Continuity of Care for Older Adults in Disasters: A Scoping Review on Resilience, Gaps, and Health System Preparedness

Document Type : Review Article

Authors
Zohreh Sarchahi 1
Mahdie Dehnavi 1
Hasan Ghodsi 1 , 2
1 Department of Nursing and Midwifery, Neyshabur University of Medical Sciences, Neyshabur, Iran
2 Healthy Ageing Research Centre, Neyshabur University of Medical Sciences, Neyshabur, Iran
Abstract
ABSTRACT
Background: Due to their multidimensional care needs, older adults are highly vulnerable to disasters. However, the continuity of care for this population during crises has received relatively little attention. This review aimed to map and synthesis the existing evidence on continuity of care for older adults in disasters.
Methods: This was a scoping review conducted following the PRISMA-ScR guidelines and the JBI methodological framework (2020). A systematic search of PubMed, Scopus, WHO, and SID databases was performed using keywords related to aging, disasters, and continuity of care. Web of Science was not included due to institutional access limitations. Regardless their design, studies were considered eligible if published between 2015 to 2025 in Persian and English, and examined continuity of care for older adults (aged 60 years and above) in disaster settings. Data were synthesized using thematic analysis.
Results: The initial search yielded 1,365 records. After removing duplicates (n=39), 1,326 records were screened by title and abstract, of which 1,285 were excluded as irrelevant. The remaining 41 full text articles were assessed for eligibility, of which 32 were excluded with reasons (no relevance to continuity of care: 18 full text not available, 6 unclear population or 8 no age disaggregation). Finally, nine studies met the inclusion criteria. Four main themes emerged from thematic analysis: (1) barriers to accessing medications and chronic care; (2) challenges in emergency evacuation and transportation; (3) mental health needs and resilience; and (4) policy and health system gaps. Most of the included studies were descriptive, with few offering practical interventions.
Conclusion: The existing literature on continuity of care for older adults in disasters remains limited and fragmented. Major gaps include a lack of context-specific and practical interventions, insufficient age-disaggregated data, inadequate training for both personnel and older adults, and failure to integrate of age-sensitive approaches into disaster management. To address future research, a conceptual model of "care resilience for older adults in disasters" is proposed.
Keywords
Older adults
continuity of care
disasters
resilience
scoping review