The older adult is one of vulnerable people who is usually affected on disaster. They are at risk for poor health outcomes both during and after disasters. This age group is more likely to have physical and sensory impairment that cause having limitation in movement, need to depend on others in daily living. For this reason, they are a priority group during disaster. The Big flood on 2011, most of older adults did not evacuate to the temporary shelter. They chose to stay at home in flood areas up to 4 months even though they might be risk to life threatening because their major concern is to protect their home and their properties. This is the main reason lot of older adults affected and death.
The elderly health screenings of Ministry of Public Health, Thailand showed that 1.3 million or 21% of Thai elderly are home bound elder and bed bound elder group. The dependent group required health services and social support. While labor force moved to urbanize city. Older adult live in small households that lack a potential to care themselves. As a result, an increasing of caring problems in elderly. The Long Term Care system (LTC) was launched in order to support the family to increase the potential of care and facilitate older adults can live in their own home. Nurses take responsibility as a care manager in this system who is primarily responsible managing care plan, coordinating with multidisciplinary team, and monitoring caregiver operation following to the care plan for dependent older adults in the normal situation. During the long period of flood situation, they also collaborated with multidisciplinary team and health volunteer team to take care dependent older adults. Flood disaster affects human well-being in both short-term and long-term. Research in vulnerabilities subgroup such as older adults, people with disabilities, and chronic conditions still need evidence to fulfill gap in disaster risk reduction for the Sendai framework and to support the Sustainable Development Goals.
Methods: The Process-Person-Context-Time (PPCT) model formulated by Urie Bronfenbrenner was used as a conceptual framework of this study. It is an important to promote healthy behaviors by integrating ecological approach that impact on health outcomes. This study will be used mixed methods design to develop a better understanding management of flood preparedness system for Thai dependent older adults in communities. The qualitative approach will be used to describe roles and caring process of care managers, caregivers, and Tambon administrative officers in taking care Thai dependent older adults for flood preparedness. The focus group with semi-structured interview and observation methods will be used to response this quest. Flood experiences and meaning of flood preparedness among Thai dependent older adults and their family caregivers will be obtained by interviewing family caregivers through semi-structured interview guide. The quantitative approach will be used to investigate bio-ecological factors relating flood preparedness for Thai dependent older adults in non-habitual flood area and habitual flood area through questionnaires. A multi-stages random sampling technique will be used to recruit households with dependent older adults and family caregivers. Two focus groups will be conducted in two communities.
Results: Using mixed methods will be able to compare or integrate the result of flood preparedness for dependent older adults. The results can answer the quest of successful or barrier of LTC system implementation in communities and might show additional activities of care managers, caregivers, and Tambon administrative officers for taking care dependent older adults in flood situation.
Conclusion: This study will be benefit for health care providers with a better explanation and providing evidence of flood preparedness to be better preparing for dependent older adults. Moreover, the findings will be useful for develop an effective intervention program for flood preparedness and create a model of care for flood preparedness for Thai dependent older adults.