She Called 911- A LTC Ombudsman Story

When no one listens, residents escalate. Advocacy exists so police intervention does not have to.

I had worked extensively with a resident in my role as a long-term care ombudsman. She contacted our office frequently. We are not emergency responders, but we investigate concerns and advocate for residents.

She was unhappy with her care, her family, and her life. She felt trapped—and in many ways, she was. She was bedbound and physically unable to leave the building. She had no financial resources or physical ability to move. She had recently undergone a foot amputation.

Knowing her options were limited, she sought advocacy to make the best of where she lived.

One afternoon, she left a message. She was sobbing and asked me to come immediately. Staff had moved her to another room without notice, she said, and her purse had been stolen.

She included photographs.

She had taken them while lying in her bariatric bed as staff pushed her down the hallway. Her belongings—bags, clothing, and miscellaneous items—were stacked across her legs and torso.

The reason for the room change was unclear. Most facilities provide at least 24 hours’ notice before an internal transfer. She received less than one. She was told, “We need your room for a new resident.”

She could not stand, assist, or reach her belongings. When she arrived in the new room, everything was piled on the floor and chairs. When she asked for her purse, no one could locate it.

The more she asked, and no one helped, the more distressed she became. She reported that she questioned multiple staff members—including the social worker and the director of nursing—and no one could or would find it.

Feeling powerless, she called the police and reported a theft at the nursing home.

Police arrived and questioned the staff involved in the transfer. A coordinated search began immediately. The purse was located in her bathroom, on a shelf above the toilet—a toilet she was physically incapable of using.

She said no one apologized. She felt the staff implied she was responsible for where it had been placed.

When I met with her to discuss the move and the events that followed, there were many concerns to address. But we began with this:

Police intervention should not be required to locate a bedbound resident’s missing purse after staff have moved her and her belongings.

She did not call the police because she was confused.

She called because no one was listening.