A Flex-Model for long-term assessment of community-residing older adults following disasters

Authors

  • Marlene M. Rosenkoetter, PhD, RN, CNS, FAAN
  • JoEllen McDonough, PhD, RN
  • Amber McCall, PhD, RN
  • Deborah Smith, DNP, RN
  • Stephen Looney, PhD

DOI:

https://doi.org/10.5055/ajrt.2016.0098

Keywords:

disasters, assessments of older adults

Abstract

For the rapidly growing older adult population, disaster consequences are frequently life disruptive and even life threatening. By 2050, it is estimated that the global older adult population will reach 22 percent of the total. With declining health, this population poses a particular risk needing to be addressed in emergency preparedness and disaster recovery. The purpose of this article is to describe a Flex-Model (F-M) for the long-term assessment of older adults following a disaster. An F-M is a series of three-dimensional representations of an archetype with flexible components, both linear and parallel, that can be adapted to situations, time, place, and needs. The model incorporates the Life Patterns Model and provides a template that can be adjusted to meet the needs of a local community, healthcare providers, and emergency management officials, regardless of the country or region, during the months after a disaster. The focus is on changes resulting from the disaster including roles, relationships, support systems, use of time, self-esteem, and life structure. Following a baseline assessment, each of these life patterns is assessed through the model with options for interventions over time. A pilot study was conducted in Georgia to gain information that would be helpful in developing a more specific assessment tool following a severe winter storm. While this is a local study, the findings can nevertheless be used to refine and focus the F-M for future implementation. Results indicated that older adults used high-risk heating and lighting sources and many were totally responsible for their own welfare. Findings have implications for emergency preparedness and long-term recovery.

Author Biographies

Marlene M. Rosenkoetter, PhD, RN, CNS, FAAN

College of Nursing, Georgia Regents University, Augusta, Georgia.

JoEllen McDonough, PhD, RN

College of Nursing, Georgia Regents University, Augusta, Georgia

Amber McCall, PhD, RN

College of Nursing, Georgia Regents University, Augusta, Georgia

Deborah Smith, DNP, RN

College of Nursing, Georgia Regents University, Augusta, Georgia

Stephen Looney, PhD

College of Nursing, Georgia Regents University, Augusta, Georgia.

 

References

EM-DAT: The International Disaster Database. Center for Research on the Epidemiology of Disasters. Available at http://www.emdat.be. Accessed April 28, 2014.

Prevention Web: United States of America—Disaster Statistics. Available at http://www.preventionweb.net/eng lish/countries/statistics/?cid=185. Accessed April 28, 2014.

UNISDR: Making Cities Resilient: My City is Getting Ready. 2012. Available at http://www.unisdr.org/campaign/resilientcities/. Accessed June 8, 2015.

World Bank: Disaster Risk Management. 2011. Available at http://go.worldbank.org/WJBQY43AF0. Accessed April 28, 2014.

Basolo V, Steinberg L, Burby R, et al.: The effects of confidence in government on perceived and actual preparedness for disasters. Environ Behav. 2009; 41(3): 338-364.

UNISDR: Terminology. United Nations International Strategy for Disaster Reduction. The United Nations Office for Disaster Risk Reduction. 2007. Available at http://www.unisdr.org/we/inform/terminology#letter-d. Accessed April 28, 2014.

WHO: Are you ready? What you need to know about aging. 2012. Available at http://www.who.int/world-healthday/2012/toolkit/background/en/. Accessed April 28, 2014.

Pew Research: Global attitudes project. Attitudes about aging: A global perspective. 2014. Available at http://www.pewglobal.org/2014/01/30/attitudes-about-aging-a-globalperspective/. Accessed September 15, 2014.

Administration on Aging: U.S. Department of Health and Human Services. A profile of older Americans, 2013.

Federal Interagency Forum on Aging & Related Statistics: Older Americans: Key Indicators of Well-Being. Federal Interagency Forum on Aging-Related Statistics. Washington, DC: US Government Printing Office, 2012. Available at http://www.agingstats.gov/agingstatsdotnet/Main_Site/Data/2012_Documents/Docs/EntireChartbook.pdf. Accessed September 16, 2014.

TBTS: Bureau of Transportation Statistics, Freedom to Travel, BTS03-08. Washington, DC: U.S. Department of Transportation, 2003. Available at http://www.rita.dot.gov/bts/sites/rita.dot.gov.bts/files/publications/freedom_to_travel/index.html. Accessed June 8, 2015.

Healthy People 2020: Older Adults. Why is the health of older adults important? Available at http://www.healthypeople.gov/2020. Accessed April 28, 2014.

NCOA: Healthy Aging. Washington, DC: National Council on Aging, 2014. Available at http://www.ncoa.org/press-room/fact-sheets/healthy-aging-fact-sheet.html. Accessed September 15, 2014.

Mack D, Brantley KM, Bell KG: Mitigating the health effects of disasters for medically underserved populations: Electronic health records, telemedicine, research, screening, and surveillance. J Health Care Poor Underserved. 2007; 18(2): 432-442.

BLS: Spotlight on statistics. Older workers. Bureau of Labor Statistics. 2008. Available at http://www.bls.gov/spotlight/2008/older_workers. Accessed April 28, 2014.

Lu A: Stress and physical health deterioration in the aftermath of Hurricane Katrina and Rita. Sociol Perspect. 2011; 54(2): 229-250.

Ruggiero KJ, Amstadter AB, Acierno R, et al.: Social and psychological resources associated with health status in a representative sample of adults affected by the 2004 Florida hurricanes. Psychiatry. 2009; 72(2): 195-210.

Yun K, Lurie N, Hyde PS: (2010). Moving mental health into the disaster preparedness spotlight. New Engl J Med. 2010; 363(13): 1193-1195.

NIH: Older adults: Depression and suicide facts (Fact Sheet). NIH Publication No. 4593. Washington, DC: National Institutes of Health, 2007.

Aging Services Council of Central Texas: What are the current conditions for older adults? Transportation. Available at http://www.agingservicescouncil.org/documents/Report/00AGINGSERVICESSCANtransportation.htm. Accessed January 16, 2015.

National Caregivers Library: Transportation and the elderly. Available at http://www.caregiverslibrary.org/caregivers-resources/grp-transportation/transportation-andthe-elderly-article.aspx. Accessed January 16, 2015.

Transportation problems of older adults (2008, February 10). Available at http://www.academon.com/research-paper/transportation-problems-of-older-adults-100887/. Accessed January 16, 2015.

MacLeod K, Satariano W, Ragland D: The impact of health problems on driving status among older adults. J Transp Health. 2014; 1(2): 86-94.

CDC: Older Adult Drivers: Get the Facts. Atlanta, GA: Centers for Disease Control and Prevention, 2013.

Henderson TL, Roberto KA, Kamo Y: Older adults’ responses to Hurricane Katrina: Daily hassles and coping strategies. J Appl Gerontol. 2010; 29(1): 48-69.

Cherry KE, Brown JS, Marks LD, et al.: Longitudinal assessment of cognitive and psychosocial functioning after Hurricane Katrina and Rita: Exploring disaster impact onmiddle-aged, older, and oldest-old adults. J Appl Biobehav Res. 2011; 16(3-4): 187-211.

Hrostowski S, Rehner T: Five years later: Resiliency among older adult survivors of Hurricane Katrina. J Gerontol Soc Work. 2012; 55(4): 337-351.

Stein RM, Dueñas-Osorio L, Subramanian D: Who evacuates when hurricanes approachϿ. The role of risk, information, and location. Soc Sci Q. 2010; 91(3): 816-834.

Lindell MK, Huang SN: Households’ perceived personal risk and responses in a multi-hazard environment. Risk Anal. 2008; 28(2): 539-556.

Horney J, Macdonald PD, Van Willigen M, et al.: Individual, actual, or perceived property flood risk: Did it predict evacuation from Hurricane Isabel in North Carolina, 2003. Risk Anal. 2010; 30(3): 501-511.

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.

Regnier E: Public evacuation decisions and hurricane track uncertainty. Manag Sci. 2008; 54(1): 16-28.

Stough LM, Sharp AN, Decker C, et al.: Disaster case management and individuals with disabilities. Rehabil Psychol. 2010; 55(30): 211-220.

Nepal V, Banerjee D, Perry M, et al.: Disaster preparedness of linguistically isolated populations: Practical issues for planners. Health Promot Pract. 2012; 13(2): 265-271.

The Atlantic Cities: Where 60 million people in the U.S. don’t speak English at home. The Atlantic Monthly Group. 2014. Available at http://www.citylab.com/politics/2013/08/geography-americas-many-languages/6438/. Accessed June 8, 2015.

Beaudoin CE: Mass media use, neighborliness, and social support: Assessing causal links with panel data. Commun Res. 2007; 34(6): 637-664.

Kapucu N, Van Wart M: The evolving role of the public sector in managing catastrophic disasters: Lessons learned. Admin Soc. 2006; 38(3): 280-308.

Storr VH, Haeffele-Balch S: Post-disaster community recovery in heterogeneous, loosely connected communities. Rev Soc Econ. 2012; 70(3): 295-314.

Aten JD, Topping S: An online social networking disaster preparedness tool for faith communities. Psychol Trauma. 2010; 2(2): 130-134.

Pyles L: Community organizing for post-disaster social development: Locating social work. Int Soc Work. 2007; 50(3): 321-333.

Scott D: The Red Guide to Recovery. Resource Handbook for Disaster Survivors. Tribal Community Disaster Recovery. San Diego: Heritage Publishing, 2013. Available at http://www.theredguidetorecovery.com/recovery-tools/tribalcommunity-resources/. September 5, 2014.

Bryant D: Homeland1. Challenges of rural emergency management. April 8, 2009. Available at http://www.homeland1.com/disaster-preparedness/articles/480917-Challenges-of-rural-emergency-management/. Accessed May 2, 2014.

Smith KI, Carbone J, Pope J, et al.: Adjusting to natural disasters. J Risk Uncertain. 2006; 33(1/2): 37-54.

Dugan B: Loss of identity in disaster: How do you say goodbye to home? Perspect Psychiatr Care. 2007; 43(1): 41-46.

Orth U, Trzesniewski K, Robins R: Self-esteem development from young adulthood to old age: A cohort-sequential longitudinal study. J Pers Soc Psychol. 2010; 98(4): 645-658.

North C, Pfefferbaum B: Mental health response to community disasters. A systematic review. JAMA. 2013; 310(5): 507-518.

van den Berg B, Wong A, van der Velder P, et al.: Disaster exposure as a risk factor for mental health problems, eighteen months, four and ten years post-disaster—A longitudinal study. BMC Psychiatry. 2012; 12: 147.

US Fire Administration: US fire statistics. Who does fire impact the most? Available at http://www.usfa.fema.gov/data/statistics/. Accessed Accessed June 8, 2015.

NFPA: Candles. Home candles fires. Available at http://www.nfpa.org/research/reports-and-statistics/fire-causes/candles. Accessed August 19, 2014.

Bronstein AC, Spyker DA, Cantilena LR, et al.: 2011 Annual Report of the American Association of Poison Control Centers’ National Poison Data System. 29th Annual Report. Clin Toxicol. 2012; 50: 911-1164.

Johnson-Arbor K, Quental A, Dadong L: A comparison of carbon monoxide exposures after snowstorms and power outages. Am J Prev Med. 2014; 46(5): 481-486.

Stanhope M, Lancaster J: Foundations of Nursing in the Community: Community-Oriented Practice. 4th ed. St Louis: Elsevier, 2014: 262.

Carter D: Disaster recovery models: What exactly are they and how do they help? The case for continuity. 2014. Available at http://ezinearticles.com/?Disaster-Recovery-Models:-What-Exactly-Are-They-And-How-Do-They-Help?&id=8323043. Accessed April 28, 1014.

Kumar S: Disaster Management Model and Framework. National Institute of Disaster Management, Government of India. Available at http://www.teriin.org/events/docs/smallpdf/Santo3.pdf?phpMyAdmin=ac2c888ba0bcc4bab16ef08607132639. Accessed April 28, 2014.

Tan N, Wang L, Yamaguchi Y, et al.: Disaster management in Asia. Models, policies and programmes for social recovery. Global Risk Forum. 2010. Available at http://www.slideshare.net/GRFDavos/asian-model-disaster-recoverydavos-tan-et-al-rev1ppt. Accessed April 28, 2014.

New Zealand Aid Programme: New Zealand disaster response partnership. Available at http://www.aid.govt.nz/funding-and-contracts/new-zealand-disaster-response-part nership. Accessed June 8, 2015.

FEMA: National Disaster Recovery Framework. Washington, DC: US Government, 2011. Available at http://www.fema.gov/media-library-data/20130726-1820-25045-5325/508_ndrf.pdf. Accessed April 28, 2014.

Giarratano G, Savage J, Barcelona-deMendoza V, et al.: Disaster research: A nursing opportunity. Nurs Inq. 2014; 21(3): 259-268.

Gibbs L, Waters E, Bryant RA, et al.: Beyond Bushfires: Community, Resilience and Recovery—A longitudinal mixed method study of the medium to long term impacts of bushfires on mental health and social connectedness. BMC Public Health. 2013; 13: 1036.

Lowe SR, Tracy M, Cerda M, et al.: Immediate and longer-term stressors and the mental health of Hurricane Ike survivors. J Trauma Stress. 2013; 26(6): 753-761.

HelpAge International: Older people in disasters and humanitarian crises: Guidelines for best practice. n.d. Available at http://www.handicap-international.fr/bibliographie-handicap/5CooperationInternationale/contextes_urgence/Helpage_guidelines.pdf. Accessed July 17, 2014.

DERA: The International Association for Preparedness and Response. Available at http://www.disasters.org/. Accessed January 16, 2015.

International Federation of Red Cross and Red Crescent Societies. Available at http://www.ifrc.org/. Accessed January 16, 2015.

Rosenkoetter M, Stachura M, Dias J, et al.: Assessment of insulin administration methods: Perceptions by patients and significant others instrument development. J Nurs Meas. 2015 (in press).

Bowcutt M, Rosenkoetter M, Chernecky C, et al.: Implementation of an intravenous medication infusion pump system: Implications for nursing. J Nurs Manag. 2008; 16: 188-197.

Rosenkoetter M, Stachura M, Dias J, et al.: CSII and MDII for intensive diabetes management: Impact perceptions of older adult patients and their significant others. Geriatr Nurs. 2013; 34(6): 469-476.

Rosenkoetter M, Bowcutt M, Khasanshina E, et al.: Perceptions of the impact of smart pumps on nurses and nursing care provided. JAVA. 2008; 13(2): 60-69.

Rosenkoetter M, Garris J, Engdahl R: Postretirement use of time: Implications for preretirement planning and postretirement management. Act Adapt Aging. 2001; 25(3-4): 1-18.

Rosenkoetter M, Garris J: Retirement planning, use of time, and psychosocial adjustment. Issues Ment Health Nurs. 2001; 22(7): 703-722.

Torke A, Sachs GA, Helft PR, et al.: Scope and outcomes of surrogate decision making among hospitalized older adults. JAMA Intern Med. 2014; 174(3): 370-377.

Rosenkoetter M, Covan E, Cobb B, et al.: Perceptions of older adults regarding evacuation in the event of a natural disaster. Public Health Nurs. 2007; 24(2): 160-168.

Congress.gov: H.R. 3858 (109th): Pets Evacuation and Transportation Standards Act of 2006. Available at https://www.govtrack.us/congress/bills/109/hr3858. Accessed January 26, 2015.

Rosenkoetter M, McDonough JE, Quinn ME, et al.: A Flex-Model for post disaster assessment of older adults. Paper presented at 163th OMICS Group Conference, International Conference on Nursing & Emergency Medicine, Invited Keynote Address, Las Vegas, NV, December 2, 2013.

Published

01/01/2016

How to Cite

Rosenkoetter, PhD, RN, CNS, FAAN, M. M., McDonough, PhD, RN, J., McCall, PhD, RN, A., Smith, DNP, RN, D., & Looney, PhD, S. (2016). A Flex-Model for long-term assessment of community-residing older adults following disasters. American Journal of Recreation Therapy, 15(1), 31–46. https://doi.org/10.5055/ajrt.2016.0098

Issue

Section

Articles