261230 Disaster Preparedness for Veterans with Dementia and their Caregivers: An Educational Intervention Pilot

Tuesday, October 30, 2012

Nancy Oliva, PhD, MHA, MPA, RN , Geriatric Research, Education and Clinical Center, VA Palo Alto Healthcare System, Palo Alto, CA
Betty Wexler, MSN, CNS, RN , Geriatric Research, Education and Clinical Center & Geriatrics and Extended Care, VA Palo Alto Healthcare System, Palo Alto, CA
Gail Gullickson, MD, MPH , Geriatric Research, Education and Clinical Center, VA Palo Alto Healthcare System, Palo Alto, CA
Megan Manco, BA , Geriatrics, Research, Education and Clinical Center, Va Palo Alto Healthcare System (formerly), Palo Alto, CA
Abbie Layton, MSN, RNP , Home-Based Primary Care, VA Palo Alto Healthcare System, Palo Alto, CA
Sue Anne McLean, BSN, RN , Geriatrics and Extended Care- San Jose Adult Day Health Center, Va Palo Alto Healthcare System, San Jose, CA
Sarah R. Brunskill, MA , Geriatrics Research, Education and Clinical Center, VA Palo Alto Healthcare System, Palo Alto, CA
Background: Sensory, cognitive and physiologic changes in older adults can result in barriers to awareness, communication and help-seeking and help-finding during a disaster. Individuals with memory loss (dementia) are at risk of isolation and injury due to cognitive impairment. This Pilot was designed to address these complex needs among community-dwelling Veterans. Methods: A multidisciplinary Disaster Kit Pilot planning committee from several VA Palo Alto Healthcare System (VAPAHCS) geriatrics programs was created, utilizing a Plan-Do-Check-Act (PDCA) Quality Improvement process model to identify and evaluate Pilot tasks. Tasks included design of a disaster kit model with supplies, tools and information customized for cognitively-impaired Veterans/their caregivers, and pre and post-intervention self-report surveys on disaster preparedness. One-hundred and sixty eight (168) Veterans with dementia and 132 caregivers were identified within VAPAHCS geriatric caseloads. Results: The pre-intervention survey was mailed to 278 caregivers/Veterans in mid-2011, with a 26% response rate (71/278). Two-thirds of respondents (68%, n=48) reported not having a disaster kit and 26% (n=17) indicated no preparation for a disaster. The post-intervention survey (36% response, 44/123) revealed a substantial, positive shift in respondents' knowledge of key disaster preparation elements. Seventy-nine percent (79%, n=19) of respondents reported that they were prepared, with none reporting Not at All Prepared. Conclusions: Pre-intervention, few Veterans with dementia or caregivers reported that they were fully prepared for a disaster. Post-intervention, respondents reported much improved disaster preparation. Disaster preparedness in a vulnerable Veteran and caregiver population calls for anticipatory guidance and structured support such as that offered in this Pilot.

Learning Areas:
Advocacy for health and health education
Assessment of individual and community needs for health education
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related nursing

Learning Objectives:
Describe planning assumptions and design processes for a unique disaster preparation educational intervention for Veterans with dementia and their family caregivers. Discuss elements of pre and post-survey design for assessing Veterans' and caregivers' disaster preparation and behavior management knowledge.

Keywords: Dementia, Disasters

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have conducted and published research on chronic disease self-care of older adults and their caregivers, and am currently researching quality of care in geriatric populations. I have worked as an educator of emergency response professionals, and have managed pre-hospital emergency care services in the community. Among my scientific interests is disaster preparation interventions for community-dwelling older adults.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.