Code Gray: Emergency Preparedness in the Nursing Home

Older Adults and Emergencies

This past summer our temperatures soared high into the 90’s and 100’s and severe thunderstorms caused power outages for many people from Illinois to Washington, D.C. to Virginia and Ohio. During Hurricane Sandy, many older adults were challenged by the loss of power and heat, but an even bigger effect of the storm were the emotions it brought forth- fear, panic, anxiety, hopelessness, and despair. Many older adults are able to withstand the unpredictability and change that a natural disaster brings. But others, especially those who have complex medical conditions and cognitive disabilities, are more at-risk.

A Bigger Problem

According to Brown, a gerontological psychologist from Florida who is in the Gerontological Society on Aging work group on disasters and older adults, older adults are the least prepared for emergencies and disasters. Jennifer Campbell, the past Director of the Hurricane Fund for the Elderly, reported that poor health impacts a person’s ability to respond to an emergency. For example if an older adult had mobility issues, they may be less likely to leave their home when ask to evacuate due to a hurricane.

How does an emergency affect older adults?

According to an American Association for Geriatric Psychiatry position paper published in November 2008, those older adults who had been through a disaster have poorer health and higher numbers of suicide and rates of death. However, the earlier an older adult has help adjusting to issues post-disaster, the better their overall health will be.

Problems with Nursing Home Emergency Preparedness Plans

According to this Huffington Post article from April 16th, 2012, nursing homes had plans for emergencies that appeared appropriate, but once implemented, showed many gaps. A study was done noting problems after Hurrican Katrina including: having competent transportation, collaborating with local emergency management professionals and managing residents with health issues. The Center for Medicare and Medicaid recommended some strategies to improve these errors, but they were not followed.

Nursing Home Emergency Preparedness: Plugging the Gaps

In order to fix these problems, investigators examined nursing homes that met federal regulations for emergency planning and training and visited these nursing homes. Louisiana, Minnesota, North Carolina, North Dakota, Tennessee and Texas nursing homes were surveyed  Each of these states had been compromised by a disaster. As one might expect, the most basic component to an emergency preparedness plan that is must be thorough and practiced. In some nursing homes, plans were in a box somewhere not easily accessible. Out of twenty four surveyed, only one nursing home had a plan to deal with illness or death while an evacuation was taking place. Fifteen had no information ready on types of medical equipment or medical needs residents had during the crisis. Seven plans did not discuss how residents would be identified during an evacuation, whether it was nametags or wristbands. Another fifteen did not include lists of medication.

Emergency Preparedness Plans that Work

In Arlington, Texas at Green Oaks Nursing and Rehabilitation Center, a tornado blew through, but somehow every one of the 130 residents and forty staff survived. The staff had a plan and responded quickly. Residents were moved out of their rooms, away from windows, and triage was completed when the tornado was gone. Five hours later, almost all of the residents were either in other nursing homes or hospitals and they had their medications and belongings with them. On August 25th, 2012, Hurricane Isaac hit Florida and Louisiana. A member of the Florida Health Care Association, LuMarie Povlika West, worked so hard to spread the word of preparation for the hurricane she actually got a hoarse voice. She called 197 members of the Association in total. All 197 members successfully used the “shelter in place” tactic during the storm. With this tactic a few rooms with few or no windows are chosen and residents take shelter.

An International Peek at Disaster Relief

Lauren Kessler, LCSW wrote a great article detailing her experience supporting the disaster relief in Haiti. In this account, she shares the barriers to setting up a clinic and the importance of a supportive infrastructure.

Examples of Emergency Plans

With so many natural and manmade disasters happening all over the country, it is important that nursing homes are ready. Below are a few examples of plans to consider.     *** Thanks for sharing the photo that we used in this post. http://www.flickr.com/photos/sigmaeye/5930371384/  

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