Evacuating the Elderly during Disasters: Nursing Homes and Assisted Living

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When Hurricane Matthew hit the Atlantic coast in the American Southeast, Florida was one of the hardest hit states. The Sunshine State is famous for its many retirement homes and senior communities. Evacuation of the elderly and infirm during this natural disaster was a challenge.

When catastrophe strikes, families rightfully question whether or not staff at a given facility can properly provide safety for those under their care. Seniorsmatter conducted an interview on this topic with John J. Schaum. Schaum is the Executive Director of Arbor Terrace, an assisted living facility in Ponte Vedra, Florida. He revealed several helpful points for evaluating facilities on this matter. Schaum’s leadership on this issue comes from over thirty years in healthcare and fourteen years working in long-term care facilities. His experience and planning led to a successful evacuation and re-entrance for his residents during the disaster.

 

Priorities for Evacuating the Elderly during Natural Disasters

When constructing plans for evacuation, Schaum studies the type of disaster anticipated. In Florida, hurricane season nearly always brings trouble. Schaum coordinates “with the other department heads” in his facility, since each person can articulate various needs and priorities. In his words, “everybody’s input is vital” to a successful emergency plan. Once Director Schaum has these in hand, he creates the Emergency Management Plan for evacuating the elderly.

As soon as a tropical storm begins brewing, Schaum coordinates with staff to begin preparation for a possible move. The preparations begin with packing enough food, clothing, and medications for a short stay away from the facility. Planning food for a few days without power can be complicated. Schaum recommends packing food that does not need to be heated, such as peanut butter and jelly sandwiches or salads. Small personal items help residents settle in well at a new place. A blanket or a few photographs of loved ones are reassuring too. Staff members assist residents with packing up such items in the days leading up to a possible evacuation. When the moment comes, though, and everyone must go, “Just go,” Schaum says. There is no time to dawdle when evacuating the elderly during a natural disaster.

 

Relationships to Local Agencies and Families

The evacuation of Arbor Terrace went so well, in part, because of the relationships Schaum cultivates with local officials. He received word one morning from a St. John’s county official that a mandatory evacuation would be announced that evening. Rather than wait for the rush of traffic or the panic to hit with the evening news, Schaum and his team sprang into action early. Administrators of assisted living facilities benefit from such relationships. These benefits get passed on to their residents in the form of safety in an emergency.

One of the first steps to coordinating an evacuation is to alert the families of residents. Schaum asks first if families would like to come to the facility and take their loved ones home with them. He and his staff then ensure that relatives’ homes will meet the needs of the seniors who will stay there. Some will need generators to power breathing machines or keep medications cold. Others need to arrange someone to be home enough to care for an elderly relative at risk for wandering. Keeping in touch with these families, as well as providing all families with telephone and email updates, keeps the circle of care strong and well-informed.

 

Transportation

Arbor Terrace owns three buses of its own. These are typically used for such activities as doctor’s visits, group outings, and running errands. However, on the day of evacuating the elderly, the buses became the best and safest way to get 38 seniors from one facility to another.

Schaum recommends loading ambulatory seniors onto a bus first. Those residents can board themselves or with a little assistance, and they can disembark more easily too. Silver Rehab, which provides occupational therapy for Arbor Terrace residents, volunteered their staff to help with evacuating the elderly with mobility challenges. Familiar with and trusting of Silver Rehab staff, the residents knew they were in good, safe hands. The boarding was expedited, and Schaum says, “Not one of our residents got hurt during that transfer.”

 

Receiving Facilities

Identifying a receiving facility in the case of evacuating the elderly is vital. The priorities here vary depending upon the residents’ needs. Ideally, the receiving facility would be fully outfitted for power loss, including having backup generators. It would have plenty of cots or beds in lots of private rooms, and be similar to the home facility. It is best that a receiving facility have staff who are at least familiar with senior care. Proximity to a hospital is an even bigger bonus, in case of any health emergencies. Schaum was able to place his residents in a new sister facility safely out of the evacuation zone, further inland. This facility had enough private space for residents and was fully outfitted to fit the needs of seniors. The staff, although unfamiliar with these specific residents, was well-trained and knowledgeable in senior care, including memory loss. All this made the transition that much easier.

 

Providing for Memory Care-Related Needs while Evacuating the Elderly

Key to caring for seniors with memory loss is a facility that allows for entrances and exits to be monitored and locked. Seniors with dementia and other cognitive decline are at high risk for wandering and confusion. If they have easy access to an exit, especially in an unfamiliar place during a stressful time, they may leave. This can occur even in the middle of a hurricane or other natural disaster. Ensuring that a receiving facility has lockable doors, or doors that can be monitored day and night, is a high priority.

During transportation, Schaum recommends first moving those seniors whose cognitive function is higher. This is because those with lower cognitive function often need more rest. They also benefit from arriving at a facility where others have begun to settle in. Higher-functioning residents are more likely to get to the new facility, understand the situation, and be able to get comfortable. Thus, they serve as role models to the residents needing more orientation.

Once seniors are settled, however, it is business as usual. Whenever possible, mealtimes, medication times, and even activities are held according to the regular schedule. In fact, activities and food may even increase. Schaum says that, during their stay at the sister community, the staff of Arbor Terrace “provided plenty of activities and food.” Chuckling, he adds,“We ate a lot.”

Reassuring everyone that they are safe also helps keep the atmosphere light. The staff explains, “We’re going to go somewhere else for a little while. We’re going to go somewhere else where we’re going to be taken care of.” Once residents arrive, activities, low lighting, closed blinds, and no news keep the weather off everyone’s minds. The other best tool for reassuring seniors they are safe is continuity of staff. Many of the people working at Arbor Terrace at the time came with the residents and stayed during the evacuation. In fact, “not only did they evacuate from their homes, but they brought their spouse, their child, to the community with us” to stay safe from the hurricane, Schaum says. Maintaining familiar staff reduces anxiety and unfamiliarity for seniors who are easily distressed by having to mentally process change.

Anyone looking into long-term care facilities should discuss emergency management plans. Natural disasters, fires, or burst water or gas pipes may lead to evacuating the elderly. Knowing how a facility cares for residents during emergencies adds to peace of mind for families. It also shows how adept and experienced the staff is. How prepared they are for emergencies shows how they react to and care about threats to their residents’ safety.

Schaum’s excellent leadership serves as a model. He says that a good leader knows that “this is a population [seniors]that needs to be targeted differently and the residents need to be cared for differently.” This is especially true for residents who suffer from cognitive decline. “Doing your homework” is good advice for leaders everywhere who want to create better outcomes for seniors, in times of emergency and at all times.

 

Sources

Assisted Living Federation of America (ALFA). Emergency Preparedness Toolkit. ALFA.org. Available at http://www.alfa.org/images/store/Emergency_Preparedness_Tool_Kit.pdf. Retrieved October 22, 2016.

California Assisted Living Association (CALA). Disaster Preparedness. CALA, 2016. Available at http://caassistedliving.org/provider-resources/and-more/disaster-preparedness/. Retrieved October 22, 2016.

Interview with John J. Schaum, Executive Director, Arbor Terrace, Ponte Verda, Florida. October 21, 2016.

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