scholarly journals Helping Fill That Gap: Aging in Place After Disaster Through the Lens of Home-Based Care

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 248-248
Author(s):  
Sue Anne Bell ◽  
Lydia Krienke ◽  
Raymond DeVries ◽  
Theodore J Iwashyna
Keyword(s):  
Older Adults ◽  
Disaster Response ◽  
Care Delivery ◽  
Aging In Place ◽  
Community Support ◽  
Chronically Ill ◽  
Community Level ◽  
Care Providers ◽  
Home Based ◽  
Home Based Care

Abstract During a disaster, home-based care is intended to continue to function using existing care delivery models. Home-based care providers (HBCP) are often the closest contact with their clients—even during a disaster, seeing them in non-traditional care settings including shelters and hotels. This closeness and commitment to clients, gives HBCP unique insights into strategies to promote aging in place. The purpose of this study was to identify the individual and community-level support needs of older adults after a disaster through the lens of home-based care. Five focus groups were conducted with HBCP (n=27) in two disaster-affected settings: 2017’s Hurricane Irma in Florida and Hurricane Harvey in Texas. Participants were identified by contacting home health agencies listed in an open-source database of agencies receiving Centers for Medicare and Medicaid Services funding. Data was manually coded using an inductive approach and themes were iteratively identified. Forty-nine codes were identified in the preliminary analysis, which were distilled into ten themes describing factors that influence care provision during and after disasters: patient autonomy/dependence, disaster-induced trauma, reluctance to evacuate, chronic disease exacerbation, unpreparedness, systemic inequality, provider preparedness actions, strong sense of community, mistrust of governmental authority, and the uniqueness of the patient and home-based care provider relationship. The perspective offered by HBCP illustrates the complexities of community-level preparedness and informal community support for chronically ill older adults surrounding disasters. Diverse groups involved in aging and disaster response can learn from strategies employed by HBCP during disasters to improve aging in place.

scholarly journals “Helping fill that gap:” a qualitative study of aging in place after disaster through the lens of home-based care providers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sue Anne Bell ◽  
Lydia K. Krienke ◽  
Sarah Dickey ◽  
Raymond G. De Vries
Keyword(s):  
Older Adults ◽  
Large Scale ◽  
Care Delivery ◽  
Care Home ◽  
Recovery Period ◽  
Aging In Place ◽  
Qualitative Inquiry ◽  
Care Providers ◽  
Home Based ◽  
Home Based Care

Abstract Background During a disaster, home-based care fills the critical need for continuation of health care. Home-based care is intended to function using existing care delivery models, continuing to provide care for patients wherever they are located, including in shelters and hotels. Home-based care providers are often the closest in contact with their patients —seeing them in place, even throughout a disaster— through which they develop a unique insight into aging in place during a disaster. The purpose of this study was to identify individual and community-level support needs of older adults after a disaster through the lens of home-based care providers. Methods Using qualitative inquiry, five focus groups were conducted with home-based care providers (n = 25) who provided in-home care during Hurricane Irma and Hurricane Harvey. Participants were identified by contacting home health agencies listed in an open-source database of agencies participating in Centers for Medicare and Medicaid Services programs. Data were coded using an abductive analytic approach, and larger themes were generated in light of existing theory. Results The results were distilled into eight themes that related to the importance of community and family, informal and formal supports throughout the disaster management cycle, maintaining autonomy during a disaster, and institutional and systemic barriers to obtaining assistance. Conclusions In this study, home-based care providers described the challenges aging adults face in the response and recovery period after a large-scale disaster including maintaining continuity of care, encouraging individual preparedness, and accessing complex governmental support. Listening to home-based care providers offers new and important insights for developing interventions to address social and health needs for older adults aging in place after a large-scale disaster.

scholarly journals “You get three different hats on and try to figure it out:” home based care provision during a disaster

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Sue Anne Bell ◽  
Sarah Dickey ◽  
Marie-Anne Rosemberg
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Focus Groups ◽  
Home Health ◽  
Care Provision ◽  
Care Providers ◽  
Home Based ◽  
Health Agencies ◽  
Home Health Agencies ◽  
Home Based Care

Abstract Background Home based care is a vital, and growing, part of the health care system that allows individuals to remain in their homes while still receiving health care. During a disaster, when normal health care systems are disrupted, home based care remains a vital source of support for older adults. The purpose of this paper is to qualitatively understand the barriers and facilitators of both patients and providers that influence the provision of home based care activities in two hurricane affected communities. Methods Using qualitative inquiry informed by the social ecological model, five focus groups were conducted with home based care providers (n = 25) in two settings affected by Hurricane Irma and Hurricane Harvey. An open-source database of home health agencies participating in Centers for Medicare and Medicaid Services programs was used to identify participants. Data were manually coded and larger themes were generated from recurring ideas and concepts using an abductive analysis approach. Results Twenty five participants were included in one of five focus groups. Of the 22 who responded to the demographic survey, 65 % were registered nurses, 20 % were Licensed Vocational Nurses (LVN), and 15 % were other types of health care providers. 12 % of the sample was male and 88 % was female. Five themes were identified in the analysis: barriers to implementing preparedness plans, adaptability of home based care providers, disasters exacerbate inequalities, perceived unreliability of government and corporations, and the balance between caring for self and family and caring for patients. Conclusions This study provides qualitative evidence on the factors that influence home based care provision in disaster-affected communities, including the barriers and facilitators faced by both patients and providers in preparing for, responding to and recovering from a disaster. While home based care providers faced multiple challenges to providing care during and after a disaster, the importance of community supports and holistic models of care in the immediate period after the disaster were emphasized. We recommend greater inclusion of home health agencies in the community planning process. This study informs the growing body of evidence on the value of home based care in promoting safety and well-being for older adults during a disaster.

scholarly journals “You Get Three Different Hats on and Try to Figure It Out:” Home-based Care Provision During a Disaster

2021 ◽  
Author(s):  
Sue Anne Bell ◽  
Sarah Dickey ◽  
Marie-Anne Rosemberg
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Focus Groups ◽  
Health Care Providers ◽  
Well Being ◽  
Home Health ◽  
Qualitative Inquiry ◽  
Care Providers ◽  
Home Based ◽  
Home Based Care

Abstract Background: Home-based care is a vital, and growing, part of the health care system that allows individuals to remain in their homes while still receiving health care. During a disaster, when normal health care systems are disrupted, home-based care remains a vital source of support for older adults. The purpose of this study was to describe the experiences of home-based care providers in providing care to older adults during a disaster in order to inform future disaster planning.Methods: Using qualitative inquiry informed by the social ecological model, five focus groups were conducted with home health nurses (n=25) in two settings affected by Hurricane Irma and Hurricane Harvey. An open-source database of home health agencies participating in Centers for Medicare and Medicaid Services programs was used to identify participants. Data were manually coded and larger themes were generated from recurring ideas and concepts using an abductive analysis approach. Results: Twenty five participants were included in one of five focus groups. Of the 22 who responded to the demographic survey, 65% were registered nurses, 20% were Licensed Vocational Nurses (LVN), and 15% were other types of health care providers. 12% of the sample was male and 88% was female. Seven themes were identified in the analysis: the importance of the community in preparedness and response, government and corporations were viewed as unreliable, disasters exacerbate inequalities, the role of the family bond, the breakdown of preparedness is at implementation, the tension between caring for self and family and caring for patients, and the resilience and adaptability of home based care providers.Conclusions: While home-based care providers faced multiple challenges to providing care during and after a disaster, the importance of community supports and existing nursing models of care in the immediate period after the disaster were emphasized. This study informs the growing body of evidence on the value of home-based care in promoting safety and well-being for older adults during a disaster.

Provision of the Continuum of Care to Noncommunicable Diseases Post-Floods in Kerala, India 2018

2021 ◽  
pp. 1-4
Author(s):  
Parasuraman Ganeshkumar ◽  
Rontgen Saigal ◽  
Bipin Gopal ◽  
Hari Shankar ◽  
Prabhdeep Kaur
Keyword(s):  
Disaster Response ◽  
Care Delivery ◽  
Treatment Protocol ◽  
Continuum Of Care ◽  
The State ◽  
Noncommunicable Disease ◽  
World Health ◽  
Guidance Document ◽  
Care Providers ◽  
The Continuum

Abstract Integrating noncommunicable disease (NCD) in health care delivery during emergency response posed a major challenge post-floods in Kerala. Kerala experienced an abnormally high rainfall during mid-2018 where more than 400 people lost their lives. State health officials and the Disaster Response Team were sensitized about the importance of including NCDs in the response action. More than 80% of patients with hypertension and diabetes were not under control in Kerala. Under the state NCD cell, an NCD expert group was consulted for drafting the treatment and referral strategies. Steps to tackle NCDs during the disaster response were formulated. The state NCD cell decided to integrate NCDs in the response measures. The technical guidance document by the World Health Organization South-East Asia Region was consulted to formulate actions. The activities were implemented in 6 steps: prioritizing of major NCDS, patient estimation and drug stock preparation, standard treatment protocol, mapping of referral facilities, public engagement, and daily reporting of NCD consultations. Prioritizing the continuum of care of NCDs during floods among the program managers and care providers was crucial. The health education and communication campaign was done to sensitize the known NCD patients to seek early care. Daily reporting of consultations was established.

scholarly journals Islamic-based Disaster Response Competencies: Perceptions, Roles and Barriers Perceived by Nurses in Aceh, Indonesia

2021 ◽  
Vol 15 (1) ◽  
pp. 18-28
Author(s):  
Cut Husna ◽  
Mustanir Yahya ◽  
Hajjul Kamil ◽  
Teuku Tahlil
Keyword(s):  
Disaster Response ◽  
Care Delivery ◽  
Group Discussion ◽  
Family Engagement ◽  
Care Providers ◽  
The Pacific ◽  
Referral Hospitals ◽  
Spiritual Problems ◽  
Islamic Values ◽  
Banda Aceh

Introduction: Indonesia, being a part of the Pacific “ring of fire,” is prone to disasters. Several disasters occurred from 2004 to 2019, which resulted in the loss of many lives. These disasters impacted the physical, psychological, psychosocial, and spiritual conditions of survivors. Nurses are the frontline care providers who need adequate competencies to respond to disasters. Objective: This study aimed to explore the nurses’ perception of disaster, roles, barriers, and Islamic-based nurses’ competencies in managing psychological, psychosocial, and spiritual problems due to disasters in hospital settings. Methods: This is a qualitative study conducted in three large referral hospitals in Banda Aceh, Indonesia. Focus group discussion was conducted on 24 nurses from three hospitals using the discussion guide consisting of five open-ended questions. The data was analyzed through inductive content analysis. Results: The study found four themes of Islamic nurses’ competencies in disaster response: 1) perception about the disaster is influenced by religiosity, belief, and values, 2) communication skills, 3) nurses’ roles in disaster response consisted of disaster competencies (the use of Islamic values in managing patients’ conditions, and family engagement, 4) competency barriers consisted of inadequate training, insufficient Islamic-based services, and inadequate involvement of policymakers. This study explored Islamic nurses’ competencies in disaster response related perceptions about the disaster, nurses’ roles, and barriers. The limitation and future of the study were also discussed. Conclusion: Perceptions, roles, and barriers in disaster response might influence the development of the Islamic-based nurses’ competencies in care delivery.

SOCIAL ENGAGEMENT OF FRAIL ELDERS

2012 ◽  
pp. 1-6
Author(s):  
A. BARUSCH ◽  
D.L. WATERS
Keyword(s):  
Older Adults ◽  
Self Efficacy ◽  
Social Engagement ◽  
Functional Independence ◽  
Personal Attributes ◽  
Social Activities ◽  
Cross Sectional ◽  
Frail Older Adults ◽  
Home Based ◽  
Home Based Care

Background:Social isolation is a significant problem for frail older adults and the determinants ofsocial engagement are poorly understood. Objectives:This study explored the social engagement of frail eldersto identify personal attributes associated with social engagement. Design, Setting and Participants:A cross-sectional sample of seventy-three people receiving home-based care in one town on the South Island of NewZealand (mean age 82 (7.2) yrs, n=51 Females, 21 Males). Measurements:Face-to-face semi-structuredinterviews and questionnaires. Functional independence was measured using Nottingham Extended Activities ofDaily Living (EADL), self-efficacy by General Self Efficacy Scale, and 2 open-ended questions were piloted onsocial activities and helping others. Results:Regression models identified two statistically associatedcomponents of social engagement: social activities and civic involvement. Contributions to families andcommunity organizations and exercise were important social activities. Personal attributes included perceivedfunctional independence and self-efficacy. Conclusions:In frail older adults, a measurement of socialengagement should address activities older adults identify as important, including exercise. Independence, self -efficacy, and social engagement may interact in reinforcing cycles of empowerment and could play a role indeveloping interventions to retain and maintain function in frail older adults.

scholarly journals Improvements of Disability Outcomes in CAPABLE Older Adults Differ by Financial Strain Status

2020 ◽  
pp. 073346482097555
Author(s):  
Minhui Liu ◽  
Qian-Li Xue ◽  
Laura Samuel ◽  
Laura N. Gitlin ◽  
Jack Guralnik ◽  
...  
Keyword(s):  
Older Adults ◽  
Low Income ◽  
Daily Living ◽  
Aging In Place ◽  
Low Energy ◽  
Attention Control ◽  
Financial Strain ◽  
Home Based ◽  
Home Based Intervention ◽  
Strain Status

The Community Aging in Place–Advancing Better Living for Elders (CAPABLE) program reduces disability in low-income older adults. In this study, we used CAPABLE baseline and 5-month data to examine whether its effects in reducing activities of daily living (ADLs) and instrumental ADLs (IADLs) difficulties differed by participants’ financial strain status. At baseline, participants with financial strain were more likely to report higher scores on depression ( p < .001), have low energy ( p < .001), and usually feel tired ( p = .004) compared with participants without financial strain, but did not differ in ADL/IADL scores. Participants with financial strain benefited from the program in reducing ADL (relative risk [RR]: 0.61, 95% confidence interval [CI]: 0.43, 0.86) and IADL disabilities (RR: 0.69, 95% CI: 0.54, 0.87), compared with those with financial strain receiving attention control. Individuals with financial strain benefited more from a home-based intervention on measures of disability than those without financial strain. Interventions that improve disability may be beneficial for financially strained older adults.

scholarly journals Home-Based Care for People with Alzheimer’s Disease and Related Dementias (ADRD) during COVID-19 Pandemic: From Challenges to Solutions

2020 ◽  
Vol 17 (24) ◽  
pp. 9303
Author(s):  
Atiqur sm-Rahman ◽  
Chih Hung Lo ◽  
Azra Ramic ◽  
Yasmin Jahan
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Supporting Evidence ◽  
Psychological Issues ◽  
Home Based ◽  
The Social ◽  
Novel Coronavirus ◽  
Home Based Care ◽  
The Impact

There has been supporting evidence that older adults with underlying health conditions form the majority of the fatal cases in the current novel coronavirus disease (COVID-19) pandemic. While the impact of COVID-19 is affecting the general public, it is clear that these distressful experiences will be magnified in older adults, particularly people living with Alzheimer’s disease and related dementia (ADRD), making them the most vulnerable group during this time. People with differing degrees of ADRD are especially susceptible to the virus, not only because of their difficulties in assessing the threat or remembering the safety measures, but also because of the likelihood to be subject to other risk factors, such as lack of proper care and psychological issues. Therefore, in this article, we will discuss the challenges related to home-based care for people with ADRD during a pandemic and propose a formulation of systematic solutions to address these challenges and to alleviate the social and economic impact resulting from the crisis.

scholarly journals A Pilot Study to Test the Feasibility of a Home Mobility Monitoring System in Community-Dwelling Older Adults

2019 ◽  
Vol 16 (9) ◽  
pp. 1512 ◽  
Author(s):  
Heesook Son ◽  
Hyerang Kim
Keyword(s):  
Older Adults ◽  
Monitoring System ◽  
Health Care Providers ◽  
Community Dwelling ◽  
Care Providers ◽  
Remote Communication ◽  
Baseline Activity ◽  
Home Based ◽  
Health Related ◽  
Community Dwelling Older Adults

Technology enables home-based personalized care through continuous, automated, real-time monitoring of a participant’s health condition and remote communication between health care providers and participants. Technology has been implemented in a variety of nursing practices. However, little is known about the use of home mobility monitoring systems in visiting nursing practice. Therefore, the current study tested the feasibility of a home mobility monitoring system as a supportive tool for monitoring daily activities in community-dwelling older adults. Daily mobility data were collected for 15 months via home-based mobility monitoring sensors among eight older adults living alone. Indoor sensor outputs were categorized into sleeping, indoor activities, and going out. Atypical patterns were identified with reference to baseline activity. Daily indoor activities were clearly differentiated by sensor outputs and sensor outputs discriminated atypical activity patterns. During the year of monitoring, a health-related issue was identified in a participant. Our findings indicate the feasibility of a home mobility monitoring system for remote, continuous, and automated assessment of a participant’s health-related mobility patterns. Such a system could be used as a supportive tool to detect and intervene in the case of problematic health issues.

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