Negotiating Dementia care in networks of care: The effects of compounded disasters on social networks of care in rural Puerto Rico

Abstract

AbstractBackgroundAlready living through public health infrastructure cuts and austerity measures, Puerto Rico has experienced a multifaceted series of compounded disasters: hurricanes, earthquakes, and the ongoing COVID‐19 pandemic. These events have further exacerbated and disrupted the protocols and procedures employed by health and government officials in the care and support of caregivers and family members living with dementia. In the mountainous interior of the island, this has further been pronounced, where the roles and resources of healthcare professionals have been pressed and stretched. This study aims to explore the disruption to the social networks of health care professionals and social workers in the aftermath of these events.MethodNarrative interviews were carried out with 16 health care professionals and social workers who served as brokers—a link between groups, information and/or resources—to the citizens of various towns in the interior of the island of Puerto Rico. Grounded theory methodology was employed to explore changes within the network.ResultGaps in the networks of public health officials were identified, resulting in the emergence of multiple structural holes. These gaps were bridged by the local communities of health care and social workers, who were responsible for providing resources and support beyond those typically provided to the community. The bridging of these gaps—although at times limited—was crucial in order to ensure the provision of resources and support to caregivers of family members with dementia.ConclusionThe results reveal the diverse roles assumed by health care and social work professionals as intermediaries in the aftermath of compounded disasters. These findings provide insight into the necessary connections within the health care and local community that must be established to mitigate the effects of natural and human‐caused catastrophes. The understanding of the roles performed and assumed by these professionals can aid in the development of mitigation strategies that could improve the provision of resources and support to vulnerable populations of elderly living with dementia in future disaster situations.