An increasing number of older adults in the U.S. rely on home-care agencies for their medical needs and other personal care. Many of these individuals prefer to remain in their own homes, but have come to depend on professional services for daily self-care and medical support. This population is particularly vulnerable to disasters, such as hurricanes, tornadoes, and wildfires, due to mobility limitations and reliance on electricity and clean water. However, little is known about the disaster preparedness of the agencies that serve these individuals, and that are often a crucial source of support in emergencies. A forthcoming article in Gerontology presents some initial findings on the disaster preparedness of home-care agencies.
Because this is a relatively new area of study, the authors of the article designed an exploratory qualitative study to establish initial findings. This enabled them to identify important themes for further, larger-scale quantitative surveys and other disaster preparedness research being conducted at their institution, the Preparedness and Emergency Response Center at Emory University.
For this pilot study, the researchers contacted 179 home care agencies in coastal Georgia and southern California, two areas that frequently experience large-scale disasters (hurricanes and wildfires, respectively). These agencies included home health care agencies, which provide occasional medical care in the home, and personal care agencies, which provide more frequent (usually daily, often 24-7) in-home assistance with activities of daily living.
Twenty-one agencies agreed to participate in interviews, in which the researchers conducted semi-structured interviews with agency administrators. The authors note that this is a small, self-selecting sample, which may influence their findings. However, such exploratory qualitative research is important for establishing initial theoretical and knowledge frameworks.
The analysis of the interview produced four major themes about disaster preparedness and response among the agencies:
- Little to no disaster preparedness training is provided at these agencies. Seven respondents had no formal disaster training at their agencies, and minimal training was conducted at most of the remaining agencies. Some respondents stated that they voluntarily took self-directed training, and many expressed interest in more formal training.
- Agencies differ in how they define and prepare for “disasters.” Respondents from home health care agencies conceived of disasters as unusual large-scale events, such as hurricanes or epidemics, while personal care agencies were more focused on personal-scale disruptions, like employee absences or falls in the home. Agencies also differed in the degree of responsibility for which they are responsible in disasters.
- Agencies expect families and emergency responders to assist in disasters. Most of the respondents stated that their agencies have informal or unstated agreements with clients’ families, and with local emergency responders, to provide assistance. However, in the absence of a formal plan, these agencies lack contingency arrangements in the events that families and local responders are unable to assist.
- Agencies that participated in the study were resilient in previous disasters. The 15 agencies that had experienced a disaster reported that they were able to continue providing care to their clients, whether or not they had a standing disaster plan. Respondents were clearly motivated to serve their clients well in these emergencies. However, since the study was based on a self-selecting sample, it may be the case that agencies that had been unsuccessful in previous disasters were less inclined to participate in this study.
This study provides useful groundwork for future research in the area, and suggests that home-care agencies may need assistance in forming and testing disaster plans.