Impact of the caregiver-to-resident ratio on evacuation efficiency in nursing homes: A simulation-based study

With the growing aging population, ensuring effective and safe evacuation of older people in nursing homes has become a pressing concern in emergency planning. This study presents an enhanced agent-based evacuation model that explicitly incorporates caregiver-assisted movement dynamics, intelligent pathfinding, and collision avoidance to simulate evacuation processes in nursing homes. The model is applied to evaluate the caregiver-to-resident ratio’s influence on the evacuation efficiency of residents with different distributions. The results demonstrate that increasing the caregiver-to-resident ratio does not positively affect evacuation efficiency and may even hinder it in complex building layouts. When caregivers are rationally allocated, evacuation time in scenarios involving wheelchair users can be shorter than in those without wheelchairs, due to more coordinated and assisted movements. These findings provide valuable insights for optimizing the evacuation strategies of nursing homes and emphasize that the allocation of caregivers needs to consider the locations of residents and their mobility capabilities. • An agent-based model is improved to simulate caregiver-assisted evacuation of older people, incorporating intelligent route selection and collision avoidance mechanisms. • Increasing the caregiver-to-resident ratio does not improve evacuation efficiency in complex nursing home environments. • When rationally allocating nursing staff, the evacuation time in scenarios with wheelchair users is shorter than that of people without wheelchairs. • Practical implications for optimizing evacuation strategies in nursing homes are discussed, emphasizing the need for scenario-specific approaches.