Public Health

Area of Science:

• Gerontology
• Public Health
• Health Services Research

Background:

• Alzheimer's disease (AD) patients face increased risks during disasters due to disrupted care and limited medical access.
• Hurricane Maria in 2017 highlighted significant vulnerabilities for AD patients and their caregivers in Puerto Rico.
• This study addresses the critical need to understand and improve health service delivery for AD populations during emergencies.

Purpose of the Study:

• To assess the health service needs of Alzheimer's disease patients and family caregivers in Puerto Rico post-disaster.
• To identify policy opportunities for enhancing care access and support for this vulnerable group.

Main Methods:

• Conducted 51 in-person interviews with AD patients and caregivers in Puerto Rico (12/2023-11/2024).
• Interviews were conducted in Spanish, transcribed, and translated to English.
• Utilized directed content analysis with established interrater reliability (Cohen's kappa).

Main Results:

• Key needs identified include personal care assistance, trauma symptom management for patients, and caregiver respite care.
• Care coordination challenges, including prescription and lab result management, were significant.
• Health-related social needs, such as nutritional support and improved communication with providers, were also reported.

Conclusions:

• Disasters create substantial service needs for Alzheimer's disease patients and their caregivers.
• Policy recommendations include digitizing administrative processes, maintaining telehealth, enhancing long-term care financing, and improving Puerto Rico's electrical infrastructure.