Kill, one of two certified ombudsman volunteers in Douglas County.

Close connections help

On a snowy January morning, the area’s other certified ombudsman volunteer, Char Hanson, arrives at Bethany on the Lake. She has been visiting Bethany for nearly five years, helping residents with complaints and keeping an eye on their surroundings. The word “ombudsman” comes from Swedish and means a legal representative.

On this visit, Hanson greets residents by name and touches them lightly on the shoulder.

“Look out your window, it’s like a picture postcard,” she tells one woman whose window looks out at a blanket of snow and snow-laden spruce trees.

Hanson hands the woman a bookmark-sized card that lists key rights of nursing home residents.

Minnesota has decided these rights matter so much that legislators have enshrined them in state law. Among them: the right to come and go as they please, as long as they are able; the right for married couples to privacy; the right to organize; the right to have friends and family visit; and the right to due process if the facility tries to kick them out.

Hanson, a retired public health nurse, said she was recruited for the volunteer position, and it came at a welcome time.

“I knew I had to have some structure in my life or I’d turn into a fat slob in a rocking chair,” she said.

At Bethany, she plays balloon ball with the residents, who sit in chairs in a circle, batting two huge balloons around with the help of aides. Or she'll chat with them in the activity room. She attends resident councils, where they discuss issues important to them. And she visits one-on-one with the elderly. All these are intended to build trust with the residents, to help them feel safe sharing their concerns.

To this point, Hanson said, she has not come across anybody seriously mistreated.

“The nursing homes in Alexandria are really, really good,” she said.

She believes that the close connections in a rural area play a big part in the quality of care. Nursing home staff might have gone to church with one of the residents, or babysat their children or grandchildren.

If there’s one thing Hanson would like to change, it’s for residents to receive more visits, phone calls and cards. They light up, she said, when they are remembered by their families.

The need for volunteers like Hanson and Kill will likely rise in coming decades. About 10,000 people in the U.S. are turning 65 each day, according to the Federal Reserve Bank of St. Louis, while investment advice firm Morningstar says that 79 is the average age upon admittance to a nursing home.

‘Bowled over’

When Jane Kill first heard about the chance to volunteer as an ombudsman volunteer, she wasn't excited about it. She knew no-one in nursing homes. But she wanted to volunteer somewhere, and the more she learned, the more interested she became.

“The idea of this whole thing is to be an advocate for the residents,” she said. “They come to a nursing home and things have to change and when you're old, change is not easy.”

She helped one resident with eyeglasses and another one with a more suitable wheelchair.

Because of Kill, the residents at Knute Nelson now have audio players to listen to books on tape. And because of her work, she has a new view of nursing homes.

“In my day and age, my parents said, 'I'm never going into a nursing home.' That has an effect on how you view that part of life.”

Like Hanson, Kill is impressed by the quality of care she has witnessed in Alexandria. She admits to being “bowled over” by how well residents are treated.

“This particular nursing home is phenomenal,” she said.

While more complaints have been reported at the state level, Laurie Kluver, a social worker at Knute Nelson, said her facility has not seen an increase.

“It’s been a long time since we reported a case of abuse,” she said. “It’s mostly falls that we report.”

Still, residents can be reluctant to talk about things that bother them.

“They don’t want to be seen as a complainer,” Kluver said.

And that, she said, is where volunteers like Kill and Hanson come in handy. They’re a neutral party and build trust with residents.

“It’s an additional support and set of ears,” she said.