Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-26T05:24:47.911Z Has data issue: false hasContentIssue false
  • English
  • Français

Vulnerability of Urban Homebound Older Adults in Disasters: A Survey of Evacuation Preparedness

Published online by Cambridge University Press:  24 April 2015

Patrick J. Dostal Open the ORCID record for Patrick J. Dostal [Opens in a new window]
Patrick J. Dostal*
Affiliation:
Master of Public Health Program and Division of Geriatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
*
Correspondence and research requests to Patrick J. Dostal, MD, MPH, 100 E Lancaster Ave, Wynnewood, PA 19096 (e-mail: DostalP@MLHS.org).
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

Recent disasters within the United States, such as Hurricanes Katrina and Sandy, have highlighted the vulnerability of older adults, and recent litigation has upheld the responsibility of government in assisting the public during mandatory evacuations. Older adults designated as homebound due to their disabilities are at greatest risk of poor outcomes in disasters. This study aimed at assessing the willingness and ability of homebound older adults to evacuate, as well as categorizing their medical needs in the event they are relocated to an emergency shelter.

Methods

Fifty-six homebound older adults and medical decision surrogates from 1 homebound primary care practice in Philadelphia were assessed with a novel structured interview.

Results

Respondents reported limitations in both their ability and their willingness to evacuate their neighborhoods. Medical needs of homebound older adults were on par with those of nursing home residents.

Conclusions

Many homebound older adults are unable or unwilling to evacuate in a mandatory evacuation situation, highlighting a need for public assistance. Their complex medical needs will require significant preparation by special needs shelters. (Disaster Med Public Health Preparedness. 2015;9:301-306)

Keywords

disaster planningemergency preparednessvulnerable populations
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 9 , Issue 3 , June 2015 , pp. 301 - 306
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Administration on Aging (AOA). A profile of older Americans: 2012. AOA website. http://www.aoa.gov/Aging_Statistics/Profile/2012/docs/2012profile.pdf. Accessed February 4, 2014.Google Scholar
2. McGuire, LC, Ford, ES, Okoro, CA. Natural disasters and older US adults with disabilities: implications for evacuation. Disasters. 2007;31(1):49-56.Google Scholar
3. Luppa, M, Luck, T, Weyerer, S, et al. Prediction of institutionalization in the elderly. A systematic review. Age Ageing. 2010;39(1):31-38.Google Scholar
4. Murtaugh, C, Peng, T, Totten, A, et al. Complexity in geriatric home healthcare. J Healthc Qual. 2009;31(2):34-43.Google Scholar
5. Qiu, WQ, Dean, M, Liu, T, et al. Physical and mental health of homebound older adults: an overlooked population. J Am Geriatr Soc. 2010;58(12):2423-2428.Google Scholar
6. Knickman, JR, Snell, EK. The 2030 problem: caring for aging baby boomers. Health Serv Res. 2002;37(4):849-884.Google Scholar
7. Disaster Relief Act Amendments of 1974, Public Law 93-288 (22 May 1974), Title II, Disaster Preparedness Administration, and Title III, Disaster Assistance Administration, US Statutes at Large 88 (1974):144-146.Google Scholar
8. Americans with Disabilities Act (ADA), http://www.ada.gov/pubs/adastatute08.htm. Accessed February 4, 2014.Google Scholar
9. Smith, SM, Tremethick, MJ, Johnson, P, et al. Disaster planning and response: considering the needs of the frail elderly. Int J Emergency Management. 2009;6(1):1-13.Google Scholar
10. Aldrich, N, Benson, WF. Disaster preparedness and the chronic disease needs of vulnerable older adults. Prev Chronic Dis. 2008;5(1):A27.Google Scholar
11. Brunkard, J, Namulanda, G, Ratard, R. Hurricane Katrina deaths, Louisiana, 2005. Disaster Med Public Health Prep . 2008;2(4):215-223.Google Scholar
12. Lin, S, Fletcher, BA, Luo, M, et al. Health impact in New York City during the northeastern blackout of 2003. Public Health Rep. 2011;126(3):384-393.CrossRefGoogle ScholarPubMed
13. Jellinek, I, Willig, J. When a terrorist attacks: September 11 and the impact on older adults in New York City. Generations. 2007;31(4):42-46.Google Scholar
14. Nakahara, S, Ichikawa, M. Mortality in the 2011 tsunami in Japan. J Epidemiol. 2013;23(1):70-73.CrossRefGoogle ScholarPubMed
15. Chan, EY, Kim, J. Chronic health needs immediately after natural disasters in middle-income countries: the case of the 2008 Sichuan, China earthquake. Eur J Emerg Med. 2011;18(2):111-114.Google Scholar
16. Powell, S, Plouffe, L, Gorr, P. When ageing and disasters collide: lessons from 16 international case studies. Radiat Prot Dosimetry. 2009;134(3-4):202-206.Google Scholar
17. Chan, EY, Griffiths, S. Comparison of health needs of older people between affected rural and urban areas after the 2005 Kashmir, Pakistan earthquake. Prehosp Disaster Med. 2009;24(5):365-371.Google Scholar
18. Dosa, D, Feng, Z, Hyer, K, et al. Effects of hurricane Katrina on nursing facility resident mortality, hospitalization, and functional decline. Disaster Med Public Health Prep. 2010;4(suppl 1):S28-S32.Google Scholar
19. Dosa, D, Hyer, K, Thomas, K, et al. To evacuate or shelter in place: implications of universal hurricane evacuation policies on nursing home residents. J Am Med Dir Assoc. 2012;13(2):190.e1-190.e7.CrossRefGoogle ScholarPubMed
20. Dosa, DM, Grossman, N, Wetle, T, et al. To evacuate or not to evacuate: lessons learned from Louisiana nursing home administrators following hurricanes Katrina and Rita. J Am Med Dir Assoc. 2007;8(3):142-149.Google Scholar
21. Zaenger, D, Efrat, N, Riccio, RR, et al. Shelter-in-place versus evacuation decision making: a systematic approach for healthcare facilities. Risk, Hazards & Crisis in Public Policy. 2010;1(3):19-33.Google Scholar
22. Dobalian, A, Claver, M, Fickel, JJ. Hurricanes Katrina and Rita and the Department of Veterans Affairs: a conceptual model for understanding the evacuation of nursing homes. Gerontology. 2010;56(6):581-588.Google Scholar
23. Nomura, S, Gilmour, S, Tsubokura, M, et al. Mortality risk amongst nursing home residents evacuated after the Fukushima nuclear accident: a retrospective cohort study. PLoS One. 2013;8(3):e60192.Google Scholar
24. Brown, LM, Dosa, DM, Thomas, K, et al. The effects of evacuation on nursing home residents with dementia. Am J Alzheimers Dis Other Demen. 2012;27(6):406-412.Google Scholar
25. Bethel, JW, Foreman, AN, Burke, SC. Disaster preparedness among medically vulnerable populations. Am J Prev Med. 2011;40(2):139-143.Google Scholar
26. Daugherty, JD, Eiring, H, Blake, S, et al. Disaster preparedness in home health and personal-care agencies: are they ready? Gerontology. 2012;58(4):322-330.Google Scholar
27. Uscher-Pines, L, Hausman, AJ, Powell, S, et al. Disaster preparedness of households with special needs in southeastern Pennsylvania. Am J Prev Med. 2009;37(3):227-230.Google Scholar
28. Gershon, RR, Kraus, LE, Raveis, VH, et al. Emergency preparedness in a sample of persons with disabilities. Am J Disaster Med. 2013;8(1):35-47.Google Scholar
29. McCormick, LC, Pevear, J III, Xie, R. Measuring levels of citizen public health emergency preparedness, Jefferson County, Alabama. J Public Health Manag Pract. 2013;19(3):266-273.Google Scholar
30. Christensen, JJ, Richey, ED, Castaneda, H. Seeking safety: predictors of hurricane evacuation of community-dwelling families affected by Alzheimer’s disease or a related disorder in south Florida. Am J Alzheimers Dis Other Demen. 2013;28(7):682-692.Google Scholar
31. Al-Rousan, TM, Rubenstein, LM, Wallace, RB. Preparedness for natural disasters among older US adults: a nationwide survey. Am J Public He alth . 2014;104(3):506-511.Google Scholar
32. Jenkins, JL, McCarthy, M, Kelen, G, et al. Changes needed in the care for sheltered persons: a multistate analysis from Hurricane Katrina. Am J Disaster Med. 2009;4(2):101-106.Google Scholar
33. Laditka, SB, Laditka, JN, Xirasagar, S, et al. Providing shelter to nursing home evacuees in disasters: lessons from Hurricane Katrina. Am J Public Health. 2008;98(7):1288-1293.Google Scholar
34. Brodie, M, Weltzien, E, Altman, D, et al. Experiences of Hurricane Katrina evacuees in Houston shelters: implications for future planning. Am J Public Health. 2006;96(8):1402-1408.Google Scholar
35. Gibbs, L, Holloway, C. Hurricane Sandy after action: report and recommendations to Mayor Michael R. Bloomberg. May 2013. New York City government website. http://www.nyc.gov/html/recovery/downloads/pdf/sandy_aar_5.2.13.pdf. Accessed February 4, 2014.Google Scholar
36. Langan, JC, Christopher, KM. Factors influencing the decision to evacuate or shelter in place: follow-up of Hurricane Katrina. Journal of Emergency Management. 2012;10(3):185-195.CrossRefGoogle Scholar
37. Rosenkoetter, MM, Covan, EK, Cobb, BK, et al. Perceptions of older adults regarding evacuation in the event of a natural disaster. Public Health Nurs. 2007;24(2):160-168.Google Scholar