scholarly journals Vulnerable Older Adults in Disasters: Effects of Hurricane Irma on Nursing Homes and Assisted Living

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 733-734
Author(s):  
Lindsay Peterson ◽  
David Dosa ◽  
Patricia D’Antonio
Keyword(s):  
Older Adults ◽  
Assisted Living ◽  
Gulf Coast ◽  
Secondary Data ◽  
Morbidity And Mortality ◽  
Term Care ◽  
The Face ◽  
Qualitative Methodologies ◽  
Hurricane Irma

Abstract Preparedness of residents in long-term care (LTC) in the face of hurricane emergencies is a contested and largely unanswered question. Our prior work involving the U.S. Gulf Coast hurricanes of 2005-08 showed that exposure to various storms on nursing home (NH) residents resulted in significantly more deaths than reported by health care officials. This work also highlighted that evacuation of NH residents, compared to sheltering in place, was independently associated with morbidity and mortality. Hurricane Irma struck Florida on Sept. 10, 2017, prompting the evacuation of thousands of NH and assisted living community (ALC) residents. This symposium will discuss the effects of Hurricane Irma on vulnerable older adults residing in NHs and ALCs using mixed quantitative and qualitative methodologies. The first presentation will discuss morbidity and mortality of NH residents exposed to Hurricane Irma and will stratify by long stay/short stay status and hospice enrollment. The second presentation will discuss improvements and continued barriers to NH preparedness based on interviews with 30 administrators following Hurricane Irma. Using a novel methodology to identify residents of ALCs using secondary data sources, the third presentation will document AL resident morbidity and mortality risk following Hurricane Irma. The final presentation will highlight results of interviews with 70 stakeholders from small and large ALCs concerning the hurricane experiences of residents, including those with dementia. This symposium offers a multi-faceted view of a disaster’s effects on LTC residents across Florida, including novel data from the NH environment and lesser-examined ALCs.

scholarly journals Major Disasters’ Impacts on Long-Term Care Settings, Vulnerable Older Adults, and Care Providers

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 201-201
Author(s):  
Leah Haverhals ◽  
Katie Cherry
Keyword(s):  
Older Adults ◽  
Assisted Living ◽  
Long Term Care ◽  
The United States ◽  
Care Providers ◽  
Term Care ◽  
The Us ◽  
The Impact ◽  
Hurricane Irma

Abstract The COVID-19 pandemic has disproportionately negatively affected older adults, and has specifically devasted older adults who are minorities and those who reside in long-term care (LTC) facilities. For professionals working in LTC facilities, major stressors and challenges due to the pandemic must be navigated, sometimes in parallel with the effect that major disasters like hurricanes can have on LTC facilities. This symposium will focus on the impact major disasters, including the COVID-19 pandemic and Hurricane Irma, had on LTC settings and those who live and work there, as well as older adults who are minorities and their communities. First, Dr. Roma Hanks will present findings from a study of community members and leaders in a majority African-American community in the United States (US) about their experiences with and challenges faced related to the pandemic. Second, Dr. Lisa Brown will share experiences and perceptions of mental health clinicians from across the US who worked in LTC settings before and during the pandemic. Third, Dr. Ella Cohn-Schwartz will describe how the pandemic impacted Holocaust survivors ages 75+ in Israel compared to older adults who did not experience the Holocaust. Fourth, Dr. Lindsay Peterson will present findings from interviews with nursing home and assisted living community representatives in the US regarding vulnerabilities LTC facilities experienced related to Hurricane Irma in 2017. As a whole, these presenters will provide insights into experiences of older adults, care providers, LTC facilities, and communities as they navigated challenges associated with the COVID-19 pandemic and a major hurricane.

scholarly journals EVACUATING OR SHELTERING IN PLACE DURING A DISASTER: HOW ASSISTED LIVING ADMINISTRATORS MAKE THE DECISION

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S699-S699
Author(s):  
Lindsay J Peterson ◽  
Kathryn Hyer ◽  
David Dosa ◽  
Joseph June ◽  
Debra J Dobbs ◽  
...  
Keyword(s):  
Assisted Living ◽  
Long Term Care ◽  
Lessons Learned ◽  
Structured Interviews ◽  
Term Care ◽  
Nursing Home Administrators ◽  
Axial Coding ◽  
Storm Characteristics ◽  
Hurricane Irma

Abstract The decision to evacuate or shelter in place during a natural disaster such as a hurricane is complicated and poses risks to long-term care residents. While research has documented the difficulty of the evacuation decision for nursing home administrators, little is known about how assisted living residence (ALR) administrators make this decision. This is a concern given the physical and cognitive impairment level of many ALR residents, the increasing number of ALRs in the U.S., and the frequency of natural disasters. The purpose of this paper was to explore the factors that influenced whether assisted living administrators evacuated their ALRs for Hurricane Irma, a large hurricane that made landfall on Florida’s Southwest coast in September, 2017. This qualitative study used semi-structured interviews and focus groups with ALR owners or administrative staff (N=60) with questions including how they prepared for Hurricane Irma, their experiences during the hurricane, including whether they evacuated or sheltered in place, and lessons learned. The sample includes small (< 25 beds) and large ALRs in the multiple Florida counties affected by the hurricane. A content analysis approach was used. Atlas.ti version 7 was used for initial and axial coding. Prevalent themes included “emergency management planning”, “logistics”, “pressure”, “storm characteristics,” and “staffing”. The results of this study have implications for long-term care policy and training, potentially leading to changes in how ALR leaders prepare for and respond to disasters to improve the safety of residents.

scholarly journals Satisfaction With Outdoor Activities Over Time Among Long-Term Services and Supports Recipients

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 189-190
Author(s):  
Justine Sefcik ◽  
Karen Hirschman ◽  
Darina Petrovsky ◽  
Liming Huang ◽  
Nancy Hodgson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Assisted Living ◽  
Term Care ◽  
Chronic Health ◽  
Outdoor Activities ◽  
Services And Supports ◽  
Over Time

Abstract Approximately 85% of older adults have at least one chronic health condition. The onset of chronic health conditions and mobility issues can constrain activities, including outdoor recreation. There is limited knowledge of older adults receiving long-term services and supports (LTSS) and their satisfaction with outdoor activities over time after enrolling in services. This study examined predictors of change in ratings of satisfaction with outdoor activities. A secondary analysis was conducted of data involving structured interviews with older adults (N=470) over the first two years of receiving LTSS (Health-Related Quality of Life: Elders in Long-Term Care; R01AG025524). Participants lived in assisted living communities, nursing homes, or their home. A single item on satisfaction with outdoor activities (assessed using a 5-point Likert scale: not at all to extremely satisfied) was the primary outcome. Mixed effects linear regression modeling using a backward elimination process was used for building a final multivariable model. In the final model, older age (p<0.001) and higher overall quality of life ratings (p<0.001) at baseline were associated with slower rates of increase in outdoor satisfaction over time. Higher education level (p=0.035) at baseline was associated with a faster rate of increase in outdoor satisfaction over time. Additionally, those who moved into an assisted living community (p=0.024) or nursing home (p=0.016) at baseline were associated with faster rates of increase in outdoor satisfaction over time compared to those in the home. Knowledge of factors influencing satisfaction with outdoor activities can assist interdisciplinary teams implement interventions for individual or organizational changes.

scholarly journals Maybe She’ll Make Some Friends?: Family Members Cultivating Intimacy in Assisted Living

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 486-487
Author(s):  
Andrea Fitzroy ◽  
Candace Kemp ◽  
Elisabeth Burgess
Keyword(s):  
Older Adults ◽  
Assisted Living ◽  
Intimate Relationships ◽  
Long Term Care ◽  
Participant Observation ◽  
Family Members ◽  
Later Life ◽  
Theory Approach ◽  
Term Care

Abstract Intimacy continues to be important in later life, including for older adults in long-term care settings such as assisted living (AL). Our past work shows that intimacy is a multi-dimensional process and can involve a variety of partners. Drawing on data from the qualitative longitudinal “Convoys of Care” study (R01AG044368), we extend this research to examine the role family members play in cultivating intimacy and close relationships of AL residents. Using a grounded theory approach, we analyzed 2,224 hours of participant observation, and formal interviews with 28 assisted living residents (aged 58-96) and their formal and informal care partners (n=114) from four diverse AL communities. Findings show that family members can play integral roles in residents’ experiences with intimacy, directly as relationship partners, and by facilitating or impeding residents’ contacts with others. Family members cultivated residents’ intimacy opportunities and experiences by direct engagement, resident advocacy, to non-involvement and disengagement. Family members’ roles in cultivating intimacy fluctuated over time, increasing at times of health concerns and family change. Perceptive family members considered older adults’ intimacy preferences when cultivating their intimate relationships. Family members concerned for the safety of their loved one sometimes acted as “gatekeepers” to intimacy by interfering in intimate relationships. We conclude with a discussion of implications for policy and practice aimed at improving the intimacy process and opportunities for older adults receiving long-term care.

scholarly journals ABUSE, NEGLECT, AND EXPLOITATION IN ASSISTED LIVING: AN EXAMINATION OF LONG-TERM CARE OMBUDSMAN COMPLAINT DATA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S477-S477
Author(s):  
Karen Magruder ◽  
Ling Xu ◽  
Noelle L Fields
Keyword(s):  
Assisted Living ◽  
Long Term Care ◽  
Elder Abuse ◽  
Secondary Data ◽  
Community Dwelling ◽  
Empirical Literature ◽  
Nursing Facilities ◽  
Term Care ◽  
Skilled Nursing

Abstract Adult Protective Services (APS) has seen cases of elder abuse increase recently and older adults living in long-term care facilities are subject to abuse, neglect and exploitation (ANE) at higher rates than community-dwelling seniors. However, there is scant empirical literature about ANE in assisted living (AL) settings and skilled nursing facilities (SNFs). The purpose of this study is to examine ANE complaints in AL and SNFs as recorded by Long-term Care Ombudsman Programs (LTCOPs) utilizing secondary data from a statewide database as well as an agency database used by staff ombudsmen who work in a large Metropolitan city in Texas. The sample included 140,497 complaints made at 1,940 licensed ALs with approximately 45,107 residents and 1,231 SNFs with 93,932 residents in Texas from 2010-2017. The percent of total complaints coded as ANE was higher in AL (2.01%) than in SNFs (1.46%) (p < .001). However, after controlling for number of residents, the rate of total ANE complaints per resident was higher (0.019) in SNF compared to AL (0.007) (z = -17.221, p <. 001). The incidence of financial exploitation was significantly higher in AL (23.46%) than in SNF (11.90%) (z = 5.582, p < .001). The percentage of verbal/psychological abuse in SNF (34.78%) was significantly higher than that in AL (23.4%) (z = -2.238, p < .05). Study findings contribute to the knowledge about the prevalence and nature of ANE in long-term care communities and bolster support for increased AL ombudsman presence, staff training, resident-centered care models, and AL oversight.

scholarly journals "You Just Forge Ahead”: The Continuing Challenges of Disaster Preparedness and Response in Long-term Care

2021 ◽  
Author(s):  
Lindsay J Peterson ◽  
Debra Dobbs ◽  
Joseph June ◽  
David M Dosa ◽  
Kathryn Hyer
Keyword(s):  
Nursing Homes ◽  
Assisted Living ◽  
Disaster Preparedness ◽  
Long Term Care ◽  
Ecological Model ◽  
Term Care ◽  
Staff Members ◽  
Design And Methods ◽  
Hurricane Irma

Abstract Background and Objectives Protecting nursing home and assisted living community residents during disasters continues to be a challenge. The present study explores the experiences of long-term care facilities in Florida that were exposed to Hurricane Irma in 2017. Research Design and Methods We used an abductive approach, combining induction and deduction. Interviews and focus groups beginning in May 2018 were conducted by telephone and in person with 89 administrative staff members representing 100 facilities (30 nursing homes and 70 assisted living communities). Analyses identified themes and subthemes. Findings were further analyzed using the social ecological model to better understand the preparedness and response of nursing homes and assisted living communities to Hurricane Irma. Results Three main themes were identified including: 1) importance of collaborative relationships in anticipating needs and planning to shelter in place or evacuate, 2) efforts required to maintain safety and stability during an unprecedented event, 3) effects, repercussions, and recommendations for change following the disaster. Discussion and Implications Preparing for and managing disasters in nursing homes and assisted living communities involves actions within multiple environments beyond the residents and facilities where they live. Among these, community-level relationships are critical.

scholarly journals Geospatial panorama of long-term care facilities in Brazil: a portrait of territorial inequalities

2021 ◽  
Vol 15 ◽  
Author(s):  
Tatiana Teixeira Barral de Lacerda ◽  
Ana Paula Miranda Neves ◽  
Giselle Layse Andrade Buarque ◽  
Denise Cuoghi de Carvalho Veríssimo Freitas ◽  
Mariana Medeiros Mota Tessarolo ◽  
...  
Keyword(s):  
Older Adults ◽  
Older People ◽  
Long Term Care ◽  
Secondary Data ◽  
Term Care ◽  
The North ◽  
Care Facilities ◽  
The Relationship ◽  
Different Sources

OBJECTIVES: To map the number and geospatial distribution of Brazilian long-term care facilities (LTCFs) for older adults. Additionally, we sought to highlight the relationship between these findings and the number of older people in the country’s 27 Federation Units, demonstrating the growth of these facilities in the last decade. METHODS: This is a descriptive observational study, using secondary data, which was performed in 3 stages: 1) searching and consolidating national and subnational data from different sources and mapping LTCFs; 2) preparing a geospatial map using Brazilian postal codes; and 3) triangulating the number of facilities and of older people in each state and all 5 Brazilian regions. RESULTS: We found 7029 LTCFs in the country, mostly in the Southeast and South regions: São Paulo, Minas Gerais and Rio Grande do Sul had the highest numbers of facilities while states in the North region represented only 1.12% of Brazilian LTCFs. Geospatial mapping highlighted that 64% of the 5 570 Brazilian municipalities did not have any LTCFs for older adults. CONCLUSIONS: We observed a large difference between Brazilian regions regarding the provision of long-term care.

scholarly journals Multiple Perspectives on Disaster Preparedness in Long-Term Care: From Heat to Hospice

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 285-285
Author(s):  
David Dosa ◽  
Ross Andel ◽  
Lisa Brown
Keyword(s):  
Disaster Preparedness ◽  
Long Term Care ◽  
Heat Exposure ◽  
Risk Groups ◽  
Morbidity And Mortality ◽  
Multiple Perspectives ◽  
Staffing Level ◽  
Term Care ◽  
Hurricane Irma

Abstract Preparedness of residents in long-term care (LTC) exposed to disasters continues to warrant concern. Prior work by our research team highlights explicit evidence of the profound vulnerability of Florida nursing home (NH) residents exposed to Hurricane Irma in 2017. This research adds to our knowledge of the profound effect of disasters on long term care residents. This symposium will utilize mixed methodologies to discuss the varied effects of Hurricane Irma on vulnerable older adults residing in Florida NHs and Assisted Living communities (ALCs). Using a novel methodology for identifying a cohort of ALC residents, the first presentation will present the morbidity and mortality effects of Hurricane Irma on Florida ALC residents and identify high risk groups by health condition. The second presentation will document the effect of Hurricane Irma on NH Residents previously enrolled in Hospice and expound on the effect of the disaster on hospice enrollment after the storm. The third presentation will present qualitative results of interviews with ALC administrators highlighting the effect of the storm on both large and small (<25 beds) facilities. The fourth presentation will address the issue of heat exposure in the days after Hurricane Irma and consider the preventative effect of generators on morbidity and mortality. Finally, a fifth presentation will examine NH staffing level variation in the days leading to the hurricane. To conclude, this symposium offers a multi-faceted view of a disaster’s effects on LTC residents across Florida, including novel data from the NH environment and lesser-examined ALCs.

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