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Factors Important to Success in the Volunteer Long-Term Care Ombudsman Role

Correspondence: Address correspondence to H. Wayne Nelson, Jr., PhD, Department of Health Science, Towson University, 8000 York Road, Towson, MD 21252-0001. E-mail: wnelson{at}towson.edu

	Abstract

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This study found that the satisfaction of one state's largely older volunteers' altruistic, affiliation, and self-improvement motives corresponded to increased organizational loyalty and better performance across several dimensions. Younger volunteers served for shorter periods and were more highly motivated by the "self-improvement" need. Altruism and organizational loyalty emerged as particularly important motivations.

Key Words: Volunteerism • Resident advocates • Motivation • Organization commitment

Given the importance of the ombudsman's job, and the trouble of finding and keeping good volunteers, it is important to understand what motivates people to persist in this tough role. Although there is little research on this topic, Nathanson and Eggleton (1993) found that volunteer ombudsmen were motivated by a desire "to give to the community" and by the experience of "having had a family member in a nursing home" (1993, p. 103). Nelson, Pratt, Carpenter, and Walter (1995) found that high organizational loyalty was related to less burnout, job confusion, and role conflict and to higher perceived self-efficacy.

Our study extends this scarce literature by examining volunteers' motives, their satisfaction in their volunteer role, and the link to performance outcomes. Three broad motives described in the volunteer literature as important for understanding volunteer behaviors are these: (a) self-development, (b) affiliation, and (c) altruism (Bonjean, Markham, & Macken, 1994). Motives of self-development reflect the volunteers' personal desire for improved skills and capability. These motives are thought to be more highly valued by younger volunteers, who are often trying to launch careers. Motives of affiliation reflect the volunteers' need for desirable social contact, and motives of altruism reflect the volunteers' value of helping others. Organizational commitment reflects the volunteers' loyalty to the agency's core values and goals by performing on behalf of the organization (Mowday, Steers, & Porter, 1979). We operationalize satisfaction as a morale-enhancing affective state that is engendered by fulfilling one or more of this study's self-development, altruistic, and affiliation goals. Because these motives derive from a role in the organization, satisfaction is hypothesized to be related to increased organizational commitment and, ultimately, to work-role success. This study's success (outcome) measures are as follows: (a) the submission of monthly complaint reports; (b) monthly reports of the number of facility visits per month; and (c) total amount of time committed to the role each month. To these positive work outcomes, we added a fourth success measure: (d), fewer complaints filed against the ombudsman (the assumption here is that more effective ombudsmen will have fewer complaints lodged against them by providers).

We also explored how age, gender, volunteer rank (advanced, veteran ombudsmen are called Certified Ombudsman Investigators), tenure in the ombudsman role, and previous involvement with long-term care might contribute to volunteer success. We predicted that higher organizational commitment, satisfaction, and gratified motives would be related to desirable patterns of volunteer participation (longer service, more time devoted to the program, more cases filed, and a larger number of visits to facilities).

	Methods

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Participants
Data for these analyses were drawn from returned surveys that had been mailed to all volunteers serving the Oregon Long Term Care Ombudsman Program in October 1998. Participants included 106 of 135 active volunteers for a 79% response rate. Participants ranged from 23 to 82 years of age (M = 63, SD = 11.94). The majority were retired (64.2%), female (69%), married (61.3%), Caucasian (99%), and well educated (100% had a high school diploma; 46.2% had a college degree, and 22.6% had at least some graduate school). Approximately 40% of the participants reported prior family or personal involvement in long-term care. Tenure in the ombudsman role ranged from newly certified to 17 years, with a mean of just over 3 years. These demographics accord with previously reported ombudsman volunteer profiles (Keith, 2000; Nelson et al., 1995).

Measures
We measured motivations (self-development, affiliation, and altruism) and satisfaction with the 42-item Self Expression Instrument (Bonjean et al., 1994). This instrument has good psychometric properties, and reliabilities for the three motive scales and the satisfaction scale were acceptable in this study (Cronbach's s =.66–.89; contact the authors for more information). The widely used 15-item Organizational Commitment Questionnaire (Mowday et al., 1979) was the measure of organizational commitment (Cronbach's =.85).

The outcome variables of (a) monthly complaint reports submitted, (b) the number of facility visits per month, (c) the amount of time (total minutes) served, and (d) complaints filed against the ombudsman were gleaned from agency records and monthly activity reports submitted by active volunteers from October 1996 to March 1998. Complaints filed against the ombudsman were recorded from a complaint log maintained by the agency. To equitably compare this variable among volunteers, we divided the total number of cases reported by an ombudsman by the number of months the volunteer actively served. (Participants spent an average of 9.4 hr/month in service with the ombudsman program, SD = 13.28, and made an average of 7.2 visits to their assigned facilities each month, SD = 15.1, with a range of from 0 to 19 visits. They filed an average of 4.14 cases/month, with a range of 0 to 105, and had only a total of 13 complaints filed against them by aggrieved facility staff, M =.12, SD =.56, with a range of 0 to 4 complaints lodged per ombudsman.)

Data Analyses and Results
Four regression equations were run to explore the relationship between motivations, satisfaction, and organizational commitment to indicators of success in the ombudsman role. Demographic variables were included as covariates in the first step of the regression equation if they were significantly correlated with outcomes. This correlation table is available from the authors upon request.

Correlations
As we expected, all motives were significantly related to satisfaction; the affiliation motive was most fulfilling (r =.35, p .001), followed by the self-development motive (r =.28, p .01), and then the altruistic motive (r =.23, p .05). Men were less satisfied (r = -.19, p .10) but more likely to be Certified Ombudsmen Investigators (r =.23, p .1) than women.

Ombudsmen with higher organizational commitment spent more time in the ombudsman role (r =.37, p .001); made more facility visits (r =.25, p .05); filed more case reports (r =.32, p .010); expressed greater satisfaction (r =.34, p .001); and expressed higher levels of affiliation (r =.24, p .05), altruism (r =.23, p .05), and need for self-development (r =.20, p .07). Surprisingly, satisfaction was linked to only one success outcome: number of facility visits (r =.19, p .10). Among dependent variables, the time devoted to the ombudsman role was highly correlated to frequency of facility visits (r =.86, p .001) and to the number of case reports (r =.66, p .001). All three motives were modestly tied to more facility visits (rs ranged from.19 to.20, p .10).

Advanced volunteer Certified Ombudsman Investigators were more organizationally committed (r =.23, p .05), more likely to be moved by the altruistic motive (r = 19, p .10), devoted more time to their role (r =.33, p .01), made more visits (r =.35, p .001), filed more case reports (r =.40, p .001), had more previous experience with the long-term care system (r =.32, p .01), had longer tenure in the ombudsman role (r =.28, p 01), and had more complaints filed against them (r = -.25, p .05) than regular volunteers.

Older ombudsmen had longer tenure in the ombudsman role (r =.35, p .001). Longer tenure was also linked to time dedicated to the ombudsman role (as a per month average). Younger ombudsmen were more driven by self-development needs (r = -.23, p .03). Finally, previous long-term care experience was tied to time devoted to the role (r =.33, p .01), frequency of visits (r =.28, p .05), cases reported (r =.24, p .08), the number of complaints filed against the ombudsman (r =.23, p .06), and being an advanced Certified Ombudsman Investigator (r =.32, p .01).

Regressions
We conducted four regressions. Only two proved significant and are reported here. We regressed eight independent variables on the dependent variable of time devoted to the ombudsman role (F = 4.29, p =.000). This model explained 27% of the variance (R² =.27, adjusted R² =.21) in time devoted to the ombudsman role. Significant predictors were tenure in the ombudsman role (t = 2.96, p =.002), organizational commitment (t =2.13, p =.018), altruism (t = 1.67, p =.05), and (higher) satisfaction (t = -1.91, p =.03). Age, gender, self-development, affiliation, and altruism failed to achieve significance in this model. The second significant model (F = 4.13, p =.000) regressed the same eight independent variables on the dependent variable of visits to assigned facilities per month. This explained approximately 27% of the variance in visits to assigned facilities per month (R² =.266, adjusted R² =.20). The only significant predictor was tenure in the ombudsman role (t = 3.81, p =.000), though the altruistic motive came close to being significant (t = 1.49, p =.07). All tests were one-tailed tests because predictions were made a priori.

	Discussion

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Our results speak to issues of volunteer recruitment and to what may be keeping volunteers effectively engaged in their ombudsman role, though future longitudinal studies will be necessary to clarify the directional nature of these relationships. Our findings show that the satisfaction of individual motives encourages volunteer commitment and consequent effort to work on behalf of the organization. Certain motives may be more important than others in determining the link between satisfaction and measures of success. Our findings suggest a complex relationship for the altruistic motive, which was less correlated with satisfaction than either the affiliation motive or self-development motive, despite its higher valuation by volunteers (altruism, M = 2.96, on a range of 1–4; affiliation, M = 2.27; and self-development, M = 2.22). However, only the altruistic motive achieved significance in predicting a success outcome, time devoted to the ombudsman role, and near significance in predicting visits to assigned facilities per month.

Perhaps the highly valued altruistic motive is more difficult to fulfill than the other two drives because of the general adversity of the long-term care system and the extreme difficulty of the ombudsman role itself. As Monk, Kaye, and Litwin wrote, ombudsmen, "armed primarily with good will," are "scarred and often deeply shaken" by entrenched and even hostile provider resistance, which is common (1984, p. 166), upsetting to volunteers (Connor, cited in Nelson, 1995), and clearly deleterious to their job satisfaction (Keith, 2001).

Frustration of the altruistic motive might be explained by the research suggesting that, although volunteers increase complaint handling and regulatory involvement, they find it difficult to markedly improve overall facility conditions (Nelson et al., 1995). One ombudsman expressed this unmet need by lamenting that much of her work "was making the patients feel that someone cared about them. I don't feel I had as great an impact as I could if we'd had more authority than I did" (Nelson, 1995, p. 38). This may be an example of someone who would like to help more directly but was reduced to a more passive and, for her, frustrating, affiliative friendly visiting orientation.

Our analysis also supports the widely held idea that younger volunteers are more highly motivated by self-development factors as a result of their focus on building experience and career enhancing contacts—needs that are logically diminished in older volunteers, as our study also suggests. These self-development drives would, on the face of it, appear to present motivational opportunities for volunteer coordinators. However, much experience and anecdotal evidence suggests that the younger volunteer's quest for self-development is a double-edged sword. This is because although it may take a year or more to master the complexities of the ombudsman's role, self-development motives can, in fact, be easily sated, and hence extinguished quite early in the volunteer's career. Consider, for example, how receiving initial training, gaining certification credentials, making new contacts, and receiving college credit for service learning provide decent career-starting resume entries. Once these are achieved, the career-chasing volunteer may be inspired to seek new skill-building opportunities, or paid work, elsewhere. Conversely, altruistic needs can be fulfilled only by the effective sustenance of the ombudsman role. This is also true for the affiliation drive, which is sustained only so long as the volunteer remains on the job. Our found tie between youth, self-development needs, and higher attrition not only supports this theory but also upholds the Oregon program leaders' decision to discontinue college campus recruiting and to exclude students who are seeking college credit for "ombudsman" service learning.

We also found that older volunteers with previous long-term care experience are more role involved. They submit more case reports, devote more time to the job, make more frequent visits to facilities, are more satisfied than younger ombudsmen, and are more likely to assume a leadership role (advanced Certified Ombudsman status). This confirms earlier research suggesting that older ombudsmen are more highly motivated in general (Nathanson & Eggleton, 1993). In a similar vein, our findings that older, advanced ombudsmen spend more time on the job, make more facility visits and file more cases per month are easily explained by the fact that they were promoted precisely because of their proven acumen and diligence.

Our finding that advanced Certified Ombudsmen have more complaints filed against them, however, countered our expectations. Although speculative, this may be explained by Keith's (2000) finding that more engaged and assertive advocates had more complaints filed against them. Because these ombudsmen handle more and tougher cases, often in facilities where they are not well known (because they "rove" among countywide facilities), it makes some sense that they will encounter greater opposition manifesting as complaints against them. It is often heard in ombudsman circles, for example, that complaints against ombudsmen are often a sign that "they are doing their job."

An unexpected finding was the tie between being a man and experiencing lower satisfaction, though Nelson and colleagues (1995) found something similar in their discovery that male ombudsmen felt far less efficacious than female ombudsmen. They speculated that this happened because male ombudsmen were more likely to devalue volunteer work than female ombudsmen, either as a result of their "higher status expectations" or the likelihood that men had left behind more prestigious paid employment than women (Chambre, cited in Nelson et al., 1995, p. 229). This bears future scrutiny.

Our strongest finding relates to the importance of organizational commitment as a catalyst for positive volunteer affect and behavior. Results indicated a very high level of organizational commitment among Oregon ombudsmen (M = 6.07 on a 7-point scale). This strongly indicates their willingness to promote program goals and to assume leadership responsibilities. That this commitment is tied to satisfaction, to all three motive classes, and to every measure of success except complaints against ombudsmen supports the volunteer literature's assertion that commitment is essential to volunteer action. Indeed, such dedication may explain how it is "possible for ombudsmen to persevere despite circumstances in a facility that might drive the less dedicated away" (Keith, 2001, p. 306)—especially when their altruistic goals are only partly achieved.

	Implications and Conclusion

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Although one should be careful in generalizing these exploratory findings to other ombudsman programs, it is, nevertheless, likely that they have significance for the 38 other state ombudsmen programs that extensively use volunteer investigators to handle complaints. Our findings show that highly committed ombudsmen do more work. This means that program leaders can energize volunteer action by continuously promoting the altruistic needs explicit in the program's core values: to allay resident suffering and injustice. Managers should be aware that older volunteers, especially those with previous family involvement in long-term care, might be more committed to achieving these goals. However, the difficulty in attaining these aims may frustrate their altruism and diminish work-role satisfaction. Consequently, managers should temper exaggerated rescue hopes by creating realistic expectations about the often arduous, piecemeal, and snail-paced nature of promoting facility change. Realistic expectations, coupled with the manager's consistent recognition of the volunteer's "victories"—both large and small—will enhance the affective satisfaction that sustains fruitful commitment.

Managers must also pay attention to other volunteer motives. Opportunities for friendship, personal development, and support are also important, but these needs must be assessed and fostered within the context of the program's advocacy mission. For instance, managers should structure affiliation opportunities that reinforce desirable role behavior (partisan advocacy)—by providing social opportunities, policies, and training that encourage bonding among and between ombudsmen and residents. Conversely, they should discourage friendships between volunteers and facility staff. Such relationships may sensitize volunteers to facility values, thus undermining their resident-centered role. Careful attention to these complex, contextually bound matters should give volunteers what they need from the organization while encouraging them to meet the organization's needs. This mutual attentiveness is the key to a vibrant volunteer organization and to that organization's ultimate goal of humanizing long-term care.

	Footnotes

 
Decision Editor: Linda S. Noelker, PhD

¹ Department of Health Science, Towson University, MD.

² Human Development and Family Sciences, Oregon State University, Corvallis.

³ Program Director, Alzheimer's Association, Michigan Great Lakes Chapter, Ann Arbor.

⁴ Department of Psychology, Oregon State University, Corvallis.

⁵ Honors College, Florida Atlantic University, Juniper.

Received for publication November 1, 2002. Accepted for publication March 25, 2003.

	References

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