A qualitative survey of household emergency preparedness for the elderly and the medically frail living in coastal urban communities.

Objective: To understand how elderly and medically frail adults have experienced disasters and how this experience impacts what they do now to prepare for disasters and to generate theory regarding the process through which community members prepare for disasters. Design: This study employed a qualitative descriptive methodology, Situational Analysis (SA), to explore the social processes of disaster preparedness in vulnerable community members. The Protective Action Decision Model was used to inspire the interview guide and initial coding of the data. Discourse analysis was performed on noninterview data. Setting: A coastal urban community heavily damaged by Hurricane Sandy in 2012. Participants: Convenience sample of 33 elderly or medically frail community members. Results: Based on the findings, it was theorized that these community members are unprepared for disasters. Their lack of preparedness is due in large part to a lack of education on how best to prepare. If these community members are incidentally prepared, it is largely due to their past experience with disaster or their professional experience. The preparedness discourse did not recognize the extent to which elderly and medically frail populations rely on institutions and social support networks to meet their disaster resilience antecedents. Conclusions: Community interventions such as distributing disaster supply kits and offering evacuation assistance can help to overcome situational impediments to preparedness and provide the best chance for community members to survive disasters without becoming ill or injured. Study results can inform emergency plans and policy efforts to better meet the needs of these community members during disasters.