Closing the Gaps:
Advancing Emergency Preparedness, Response and Recovery for Older Adults
29 Evidence-Informed Expert Recommendations to Improve Emergency Preparedness, Response and Recovery for Older Adults Across Canada
DECEMBER 2020
[Excerpts] Report Development Contributors
In January 2019, the Canadian Red Cross in partnership with the National Institute on Ageing reviewed the latest evidence and expert opinions to inform the development of recommendations for governments, organizations and individuals to improve emergency preparedness, response and recovery for older adults.
Executive Summary [Excerpts]
Older adults consistently experience the greatest proportion of casualties during and after emergencies in Canada, and internationally, when compared to younger age groups.
In the 2017 wildfires in British Columbia and floods in Quebec, older adults were impacted the hardest due to their greater levels of vulnerability, while poorly coordinated protocols left them more vulnerable due to delays in initiating evacuation procedures
More recently, 97% of Canada’s first 10,000 COVID-19 deaths have occurred in older Canadians 60 years of age and older, with the greatest proportion of deaths occurring in long-term care and retirement homes.
Several research studies have demonstrated that these poor outcomes are linked to physiological age-related changes, such as impairments to sensory, cognitive and mobility disabilities; access and functional needs; social isolation and lack of access to familial and other social supports; having limited financial resources; and insufficient policies and procedures.
Furthermore, interruption to the timely provision of routine medical care is recognized as a likely contributor to mortality and morbidity associated medical complications during emergencies, especially in the immediate months following major natural disasters. The high proportion of deaths that also seem to occur in older adult congregate living settings is further indicative of fundamental issues that will need to be addressed in these settings as well.
There is a clear need to better support emergency preparedness for older Canadians living at home in the community or in congregate settings. In order to improve preparedness and response to emergencies, Canada needs greater consideration and adoption of evidence-informed, uniform
and collaborative emergency management interventions. These efforts will require improved resources and capacity to meet the emergency needs of all older adults, regardless of the variety of circumstances and settings in which they may be living.
In order to achieve a collaborative approach to improving emergency management nation-wide, the recommendations are categorized across six relevant emergency management domains:
1. Individuals and unpaid caregivers;
2. Community-based services and programs;
3. Health care professionals and emergency response personnel;
4. Care institutions and organizations; 5. Legislation and policy; and
6. Research.
The intention of these recommendations is to provide interventions that can bridge the existing gaps in emergency preparedness, response and recovery, and facilitate better outcomes for older adults across Canada.
The intention of these recommendations is to provide interventions that can bridge the existing gaps in emergency preparedness, response and recovery, and facilitate better outcomes for older adults across Canada.
A sample of recommendations:
Recommendation 2.1: Access should be increased to tailored community-based programs that educate older adults and their unpaid caregivers about emergencies that could affect their region and how best to prepare for and respond to them. Volunteer representatives of older Canadians and their unpaid caregivers should be recruited and involved in training material development and implementation, to ensure their voices and perspectives are reflected.
Recommendation 2.2: Programs that provide disaster relief and/or essential community services, such as Meals on Wheels, and daily living assistance for older people (financial, medical, personal care, food and transportation) should receive emergency preparedness training and education as well as develop and adhere to plans and protocols related to responding adequately to the needs of their clients during emergencies. Volunteer representatives of older Canadians and their unpaid caregivers should be recruited and involved in training material development and implementation, to ensure their voices and perspectives are reflected.
Recommendation 2.3: Community-based programs that provide in-home health and personal care for older adults should integrate strategies that minimize unnecessary personal contact and leverage resources (e.g. personal protective equipment such as gowns, masks, gloves, hand sanitizer etc.) in their emergency preparedness plans and protocols.
Recommendation 4.3: Care institutions and other organizations should strive to develop comprehensive emergency plans that include effective response strategies for protecting older adults against infectious disease outbreaks and reflect evidence-based standards supported by organizations such as Infection Prevention and Control Canada (IPAC).
Recommendation 5.3: All provinces and territories should support the creation of a national licensure process or program for nurses, physicians, allied health professionals and other emergency medical service personnel to allow them to provide voluntary emergency medical support across provincial/territorial boundaries during declared states of emergency.
Recommendation 5.4: All provincial and territorial governments should support legislative requirements that mandate congregate living settings for older persons (e.g. nursing homes, assisted living facilities and retirement homes) to regularly update and report their emergency plans that outline actions and contingencies to take in case of emergencies.
All provinces and territories should work towards standardizing requirements for emergency plans in congregate living settings in accordance with the priorities outlined in the 2019 Emergency Management Strategy for Canada and ensure that their emergency plans for congregate living settings are aligned with directives outlined in their provincial/territorial pandemic and emergency plans.
Recommendation 5.5: All provinces and territories should adopt a standardized approach to promoting collaborations between local pharmaceutical prescribers and dispensers (i.e. community pharmacists), physicians and nurse practitioners, to ensure an adequate supply of prescription medications are dispensed to persons with chronic health conditions prior to and during an emergency. This approach should also outline the need for collaboration between pharmaceutical providers, hospitals and relief agencies to ensure an adequate supply of prescription medications are available at hospitals, relief and evacuation shelters.
Click to Download CRC WhitePaper EN.pdf
