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

Bell, Sue Anne; Krienke, Lydia; Dickey, Sarah; Vries, Raymond G. De

doi:10.1186/s12877-021-02159-0

Cited by 15 publications

(7 citation statements)

References 18 publications

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“…Providers tasked to fulfill these vacant roles, previously filled by caregivers, led to feelings of being overwhelmed, overworked, and subsequently burnt out [ 38 ]. These findings echo studies of home-based care after Hurricane Harvey, where participants described using informal channels of community support to provide post-hurricane recovery needs [ 8 , 15 , 18 , 27 ].…”

Section: Discussionsupporting

confidence: 67%

Barriers and facilitators to providing home-based care in a pandemic: policy and practice implications

et al. 2022

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Objective The purpose of this study is to describe the experiences of home-based care providers (HBCP) in providing care to older adults during the pandemic in order to inform future disaster planning, including during pandemics. Design Qualitative inquiry using an abductive analytic approach. Setting and participants Home-based care providers in COVID-19 hotspots. Methods Telephone interviews were conducted with 27 participants (administrators, registered nurses and other members of the allied healthcare team), who provided in-home care during the pandemic in Medicare-certified home health agencies. Interviews focused on eliciting experiences from HBCP on challenges and successes in providing home-based care to older adults, including barriers to care and strategies employed to keep patients, and providers, safe in their homes during the pandemic. Results Data was distilled into four major themes that have potential policy and practice impact. These included disrupted aging-in-place resources, preparedness actions contributing to readiness for the pandemic, limited adaptability in administrative needs during the pandemic and challenges with unclear messaging from public health officials. Conclusions Home-based care plays an essential role in maintaining the health of older adults in disaster contexts, including pandemics. Innovative solutions, informed by policy that generate evidence-based best practices to support HBCP are needed to reduce barriers and increase protective factors, in order to maintain continuity of care for this vulnerable population during disruptive events.

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Section: Discussionsupporting

confidence: 67%

Barriers and facilitators to providing home-based care in a pandemic: policy and practice implications

et al. 2022

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“…The issue of how to protect vulnerable people and reduce economic losses due to natural disasters is an important issue worldwide [35]. Although various disaster preparedness measures for the vulnerable older residents have been proposed [36][37][38], the preparedness for post-disaster care is largely ignored. New guidelines for the care of older residents during and after disasters incorporating the results of this study are needed.…”

Section: Discussionmentioning

confidence: 99%

Increased care-need in older long-term care insurance users after the 2018 Japan Floods: a retrospective cohort study based on the Japanese long-term care insurance claims

Ikeda

Yoshida

Okazaki

et al. 2023

Environ. Health Prev. Med.

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Background Level of care-need (LOC) is an indicator of elderly person’s disability level and is officially used to determine the care services provided in Japan’s long-term care insurance (LTCI) system. The 2018 Japan Floods, which struck western Japan in July 2018, were the country’s second largest water disaster. This study determined the extent to which the disaster affected the LOC of victims and compared it with that of non-victims. Methods This is a retrospective cohort study, based on the Japanese long-term care insurance claims from two months before (May 2018) to five months after the disaster (December 2018) in Hiroshima, Okayama, and Ehime prefectures, which were the most severely damaged areas in the country. A code indicating victim status, certified by a residential municipality, was used to distinguish between victims and non-victims. Those aged 64 years or younger, those who had the most severe LOC before the disaster, and those whose LOC increased even before the disaster were excluded. The primary endpoint was the augmentation of pre-disaster LOC after the disaster, which was evaluated using the survival time analysis. Age, gender, and type of care service were used as covariates. Results Of the total 193,723 participants, 1,407 (0.7%) were certified disaster victims. Five months after the disaster, 135 (9.6%) of victims and 14,817 (7.7%) of non-victims experienced the rise of LOC. The victim group was significantly more likely to experience an augmentation of LOC than the non-victim group (adjusted hazard ratio 1.24; 95% confidence interval 1.06–1.45). Conclusions Older people who were affected by the disaster needed more care than before and the degree of care-need increase was substantially more than non-victims. The result suggests that natural disasters generate more demand for care services among the older people, and incur more resources and cost for society than before. Supplementary information The online version contains supplementary material available at https://doi.org/10.1265/ehpm.22-00269 .

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“…In this study, we use an abductive analytic approach ( Bell et al, 2021 ), a method for analyzing data that combines inductive and deductive approaches allowing for the purposeful examination of a range of explanations, thereby reducing the likelihood of bias. The abductive approach allows for a creative inferential process aimed at producing new models based on study results ( Timmermans & Tavory, 2012 ).…”

Section: Methodsmentioning

confidence: 99%

“…The SEM has been adapted to study disaster vulnerability ( Thomas et al, 2013 ) and further, to study home-based care provided to older and disabled adults after the 2017 Hurricane Maria ( Haverhals et al, 2020 ) and long-term care services for veterans ( Haverhals, 2016 ). Bell and colleagues (2021) used an adaptation of the SEM to study home-based care provided to older adults after Hurricanes Harvey, in 2017, and Irma. The present research applied the SEM to an examination of the factors that may have influenced preparation for and response to Hurricane Irma in NHs and ALCs.…”

mentioning

confidence: 99%

“You Just Forge Ahead”: The Continuing Challenges of Disaster Preparedness and Response in Long-Term Care

Peterson

Dobbs

June

et al. 2021

Innovation in Aging

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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.

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

Cited by 15 publications

References 18 publications

Barriers and facilitators to providing home-based care in a pandemic: policy and practice implications

Barriers and facilitators to providing home-based care in a pandemic: policy and practice implications

Increased care-need in older long-term care insurance users after the 2018 Japan Floods: a retrospective cohort study based on the Japanese long-term care insurance claims

“You Just Forge Ahead”: The Continuing Challenges of Disaster Preparedness and Response in Long-Term Care

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