Preparing Long-Term Care Facilities for Natural and Man-Made Disasters

DESCRIPTION (provided by applicant): Frail older adults represent one of the highest risk populations in disaster events. Characteristics of older adults in long-term care, including impaired physical mobility, reduced cognitive functioning, diminished sen sory awareness, and chronic health conditions, create unique emergency planning challenges. When should a facility evacuate? Where will residents take shelter? How will they be transported? These are all difficult questions that long-term care facility own ers and operators face. Despite state and federal requirements for emergency planning, there is growing evidence that suggests long-term care facilities are ill-prepared for a disaster. The purpose of the proposed research is to reduce the risk of disaster -related deaths and injuries to older adults in long-term care. This goal will be accomplished through the development and evaluation of a comprehensive emergency preparedness curriculum. The computer-based training materials developed from this curriculum will provide long-term care owners, administrators, and facility emergency planning teams with the knowledge, skills, and tools they need to develop, implement, and practice an emergency operations plan. During Phase I, researchers convened a multidiscipl inary advisory group of experts to discuss the challenges long-term care facilities face when developing and implementing an emergency plan and responding to an actual disaster event. The advisory group developed a detailed emergency preparedness curriculu m. Researchers evaluated the curriculum in a pilot test with 43 owners, operators, and facility disaster coordinators from assisted living facilities and skilled nursing facilities. Posttest results suggest that the curriculum as presented improved the par ticipants' knowledge, attitudes, and intended practices related to emergency preparedness. The average improvement from pre to posttest was 31.71%, which was significant at the .0005 level. Participant evaluation of each module on six criteria (clarity, us efulness, importance, interest, comprehensiveness, and length) suggests a strong approval of the curriculum. During Phase II, the curriculum will be the basis for the development of an interactive, computer-based training program. Modules will combine text , graphics, animation, sound, and high-resolution video to create a fully-interactive media-rich, learner-controlled environment. The program will be evaluated in a national field test with small, medium, and large long-term care facilities, using a random ized pretest/posttest experimental design with a control group. The field test will also include an evaluation of participants' emergency operations plans prior to the training and one month after the training. This proposed project supports the National I nstitute on Aging's mission to improve the health and well- being of older Americans. Considering the risk of disaster-related death and injury, the research is critically important to residents, facility owners, staff, and family members. PUBLIC HEALTH RELEVANCE: Frail older adults represent one of the highest risk populations in disaster events. Characteristics of older adults in long-term care create unique emergency planning challenges for staff. This project will seek to reduce the incidence of disas ter-related deaths and injuries through the development and distribution of a comprehensive and validated emergency preparedness curriculum.