Surviving the Storms: Emergency Preparedness in Texas Nursing Facilities and Assisted Living Facilities

Castro, Carmen; Persson, Diane; Bergstrom, Nancy; Cron, Stanley G.

doi:10.3928/00989134-20080801-01

Cited by 19 publications

(10 citation statements)

References 18 publications

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“…Prior research has found that small ALCs are more likely to be independently owned and operated ( Caffrey et al, 2014 ). Castro and colleagues (2008) found after Hurricanes Katrina and Rita in Texas (both in 2005) that small ALCs were more likely than NHs and larger ALCs to evacuate and were less likely to coordinate their responses with local emergency managers. Further research is needed to understand ALC challenges in preparing for and responding to disasters and their need for support from the communities in which they are located.…”

Section: Discussionmentioning

confidence: 99%

“… Brown and colleagues (2015) surveyed Florida ALC staff exposed to hurricanes in 2004–2005, reporting their challenges were similar to those of NHs. However, other research identified differences between the two settings, with a study in Texas after Hurricanes Katrina and Rita (2005) finding ALCs were more likely to report difficulties obtaining needed supplies and equipment ( Castro et al, 2008 ). An Ohio study based on a statewide survey found ALCs to be less prepared for disasters than NHs ( Kennedy et al, 2021 ).…”

Section: Protecting Residents Of Nhs and Alcs In Disastersmentioning

confidence: 99%

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“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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Section: Discussionmentioning

confidence: 99%

Section: Protecting Residents Of Nhs and Alcs In Disastersmentioning

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

View full text Add to dashboard Cite

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“…In this regard, the 4 studies comparing outcomes of facility residents who evacuated versus sheltering-in-place are especially informative. 6,[35][36][37] All 4 studies demonstrated worse health outcomes in evacuated residents, suggesting that evacuation aggravates adverse health effects associated with the disaster alone. A finding of excess mortality among evacuated nursing home residents compared to residents who sheltered in place was also demonstrated in the foreign language French study.…”

Section: Discussionmentioning

confidence: 99%

“…Using the National Health and Research Medical Council hierarchy 38 (Table S3 in the online data supplement), articles studying facility characteristics that predicted preparedness or response, as well as all of the studies examining interventions designed to improve preparedness, provided level IV evidence (cross-sectional surveys). Three of the articles 6,32,35 that examined health effects of interventions during response were cross-sectional surveys and thus also constituted level IV evidence. Six of the studies that examined health effects of interventions during response 30,31,33,34,36,37 were case-control studies with historic (Level III-3) or concurrent controls (Level III-2).…”

Section: Levels Of Evidencementioning

confidence: 99%

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

Pierce

Morley

West

et al. 2016

Disaster med. public health prep.

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Long-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).

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“…Previous qualitative studies have reported that AL communities that evacuated during hurricanes experienced similar difficulties as nursing homes, such as maintaining adequate staffing and communicating with family members . A survey that combined Texas AL communities with nursing homes found higher rates of resident mortality after Hurricane Katrina among communities that evacuated compared with those that did not; however, AL communities were not examined separately from nursing homes in the analysis …”

Section: Introductionmentioning

confidence: 99%

Evacuation and Health Care Outcomes Among Assisted Living Residents After Hurricane Irma

Hua,

Patel,

Thomas

et al. 2024

JAMA Netw Open

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ImportanceEvacuation has been found to be associated with adverse outcomes among nursing home residents during hurricanes, but the outcomes for assisted living (AL) residents remain unknown.ObjectiveTo examine the association between evacuation and health care outcomes (ie, emergency department visits, hospitalizations, mortality, and nursing home visits) among Florida AL residents exposed to Hurricane Irma.Design, Setting, and ParticipantsRetrospective cohort study using 2017 Medicare claims data. Participants were a cohort of Florida AL residents who were aged 65 years or older, enrolled in Medicare fee-for-service, and resided in 9-digit zip codes corresponding to US assisted living communities with 25 or more beds on September 10, 2017, the day of Hurricane Irma’s landfall. Propensity score matching was used to match evacuated residents to those that sheltered-in-place based on resident and AL characteristics. Data were analyzed from September 2022 to February 2024.ExposureWhether the AL community evacuated or sheltered-in-place before Hurricane Irma made landfall.Main Outcomes and MeasuresThirty- and 90-day emergency department visits, hospitalizations, mortality, and nursing home admissions.ResultsThe study cohort included 25 130 Florida AL residents (mean [SD] age 81 [9] years); 3402 (13.5%) evacuated and 21 728 (86.5%) did not evacuate. The evacuated group had 2223 women (65.3%), and the group that sheltered-in-place had 14 556 women (67.0%). In the evacuated group, 42 residents (1.2%) were Black, 93 (2.7%) were Hispanic, and 3225 (94.8%) were White. In the group that sheltered in place, 490 residents (2.3%) were Black, 707 (3.3%) were Hispanic, and 20 212 (93.0%) were White. After 1:4 propensity score matching, when compared with sheltering-in-place, evacuation was associated with a 16% greater odds of emergency department visits (adjusted odds ratio [AOR], 1.16; 95% CI, 1.01-1.33; P = .04) and 51% greater odds of nursing home visits (AOR, 1.51; 95% CI, 1.14-2.00; P = .01) within 30 days of Hurricane Irma’s landfall. Hospitalization and mortality did not vary significantly by evacuation status within 30 or 90 days after the landfall date.Conclusions and RelevanceIn this cohort study of Florida AL residents, there was an increased risk of nursing home and emergency department visits within 30 days of Hurricane Irma’s landfall among residents from communities that evacuated before the storm when compared with residents from communities that sheltered-in-place. The stress and disruption caused by evacuation may yield poorer immediate health outcomes after a major storm for AL residents. Therefore, the potential benefits and harms of evacuating vs sheltering-in-place must be carefully considered when developing emergency planning and response.

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Surviving the Storms: Emergency Preparedness in Texas Nursing Facilities and Assisted Living Facilities

Cited by 19 publications

References 18 publications

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

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

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

Evacuation and Health Care Outcomes Among Assisted Living Residents After Hurricane Irma

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