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 sensory awareness, and chronic health conditions, create unique disaster 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 owners and operators face. Despite JCAHO, state and federal requirements for disaster planning, there is growing evidence that suggests long-term care facilities are ill-prepared for a disaster. In addition, despite the need for training, a comprehensive, validated disaster planning program is not currently available to assist long-term care facilities with the development, implementation, and evaluation of a disaster plan. 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 disaster preparedness curriculum. The audience for this program will include owners, operators, and disaster coordinators of large and small long-term care facilities who care for older adults, including skilled nursing facilities and assisted living facilities. During Phase I, researchers will convene a multidisciplinary focus group of experts to discuss the challenges long-term care facilities face when developing and implementing a disaster plan and responding to an actual disaster event, including lessons learned from previous disasters. The advisory group will develop a detailed disaster preparedness curriculum. Researchers will convene a focus group of owners, operators, and facility disaster coordinators to evaluate the curriculum. During Phase II, the curriculum will be the basis for the development of an interactive, computer-based training program. The program will be evaluated in a national field test. Modules will combine text, graphics, animation, sound, and high-resolution video to create a fully-interactive media-rich, learner-controlled environment. The program will provide branching to allow learners to access information related to specific types of disasters. It will include interactive checklists that allow learners to enter information about their facilities to generate a customized disaster plan. A tutorial format will guide learners step-by-step through the plan development so that critical information is not overlooked. The program will also generate customized lesson plans that administrators can use for staff in-service disaster training and role-play activities. This proposed project supports the National Institute 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, and staff. Frail older adults represent one of the highest risk populations in disaster events. Characteristics of older adults in long-term care create unique disaster planning challenges for staff. This project will seek to reduce the incidence of disaster-related deaths and injuries through the development and distribution of a comprehensive and validated disaster preparedness curriculum.