The increasing frequency of disasters in recent years has made clear the importance of preparing for their devastating impacts. The intersection of immigrant status and older age in immigrant older adults subjects them to a high risk for harm in disasters. Thus, ensuring that this population can effectively prepare for disasters is crucial. However, research that focuses on disaster preparedness among immigrant older adults in a Canadian context is limited. We interviewed informal caregivers of immigrant older adults to explore their experiences regarding the disaster preparedness of their care recipients. We aimed to describe caregivers’ knowledge of disaster risk among immigrant older adults, as well as their experiences and perceptions of barriers and facilitators of preparedness among older immigrants. We conducted semi-structured individual interviews with a sample of 10 informal caregivers of older immigrants who reside in Ottawa and Toronto. All interviews were audio-recorded, and interview content was analyzed using inductive thematic analysis. Participants were able to identify the additional risks their older immigrant family members experience, and they took on the responsibility for disaster preparedness and response for the care recipients. However, the following barriers to preparedness efforts were identified: The financial costs of preparing, lack of confidence to prepare due to inadequate information about preparedness measures, communication difficulties among family members, and time constraints. Participants’ contingency plans for caregiving for the older immigrants were largely unspoken, and influenced by cultural norms. Lastly, faith-based organizations were seen by participants as potentially having a significant role in their family members’ disaster preparedness and response; participants were largely unaware of any other relevant community-based supports. We anticipate that our results will provide insight into the barriers and protective factors that older immigrants and their caregivers experience in safeguarding against harm in disasters, and we anticipate the recommendations will inform policies and interventions to support them.

Mobility safety, especially fall prevention, plays a significant role in successful aging for older adults. Fall preventive programs aim to reduce risks for mortality from fall-related injuries among older adults. However, the covariation between personal perceptions of falls and factors and confidence of self-management in falls (CSMoF) is still under-studied despite its importance to fall prevention. Using the International Classification of Functioning, Disability, and Health (ICF) model, this dissertation aimed to investigate the relative contribution of CSMoF in relation to fall risk self-perceptions while controlling for demographics and self-reported health and functioning. Participants were 691 older adults recruited from Area Agency on Aging at Arlington, Texas. They completed measures of physical functioning, CSMoF, fall risk perceptions and fear of falls. Regression analyses indicated that fear of falls was the most predictive factor of CSMoF among older persons. Physical function measures of age, chronic illnesses of metabolism, sensory impairment, and health status were also significant predictors of the CSMoF. The interaction of perception of falls and fall experience attenuated CSMoF, with physical functioning limitations. Fear of falls served as a mediator through which demographic predictors influence CSMoF. The joint effects of perception of falls and fear of falls likely explain CSMoF among older adults more than physical functional indicators. Fall prevention programs for older adults should prioritize to address modifiable subjective factors of fall perceptions, fear of falls, and CSMoF across health and functioning statuses. Fear of falls should be the center of CSMoF enhancement.

This is the peer reviewed version of the following article: [J Am Geriatr Soc 63:1355–1363, 2015.], which has been published in final form at [doi: 10.1111/jgs.13481]. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving. / 京都大学 / 0048 / 新制・課程博士 / 博士(人間健康科学) / 甲第19642号 / 人健博第34号 / 新制||人健||3(附属図書館) / 32678 / 京都大学大学院医学研究科人間健康科学系専攻 / (主査)教授 三谷 章, 教授 黒木 裕士, 教授 市橋 則明 / 学位規則第4条第1項該当 / Doctor of Human Health Sciences / Kyoto University / DFAM

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