Impact of Emergency Evacuations on Skilled Nursing Facilities Residents' Health during 2009 Floods in Fargo, North Dakota

BACKGROUND:   Emergency evacuations are stressful for all involved, but they can be especially hard on older adults. In North Dakota, emergency evacuations of skilled nursing facilities (SNFs) have occurred 3 times since 1996. The purpose of this study is to look at the health impact the 2009 flood evacuations had on Fargo SNF residents. This study investigated the possible declines in cognitive status, mood and physical function as a result of these evacuations.

METHODS:   This quantitative study used retrospective data gathered from the Minimum Data Set 2.0 from all 5 Fargo SNFs evacuated during the 2009 flood.  Controls from SNFs in Bismarck, Grand Forks, and Minot, ND for that same time period were used to look for changes in cognitive status, mood, and physical functioning. Data were analyzed using logistic regression, ANOVA, odds ratios and chi-square. 

RESULTS:  The initial chi-square analysis looking for overall changes in cognitive status, mood and physical function were not significant. However, smaller significant changes within the individual independent variables, such as varied mental function (χ²= 4.7, p=0.03), resident makes negative statements (χ²=7.04, p=.01), resident able to eat by self (χ²=12.2, p= 0.00), resident eats with support (χ²=20.32, p=<0.00), resident maintains own personal hygiene (χ²=5.7, p=0.02), and change in ADL function (χ²=19.1, p=<0.00) were present.  Additionally, a decline in mood and physical functioning could be predicted by several of the predictor variables, including age group, history of fractures, anxiety, history of falls, ulcers and chronic disease.

CONCLUSIONS:   Initial Chi-Square analysis looking at change in overall cognitive status, mood, and physical function was not significant. However, smaller significant relationships existed within those groups. Castle (2005) noted that while the odds ratios may be small in some areas, they should not be overlooked because small changes among this population may affect quality of life. These findings could provide situational awareness to emergency planners, local public health agencies, and SNF leadership by highlighting the impact emergency evacuations have on residents. Additionally, it supports the need for preparation, planning and practice drills to ensure that SNF residents are ready when the next evacuation occurs.