Ethel Paley, a social worker who for 35 years was at the forefront of helping nursing home patients and their families navigate the labyrinthine health care system, redress hidden abuses in treatment and lobby for systemic solutions, died on Nov. 18 at her home in Manhattan. She was 99 .

Her death was confirmed by her daughter Eliza Paley.

From the organization’s inception at the height of the scandals over nursing home care in New York in 1976 until it went broke in 2011 after the recession, Ms. Paley dedicated her career to Friends and Relatives of the Institutionalized Aged, a nonprofit organization of which she was the founding executive director.

Even after she stepped down from that post in 1979, she continued to serve the agency and her elderly peers for decades, well into her own advanced age, variously as president, board member, paid staff member and volunteer.

“Even though it was descriptive, our full name still reeked of a ‘social work’ look at the world,” Ms. Paley recalled in 2011 , “so we eventually dropped it and just use ‘ Fria ’ instead.”