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.

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 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.

Community Long Term Care Ombudsman Program Disaster Assistance: Ready, Willing or Able?

2020 ◽  
Vol 17 (2) ◽  
Author(s):  
H. Wayne Nelson ◽  
Bo Kyum Yang ◽  
F. Ellen Netting ◽  
Erin Monahan
Keyword(s):  
Hurricane Katrina ◽  
Disaster Preparedness ◽  
Long Term Care ◽  
Disaster Mitigation ◽  
Term Care ◽  
Disaster Assistance ◽  
Disaster Experience ◽  
Public Crisis ◽  
Disaster Training

AbstractThe high elder care death toll of Hurricane Katrina in 2005, pushed the federally mandated Long-Term Care Ombudsman Program (LTCOP) into the unsought and unforeseen realm of disaster preparedness. This new role was an extension of the LTCOP’s historic resident’s rights investigative case advocacy. To assess if, how, and to what extent local ombudsmen adapted to this new function, 102 local LTCOP leaders completed a telephone survey based on the CMS Emergency Planning Checklist. This assessed their own and their programs’: (a) readiness to help facilities reduce disaster threats to residents, (b) familiarity with relevant disaster laws, rules, and resources; (c) readiness to help residents through the disaster cycle; and (d) levels of disaster training and/or their plans to provide such training to their staff and LTC stakeholders. Forty-two respondents (41.13%) had experienced a public disaster but over half or those responding (n = 56, 54.90%) felt fairly to somewhat prepared to help in a public crisis. After being ready to work away from their office during a crisis ($\overline{x}$ = 4.14, SD = 1.00) respondents felt most prepared “to assist during nursing home emergency closure and evacuation” ($\overline{x}$ = 3.86, SD = 1.09). t-tests revealed that respondents with a disaster experience were significantly more prepared in all assessed dimensions than as those without disaster experience. The study highlights the training needs of ombudsmen in high risk areas to better prepare them for disaster mitigation in nursing homes.

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.

State Long-Term Care Ombudsmen’s Perceptions of Their Program’s Disaster Preparedness Roles and Readiness

2012 ◽  
Vol 32 (8) ◽  
pp. 952-974 ◽  
Author(s):  
H. Wayne Nelson ◽  
Daniel Agley ◽  
F. Ellen Netting ◽  
Kevin W. Borders ◽  
Ruth Huber
Keyword(s):  
Disaster Preparedness ◽  
Long Term Care ◽  
Term Care

Long-term care and disaster preparedness: A study of organizational types and levels of preparedness for a disaster or emergency

2011 ◽  
Vol 9 (2) ◽  
pp. 39 ◽  
Author(s):  
Saher Selod, MA ◽  
Janice Heineman, PhD ◽  
Catherine O’Brien, MPH, MA ◽  
Scott P. King, PhD
Keyword(s):  
Cluster Analysis ◽  
Hurricane Katrina ◽  
Disaster Preparedness ◽  
Urban Areas ◽  
Long Term Care ◽  
Disaster Plan ◽  
Term Care ◽  
Preparedness Planning ◽  
Demographic Survey

Objectives: Although the consequences of Hurricane Katrina motivated considerable research into long-term care (LTC) facility preparedness, many questions still remain. This study examines the characteristics of LTC facility in relation to the level of preparedness to discern whether there are patterns that can inform future planning efforts. The data from PREPARE, a federally funded disaster preparedness program for LTC staff, are used in the analysis.Methods: More than 400 PREPARE participants completed both baseline and impact surveys as well as a demographic survey, allowing for an analysis of the characteristics and levels of disaster preparedness among participating LTC facilities. Crosstabs were run for the baseline and impact surveys against the demographic survey that the participants completed. Cluster analysis was performed to fit organizations into distinct groups based on their baseline responses to key preparedness domains.Results: The results of the crosstabs reveal the specific areas where LTC facilities have a more comprehensive disaster plan. For example, skilled nursing facilities appear to be more prepared than continuing care retirement communities (CCRCs); rural facilities seem to be more prepared than urban facilities; and facilities that are part of a chain did not emerge as being better equipped than independent facilities. Cluster analysis found three groups of organizations: “Resourceful but Hesitant,” “Unprepared,” and “Model Preparedness.”Conclusions: These findings have important implications for public health efforts surrounding disaster preparedness in LTC. The findings suggest that CCRCs deserve special attention in preparedness planning and that consideration in disaster planning is required in both rural and urban areas.

scholarly journals Disaster Preparedness Among Older Japanese Adults With Long-Term Care Needs and Their Family Caregivers

2016 ◽  
Vol 11 (1) ◽  
pp. 31-38 ◽  
Author(s):  
Tomoko Wakui ◽  
Emily M. Agree ◽  
Tami Saito ◽  
Ichiro Kai
Keyword(s):  
Older Adults ◽  
Family Caregivers ◽  
Disaster Preparedness ◽  
Long Term Care ◽  
Community Support ◽  
The United States ◽  
Great East Japan Earthquake ◽  
Care Needs ◽  
Term Care

AbstractObjectiveIn the 2011 Great East Japan Earthquake, as in Hurricanes Katrina and Rita in the United States, older individuals were at the greatest risk of mortality. Much concern has been raised about developing plans to reduce these risks, but little information has been provided about preparedness, and the key role played by caregivers has been largely unexplored. The aims of this study were thus to examine the preparedness of family caregivers of older adults with long-term care needs and to identify the characteristics of older adults and their caregivers that are associated with poor preparedness and greater concern about disasters.MethodsShortly after the Great East Japan Earthquake, the second wave of the Fukui Longitudinal Caregiver Study was administered to the family caregivers of older Japanese individuals with long-term care needs. The sample included 952 caregivers from 17 municipalities in Fukui prefecture. Logistic regression analyses were used to identify the factors associated with self-assessed preparedness, evacuation planning, and caregivers’ concerns about preparedness.ResultsThe majority (75%) of the caregivers had no concrete plans for evacuation in an emergency, and those caring for persons with dementia were 36% less likely to have any plan. In multivariate models, caregivers who were more experienced and wealthier and who reported more family and community support were more likely to feel well prepared. Caregivers with poor health or limited financial resources or who were responsible for older persons with mobility difficulties reported higher levels of anxiety about their disaster preparedness.ConclusionsThis study indicates that most caregivers are ill prepared to respond in emergencies and that caregiver resources, community support, and the needs of older care recipients influence both preparedness and concern about disasters. Education for caregivers and the development of community support programs could provide important sources of assistance to this vulnerable group. (Disaster Med Public Health Preparedness. 2017;11:31–38)

scholarly journals Improving Long-Term Care Facility Disaster Preparedness and Response: A Literature Review

2016 ◽  
Vol 11 (1) ◽  
pp. 140-149 ◽  
Author(s):  
J. Rush Pierce ◽  
Sarah K. Morley ◽  
Theresa A. West ◽  
Percy Pentecost ◽  
Lori A. Upton ◽  
...  
Keyword(s):  
Disaster Preparedness ◽  
Disaster Response ◽  
Long Term Care ◽  
Care Facility ◽  
Disaster Planning ◽  
Patient Characteristics ◽  
Careful Consideration ◽  
Term Care ◽  
Medical Needs

AbstractLong-term care facilities (LTCFs) and their residents are especially susceptible to disruptions associated with natural disasters and often have limited experience and resources for disaster planning and response. Previous reports have offered disaster planning and response recommendations. We could not find a comprehensive review of studied interventions or facility attributes that affect disaster outcomes in LTCFs and their residents. We reviewed articles published from 1974 through September 30, 2015, that studied disaster characteristics, facility characteristics, patient characteristics, or an intervention that affected outcomes for LTCFs experiencing or preparing for a disaster. Twenty-one articles were included in the review. All of the articles fell into 1 of the following categories: facility or disaster characteristics that predicted preparedness or response, interventions to improve preparedness, and health effects of disaster response, most often related to facility evacuation. All of the articles described observational studies that were heterogeneous in design and metrics. We believe that the evidence-based literature supports 6 specific recommendations for facilities, governmental agencies, health care communities and academia. These include integrated and coordinated disaster planning, staff training, careful consideration before governments order mandatory evacuations, anticipation of the increased medical needs of LTCF residents following a disaster, and the need for more outcomes research. (Disaster Med Public Health Preparedness. 2017;11:140–149)

A Comparison of Emergency Preparedness Policies by Long-Term Care Setting Type in Ohio: Assisted Living Settings Lag Behind Nursing Homes in Key Areas

2020 ◽  
pp. 073346482090201
Author(s):  
Katherine A. Kennedy ◽  
Cassandra L. Hua ◽  
Ian Nelson
Keyword(s):  
Assisted Living ◽  
Emergency Preparedness ◽  
Disaster Preparedness ◽  
Long Term Care ◽  
Nursing Facilities ◽  
Community Based ◽  
Term Care ◽  
Skilled Nursing ◽  
Care Facilities

Skilled nursing facilities (SNFs) have received regulatory attention in relation to their emergency preparedness. Yet, assisted living settings (ALs) have not experienced such interest due to their classification as a state-regulated, home- and community-based service. However, the growth in the number of ALs and increased resident acuity levels suggest that existing disaster preparedness policies, and therefore, plans, lag behind those of SNFs. We examined differences in emergency preparedness policies between Ohio’s SNFs and ALs. Data were drawn from the 2015 wave of the Ohio Biennial Survey of Long-Term Care Facilities. Across setting types, most aspects of preparedness were similar, such as written plans, specifications for evacuation, emergency drills, communication procedures, and preparations for expected hazards. Despite these similarities, we found SNFs were more prepared than large ALs in some key areas, most notably being more likely to have a backup generator and 7 days of pharmacy stocks and generator fuel.

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