Disaster Preparedness Among Older People with Long-Term Care Needs and Family Caregivers: Who Is Vulnerable and What Do They Need for Preparedness in Communities?

Background: Hurricane Katrina in the U.S. highlighted the potentially fatal effects of a natural disaster on older individuals. This experience was reinforced by the Great East Japan Earthquake, where community-dwelling elderly were again at the greatest risk of mortality. Understanding the needs for and concerns of older persons with long-term care needs and their caregivers is vital to the development of public health programs for community level disaster planning.

Purpose: The preparedness of community-dwelling older people with long-term care needs were examined to identify characteristics of care-recipients and caregivers that are associated with worse preparedness and greater concern.

Methods. A self-administered survey among family caregivers of older Japanese with long-term care needs (n=952) were conducted in 2011. Logistic regression analysis was used to identify the predictors of disaster preparedness, including evacuation plans and caregiver’s concern about preparation. Data were analyzed in 2013.

Results. Most older people had no concrete evacuation plans, and those with dementia were 40% less likely to be prepared. Caregivers who were responsible for older persons with worse mobility, as well as those in worse health or poor financial situations, reported higher levels of anxiety about their disaster preparation. However, more experienced, wealthier, and better socially integrated caregivers in the community were more prepared.

Conclusions. Older people with long-term care needs are at heightened risk in disasters, and rely upon caregivers who may be ill-prepared to respond in emergencies. Education of caregivers and development of community support programs could provide important sources of assistance to this vulnerable group.