COVID-19 has tragically demonstrated the serious threat that pandemics and other disasters pose to older adults’ health, safety, and well-being. What role can senior centers and senior villages play in protecting older adults’ health and building their resilience during COVID-19 and other disasters

Pendergrast, Claire

English

Syracuse University Research Facility and Collaborative Environment

  Aging-in-Place Organizations are Key to Building Disaster Resilience for Older Adults  Claire Pendergrast COVID-19 has tragically demonstrated the serious threat that pandemics and other disasters pose to older adults’ health, safety, and well-being. Older adults face a greater risk of dying in disasters than other age groups. Disasters also negatively impact older adults’ health by exacerbating chronic health conditions, creating psychological strain, and disrupting access to care and social services.1   Fifteen percent of the U.S. population is currently over age 65, a number expected to grow to nearly 25% by 2060.2 Disasters are also becoming more frequent and severe in a changing climate, making the development and implementation of strategies to improve older adults’ disaster resilience an increasingly urgent public health priority.  This brief describes a study of the role of senior centers and senior villages in King County, Washington in building older adults’ disaster resilience.3 We interviewed directors and program managers representing 14 aging-in-place organizations about their organizations’ involvement in disaster-related activities. We also asked if and how they see their organizations contributing to disaster resilience for older adults in their communities.   Aging-in-Place Nearly 80% of adults age 50 and older want to remain in their communities and homes as they age, or ‘age-in-place’.4 There is increasing interest nationally and globally from policy stakeholders and researchers in strategies that enable older adults to age-in-place. In recent years, a growing number of initiatives and organizational models have been implemented across the country to create “Age-Friendly Communities” with social and physical environments to support older adults aging-in-place.5 Two of the most prominent aging-in-place organizational models are senior centers  and villages. Senior centers are one of the most widely used services among America's older adults who are aging-in-place, providing recreational, nutritional, health, and social service programs at nearly 11,000 centers nationwide. Senior centers may be non-profits or run by local government. Villages are an increasingly popular aging-in-place organizational model, differing from senior centers in that they are volunteer-based and use a ‘grassroots’ approach to provide older adults with programming aligned with local needs and interests.  RESEARCH BRIEF #23 June 5, 2020   KEY FINDINGS • Aging-in-place organization leaders view providing disaster preparedness information or resources as an appropriate role for their organization to support older adults’ disaster resilience. • Nearly all organizations had a disaster or emergency plan in place, though the details and formality of plans varied widely between organizations. • Leaders of aging-in-place organizations felt that they should have the opportunity to participate in disaster planning conversations with government leaders to share their insight on older adults’ specific needs and identify opportunities for their organization to contribute to disaster preparedness and response. 2    SYRACUSE UNIVERSITY LERNER CENTER FOR PUBLIC HEALTH PROMOTION  Community Disaster Resilience The concept of community disaster resilience includes a focus on the needs of vulnerable populations such as older adults. Disaster resilience also emphasizes the role of governmental, nongovernmental, and community-based organizations in providing social services and assistance to provide vital community needs each day and after a crisis.6   Organizations Support a Range of Resilience-Building Activities In our research, leaders of aging-in-place organizations identified several opportunities and challenges for building disaster resilience for older adults in their communities.  Opportunities included: • Trusted relationships with older adults aging-in-place • Existing programming could support disaster-related education and outreach • In-depth understanding of the specific barriers to disaster preparedness, response, and recovery for older adults • Organization staff is passionate and committed to older adults’ wellbeing • Opportunities to collaborate with partner organizations to support disaster programming  Challenges included: • Limited funding resources and staff capacity and expertise for disaster-related activities • Structure or location of organizations’ facilities may make them inappropriate for use during or after disasters • Lack of government engagement and resources related to older adults’ disaster resilience • Some older adults may need greater support in disaster preparedness, response, or recovery than some organizations can feasibly provide  All leaders of aging-in-place organizations saw providing disaster preparedness information or resources as an appropriate role for their organization to support older adults’ disaster resilience. Education and wellness programming are strong components of their existing programming, so they saw incorporating disaster-related education and outreach into their work as highly feasible. Respondents emphasized the importance of delivering disaster preparedness information in a format appropriate for an older adult audience. In-person delivery of large-font, hard-copy materials were preferred over online communication. As one respondent explained, “It probably also requires sort of boots on the ground and go and talk to people about this stuff. If it's on a website, it's just the fact that it's not going to get to everybody. Seniors necessarily aren't as savvy.”   Nearly all organizations had a disaster or emergency plan in place, though the details and formality of plans varied widely between organizations. Many respondents described plans specifically outlining procedures for their organization to evacuate the building, or policies around organizational closures during unsafe weather conditions. Several respondents pointed to the uncertainties around the type, severity, and timing of a disaster as barriers to effective planning, emphasizing the need for flexibility in disaster planning and response. Respondents frequently referenced the challenge of allocating staff time to the development and maintenance of disaster-related plans. Many organizations served as designated ‘warming centers’ or ‘cooling centers’ in extreme temperatures. However, they described relatively low attendance during hot weather in spite of efforts to make cooling centers inviting by providing refreshments and entertainment. Most government senior centers’ facilities were designated as an American Red Cross shelter site, and respondents described providing support to Red Cross volunteers who were unfamiliar with the facility. Respondents emphasized the 3    SYRACUSE UNIVERSITY LERNER CENTER FOR PUBLIC HEALTH PROMOTION  importance of considering pets in older adults’ disaster preparedness and response needs.   Organizations Differ in their Capacity to Support Disaster Resilience  Aging-in-place organizations felt their mission to serve older adults included supporting them in disaster situations. As one respondent said, “I think it's part of the philosophy of this senior center. And we are here to serve seniors. And certainly, we're here to serve them most when they're without electricity or closed in because of snow.”   Government senior centers, non-profit senior centers, and villages each identified unique strengths and weaknesses in their capacity to support older adults’ disaster resilience. Government senior centers described coordination, training opportunities, and resources from local Emergency Management departments as an asset. However, most government senior centers described few opportunities to provide input on disaster plans or take part in disaster-related activities without direction from Emergency Management.   Non-profit senior centers described greater autonomy in developing and implementing disaster-related plans and programs, but they referenced restrictive grant conditions and limited funds and staff capacity as barriers to supporting resilience-building plans and activities. Villages pointed to their organizations’ large volunteer base who are equipped to provide in-home services as advantageous for providing disaster-related support in older adults’ homes (e.g. storing water, installing air conditioning units).   Organizations that serve specific nationalities and ethnic groups described the value of their strong community ties and in-depth understanding of the unique social services needs of their members on an everyday basis and especially in a disaster. Respondents saw their organization’s physical facility and staff as influential to their organization’s capacity to support disaster resilience. Organizations that shared a space anticipated collaborating with their neighboring organizations on disaster planning and response.  Respondents also discussed the need for adequate staff capacity and expertise to support disaster-related activities. Many respondents emphasized that staff passion for the organization’s mission of serving older adults motivated them to ensure members’ needs were met on an everyday basis that would continue in a disaster.   Social Environments Support Disaster Resilience Social environments were seen as key to building disaster resilience, and respondents from urban and rural environments described differences in social support and services for older adults in disasters. Respondents felt that urban communities had less social isolation and more services available to support disaster response, including transportation, healthcare, and first responders. However, respondents from smaller cities and towns described close community connections in small communities as an asset to their organizations in providing flexible and appropriate services to support members in disasters.   Many respondents felt that the social connections created through aging-in-place organizations would reduce older adults’ disaster-related risks by connecting older adults with organization staff, volunteers, and members who could provide support in a personal emergency or a disaster. As one respondent described, “we are the 911 information center for what’s happening... It’s really just an extension of family for many, many people.” However, several respondents “I think it's part of the philosophy of this senior center. And we are here to serve seniors. And certainly, we're here to serve them most when they're without electricity or closed in because of snow.” -Government Senior Center 4    SYRACUSE UNIVERSITY LERNER CENTER FOR PUBLIC HEALTH PROMOTION  felt that groups of community-members, rather than aging-in-place organizations, should play a lead role in disaster planning, given the uncertainty that staff would be present or that the facility would be accessible in a disaster.   Local Government Leadership and Collaborative Planning and Response are Needed Respondents looked to local government agencies and organizations to coordinate inclusive disaster planning and tailor disaster communications and policies for an older adult audience. Many respondents also emphasized a desire for two-way collaborations with government planners. They felt aging-in-place organizations should have the opportunity to participate in disaster planning conversations to share their insight on older adults’ specific needs and identify opportunities for their organization to contribute to disaster preparedness and response. One respondent said, “I just think that whether it be the state or the county or cities, when they have disaster planning committees or meetings, to be sure and involve your senior centers. Because we are the focal point within the community. We know the seniors.”   Aging-in-place organizations expressed a desire for government to take a hands-on approach to developing educational materials and providing policy recommendations that specifically addressed the heightened vulnerability and unique needs of older adults.   Respondents also discussed collaborations as essential to their organization’s involvement in disaster-related activities. Many felt that partnering with local emergency management departments or the Red Cross was crucial, given these organizations’ expertise in disaster preparedness and aging-in-place organizations’ limited capacity to develop new programs. Other collaborators included food banks, neighborhood “hub” disaster volunteer groups, home care agencies, and religious organizations. Respondents described challenges in coordinating disaster planning with other community organizations due to staff and volunteer turnover. Urban organizations generally described fewer disaster-related collaborations than organizations in smaller communities.  Implications for Policy and Practice  Given limited budgets, staff capacity, and disaster-related expertise, aging-in-place organizations must prioritize effective and feasible activities to build older adults’ disaster resilience. Government agencies and organizations should support and incentivize aging-in-place organizations’ participation in disaster preparedness educational activities and neighborhood-scale disaster planning efforts. Aging-in-place organizations need accessible tools and resources to enable their organization to make use of their unique assets and identify feasible opportunities to contribute to disaster planning and response. Organizations would benefit from successful examples of aging-in-place organizations contributing to local disaster activities and supporting older adults in preparing for and responding to disasters.   Leadership from local government agencies and organizations is essential in coordinating disaster planning and response for older adults. Providing tailored policy guidance for each aging-in-place organizational model may be valuable, given the unique challenges and “I just think that whether it be the state or the county or cities, when they have disaster planning committees or meetings, to be sure and involve your senior centers. Because we are the focal point within the community. We know the seniors.” -Government Senior Center “We are the 911 information center for what’s happening... It’s really just an extension of family for many, many people” -Nonprofit Senior Center 5    SYRACUSE UNIVERSITY LERNER CENTER FOR PUBLIC HEALTH PROMOTION  opportunities faced by government senior centers, non-profit senior centers, and villages.   Similarly, aging-in-place organizations in smaller communities and large urban areas may benefit from tailored support, although more research is needed to understand how best to support older adults’ disaster resilience in rural communities. Brief planning documents, draft program materials, and web-accessible trainings may enable aging-in-place organizations with limited resources or in rural environments to participate more easily in resilience-building activities. Local and state government agencies and organizations should develop such tools in collaboration with community partners, but they may benefit from existing materials and guidance developed at the federal level.  Data and Methods The data used in this brief come from a study conducted by a University of Washington research team in King County, Washington in 2018-2019. Semi-structured interviews were conducted with a sample of 14 aging-in-place organization leaders. Interviews were audio-recorded and professionally transcribed, and transcripts were analyzed using thematic analysis. For a more detailed discussion of our study’s methods and findings please see:  https://www.cambridge.org/core/journals/ageing-and-society/article/examining-the-role-of-ageinginplace-organisations-in-building-older-adults-disaster-resilience/118964A8516C9E9ADE0AC14A7041B730  References 1. Aldrich, N., & Benson, W. F. (2008). Disaster preparedness and the chronic disease needs of vulnerable older adults. Preventing Chronic Disease, 5(1), A27. 2. Administration for Community Living. (2018). 2017 Profile of Older Americans. Retrieved from https://acl.gov/sites/default/files/Aging%20and%20Disability%20in%20America/2017OlderAmericansProfile.pdf 3. Pendergrast, C., Belza, B., Bostrom, A., Errett, N. (2020). Examining the role of Ageing-in-Place organizations in building older adults’ disaster resilience. Ageing & Society, 103(7), 1181–1189. 4. Binette, J., & Vasold, K. (2018). Home and Community Preferences: A National Survey of Adults Age 18-Plus. Washington, DC: AARP Research.  5. Greenfield, E. A. (2012). Using ecological frameworks to advance a field of research, practice, and policy on aging-in-place initiatives. The Gerontologist, 52(1), 1–12. 6. Chandra, A., Williams, M., Plough, A., Stayton, A., Wells, K. B., Horta, M., & Tang, J. (2013). Getting actionable about community resilience: the Los Angeles County Community Disaster Resilience project. American Journal of Public Health, 103(7), 1181–1189.  Acknowledgements This research was funded by the Boeing Focal Award.  Special thanks to Nicole Errett, Ann Bostrom, and Basia Belza for contributions to this research project, and to aging services practitioners who supported this research through involvement in study design or through participating in interviews. The writing of this brief was also supported by the NIA-funded Interdisciplinary Network on Rural Population Health and Aging (1 R24-AG065159). The author thanks Shannon Monnat for helpful feedback on previous drafts of this brief.  About the Author Claire Pendergrast is a PhD student in the Department of Sociology, a Graduate Associate for the Center for Policy Research, and a Graduate Research Affiliate for the Lerner Center at Syracuse University. Email: cpenderg@syr.edu   

Aging-in-Place Organizations are Key to Building Disaster Resilience for Older Adults

https://surface.syr.edu/cgi/viewcontent.cgi?article=1044&context=lerner

Aging-in-Place Organizations are Key to Building Disaster Resilience for Older Adults

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