Disaster: 6 actions to avoid leaving the elderly and disabled in danger
Tuesday, October 13, 2015
The recent wildfires once again shine a light on the importance of increased attention to the needs of the elderly and disabled during disaster planning, response and recovery phases.
Nearly 75 percent of those who died in the Hurricane Katrina disaster were older than 60. Two years later, busloads of elderly and disabled were evacuated from care facilities in San Diego County, but were left stranded and trapped by flames as wildfires raged.
The latest deaths, due to the Northern California fires, were all individuals over 65 years of age with functional limitations. A Los Angeles Times article highlights the stories of these victims, and it will help increase community awareness.
However, opportunities also exist for healthcare leaders, and their partners in social service agencies, to help educate vulnerable populations, improve alert mechanisms, facilitate more rapid evacuations and address needs while affected individuals wait to return to their homes and recover from the damage.
A 2008 After Action Report on the San Diego fires noted that most disaster response systems are designed for people who can "walk, run, see, drive, read, hear, speak and quickly understand and respond to instructions and alerts." The elderly and disabled are challenged by some of these activities and are harder to evacuate than the average person.
Some are fragile, have dementia and/or significant mobility limitations. This results in more time needed to reach and prepare these individuals for evacuation, as well as, specialized equipment, such as wheelchair and bariatric accessible vans or buses.
As baby boomers age, there must be a shift in thinking from "special needs" populations being an outlier, to them being more of the general population. This is because the "Silver Tsunami" of aging boomers with chronic and acute conditions will soon result in the number of individuals with functional limitations exceeding 50 percent of the total population. It will also contribute to the already increasing proportion of elderly living in rural communities, where access and resources are strained.
Healthcare professionals have the opportunity to lead, and six actions they can take now to contribute to improved preparedness include:
1. Operationalize planning tasks by shifting the mindset of your organization from a general "special needs" orientation to a discussion around the specific functional needs of the elderly and disabled.
2. Exercise with real blind, deaf and wheelchair-bound "patients" instead of simply healthy people with signs that say "deaf person," etc.
3. Incorporate preparedness and safety in discharge planning for those with functional limitations resulting from surgery, treatments or pain — especially for those with limited social supports or returning to rural/remote communities. Identify those who may need additional assistance and plan supports and backups.
4. If your organization is responsible for managing the health of populations with specific functional limitations, explore opportunities to improve communication, medical, transportation, supervision and maintenance of functional independence during disasters. Support these individuals in their own personal disaster planning and preparedness.
5. If your organization is responsible for long-term care patients/residents, strengthen planning activities and exercise staffing that will accompany and remain with those evacuated to shelters and/or other facilities.
6. Recognize the depth of the disability experience, and pay attention to details by including the population in the development of materials that are relevant, specific and useful. Together, also explore the needs of the community and consider educational outreach activities.
Refocusing attention on the functional needs of specific populations served by hospitals, clinics, residential care facilities and home care or other programs will help professionals to fulfill their responsibilities to individual patients. In addition, more relevant planning activities will also contribute to improvements in self-management care activities and better outcomes for those populations with chronic and acute conditions.
It may also result in lives being saved the next time a disaster hits your community.
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