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.

Hospice Attitudes among Assisted Living and Nursing Home Administrators, and the Long-Term Care Hospice Attitudes Scale

2006 ◽  
Vol 9 (6) ◽  
pp. 1388-1400 ◽  
Author(s):  
Debra Jean Dobbs ◽  
Laura Hanson ◽  
Sheryl Zimmerman ◽  
Christianna S. Williams ◽  
Jean Munn
Keyword(s):  
Nursing Home ◽  
Assisted Living ◽  
Long Term Care ◽  
Term Care ◽  
Nursing Home Administrators

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 Coronavirus Disease 2019 Regulatory Response in United States-Assisted Living Communities: Lessons Learned

2021 ◽  
Vol 9 ◽  
Author(s):  
Sarah Dys ◽  
Jaclyn Winfree ◽  
Paula Carder ◽  
Sheryl Zimmerman ◽  
Kali S. Thomas
Keyword(s):  
Older Adults ◽  
Assisted Living ◽  
Long Term Care ◽  
Well Being ◽  
Unintended Consequences ◽  
Lessons Learned ◽  
Social Model ◽  
Health Priorities ◽  
Term Care

Coronavirus disease 2019 (COVID-19) has disproportionately affected residents, their families, staff, and operators of congregate care settings. Assisted living (AL) is a type of long-term care setting for older adults who need supportive care but not ongoing nursing care and emphasizes a social model of care provision. Because AL is a type of long-term care, it has at times been referenced along with nursing homes in discussions related to COVID-19 but not recognized for its different care practices that pose unique challenges related to COVID-19; in that manner, it has largely been left out of the COVID-19 discourse, although ~812,000 older adults live in AL. To identify COVID-19 issues specific to AL, stakeholders with expertise in AL operations, policy, practice, and research (n = 42) were recruited to participate in remote interviews between July and September 2020. Using a thematic analysis, we derived the following overarching themes: (1) Policymakers are disconnected from and lack an understanding of the AL context; (2) AL administrators were left to coordinate, communicate, and implement constantly changing guidelines with little support; (3) AL organizations faced limited knowledge of and disparate access to funding and resources; (4) state-level regulatory requirements conflicted with COVID-19 guidelines resulting in uncertainty about which rules to follow; and (5) AL operators struggled to balance public health priorities with promoting their residents' quality of life and well-being. To develop evidence-informed policy and avoid unintended consequences, AL operators, direct care workers, residents, and clinicians practicing in these settings should have opportunities to provide feedback throughout the policy development process, both state and national.

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 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.

Evaluating and Motivating Activation in Long Term Care: Lessons From a Pilot Study

2021 ◽  
Vol 10 (1) ◽  
pp. 42-46
Author(s):  
J. Jbilou ◽  
A. El Bouazaoui ◽  
B. Zhang ◽  
J.L. Henry ◽  
L McDonald ◽  
...  
Keyword(s):  
Long Term Care ◽  
Driving Simulator ◽  
Care Home ◽  
Lessons Learned ◽  
Term Care ◽  
Care Facilities ◽  
Technological Intervention ◽  
The Impact ◽  
Research Recommendations

Older adults living in long-term care facilities typically receive insufficient exercise and have long periods of the day when they are not doing anything other than sitting or lying down, watching television, or ruminating (Wilkinson et al., 2017). We developed an intervention called the Experiential Centivizer, which provides residents with opportunities to use a driving simulator, watch world travel videos, and engage in exercise. We assessed the impact of the intervention on residents of a long-term care home in Fredericton, NB, Canada. In this paper, we report on the results observed and highlight the lessons learned from implementing a technological intervention within a long-term care setting. Practical and research recommendations are also discussed to facilitate future intervention implementation in long-term care.

scholarly journals Evaluating the integration of palliative care in national health systems: an indicator rating process with EAPC task force members to measure advanced palliative care development

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Natalia Arias-Casais ◽  
Eduardo Garralda ◽  
Miguel Antonio Sánchez-Cárdenas ◽  
John Y. Rhee ◽  
Carlos Centeno
Keyword(s):  
Primary Care ◽  
Palliative Care ◽  
Long Term Care ◽  
Task Force ◽  
National Level ◽  
Structured Interviews ◽  
Term Care ◽  
Care Facilities ◽  
Rating Process

Abstract Background Palliative care (PC) development cannot only be assessed from a specialized provision perspective. Recently, PC integration into other health systems has been identified as a component of specialized development. Yet, there is a lack of indicators to assess PC integration for pediatrics, long-term care facilities, primary care, volunteering and cardiology. Aim To identify and design indicators capable of exploring national-level integration of PC into the areas mentioned above. Methods A process composed of a desk literature review, consultation and semi-structured interviews with EAPC task force members and a rating process was performed to create a list of indicators for the assessment of PC integration into pediatrics, long-term care facilities, primary care, cardiology, and volunteering. The new indicators were mapped onto the four domains of the WHO Public Health Strategy. Results The literature review identified experts with whom 11 semi-structured interviews were conducted. A total of 34 new indicators were identified for national-level monitoring of palliative care integration. Ten were for pediatrics, five for primary care, six for long-term care facilities, seven for volunteering, and six for cardiology. All indicators mapped onto the WHO domains of policy and education while only pediatrics had an indicator that mapped onto the domain of services. No indicators mapped onto the domain of use of medicines. Conclusion Meaningful contributions are being made in Europe towards the integration of PC into the explored fields. These efforts should be assessed in future regional mapping studies using indicators to deliver a more complete picture of PC development.

A Comparison of Wandering Behavior in Nursing Homes and Assisted Living Facilities

2005 ◽  
Vol 19 (2) ◽  
pp. 181-196 ◽  
Author(s):  
Elizabeth R. A. Beattie ◽  
JunAh Song ◽  
Shane LaGore
Keyword(s):  
Nursing Homes ◽  
Assisted Living ◽  
Challenging Behavior ◽  
Long Term Care ◽  
Assisted Living Facilities ◽  
Term Care ◽  
Training Requirements ◽  
Care Facilities ◽  
Staffing And Training

Wandering, a challenging behavior associated with dementia, affects many residents of long-term care facilities and can result in elopement, injury, and death. Most studies of wandering have taken place in nursing homes (NH). Expansion of the long-term care sector over the last 2 decades has resulted in a surge in options such as assisted living facilities (ALF). This study compared wandering behavior of residents (N = 108) in 21 long-term care facilities (15 NH, 6 ALF). Staff used the Revised Algase Wandering Scale-Nursing Home Version (RAWS-NH) to quantify wandering. While there were some differences in demographic variables (i.e., race, motor ability) between NH and ALF participants, no significant differences were found in either RAWS-NH overall or any of the 6 subscale scores. This suggests that the expression of wandering is similar in long-term care residents across all dimensions of the RAWS-NH regardless of facility type. Findings are of concern for those involved in the safe management and protection of residents at risk for wandering, particularly in long-term care facilities with underregulated staffing and training requirements.

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