Disabled Adults in Adult Care Facilities Facing Disasters in New York City: An Aggregate Assessment

Article excerpt

Disabled adults who reside in adult care facilities (ACFs) are an at-risk population in the event of an emergency or disaster. This aggregate requires housing in congregate residential settings due to frailty, function, and/or cognitive impairments. All senior residents need long-term assistance to maintain maximum independence, including 24-hr on-site monitoring, case management, and personal care services such as eating, toileting, transferring, bathing, and dressing. Twenty-five percent of this special population of older adults has psychiatric disabilities and nonmental health comorbidities (Caron et al., 2008). Through a literature search, the challenges and risks of this aggregate in the event of a naturally occurring or manmade emergency, including epidemiological and environmental risks, are identified. Evidence-based literature reveals that the foundation of an effective emergency response and recovery is planning and preparation. Lessons learned from past disasters in the United States have brought attention to the needs of disabled and chronically ill older adults. Developing partnerships, improving communication systems, identifying emergency shelters for disabled adults, and empowering ACF residents and staffthrough education are recommended with the universal goal of reducing injury, preventing or controlling illness, and saving lives. An innovative educational program utilizing Hybrid Modality is outlined in this article including planning, coalition building, and the use of mapping systems as tools and strategies to improve outcomes. Resources such as local, state, and federal agencies; consumer groups; and trade associations are referenced for accessibility.

THE AGGREGATE

Consider the following statistics: In the United States today, there are approximately 310 million residents. Of these, an estimated 12% (almost 38 million Americans) are aged 65 years and older (U.S. Census Bureau, 2009). Of these older adults, 80% have at least one chronic health condition and 50% have at least two (He, Sengupta, Velkoff, & Debarros, 2005). These conditions include hypertension (50%), arthritis (20%), coronary heart disease (20%), cancer (20%), and diabetes (15%). Nine percent of adults aged 65 years and older have had a stroke (Aldrich & Benson, 2008). These chronic conditions often lead to moderate-to-severe disabilities and the inability to perform basic activities of daily living (ADLs). In vulnerable older adults, these chronic conditions can also impair the ability to prepare, respond, or recover from a natural or man-made disaster. Subsequently, disabled adults have been identified as a group in need for special planning in the event of an emergency (Aldrich & Benson, 2008).

The men and women in this aggregate, disabled adults who reside in adult care facilities in New York City, are primarily elderly and unable to live on their own without assistance (Caron et al., 2008). This fragile population is a subgroup of elders whose health and safety is already at risk. In the event of a disaster, they are put in double jeopardy. Emergency preparedness (EP) is essential for this aggregate. The promotion and implementation of an EP plan will improve outcomes for these individuals with physical and, oftentimes, mental disorders.

An adult care facility (ACF) is a congregate residential setting licensed by the state that houses disabled adults with functional and/or cognitive impairments. Adult care facilities are not health care facilities and, consequently, direct nursing or skilled medical care provision is prohibited. Rather, the focus is on providing residents with the supervision and assistance necessary to maintain optimal health and hygiene, including basic ADLs such as eating, toileting, transferring, bathing, and dressing.

In the aggregate discussed in this article, there are 64 licensed ACFs within the five boroughs of New York City. All of the residents, more than 9,000 persons, need housing supportive services and/or personal care to live on their own (Caron et al. …