Abstract
A study of the Long-Term Care Ombudsman in each state and the District of Columbia found that fourteen of the twenty-five respondents did not know when their state laws allowed nursing homes to refuse to honor patient end-of-life wishes. The Ombudsman is supposed to be an advocate for residents of nursing homes and a source of information. State laws vary as to when a facility may refuse to honor treatment directives and what it must do if it will not honor a patient wish. Patients and their families who do not know that an end-of-life directive will not be honored until the patient is dying may turn to the ombudsman for assistance. The ombudsman must know the laws of the state to intercede for the patient and to advocate for policy changes when the need for change is suggested.
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