Coalition Makes Disaster Care Recommendations for Frail Elderly

Born from a cooperative disaster planning and nursing home leadership effort involving eight Southeastern states and numerous state and federal organizations, a newly issued report titled "Caring for Vulnerable Elders During a Disaster: National Findings of the 2007 Nursing Home Hurricane Summit," contains ten agreed upon key recommendations to improve how frail and elderly citizens are cared for during a major disaster.

The report, funded by the John A. Hartford Foundation, is a result of two years of research and two planning summits where state, federal, and local emergency planning teams, including representatives from FEMA, CMS, and HHS, shared information and ideas with nursing home leadership.

"We all agree that integrating the needs of the elderly into regional emergency planning processes can save lives." said LuMarie Polivka-West of the Florida Healthcare Association, which convened the Hurricane Summits of 2006 and 2007 that led to the development of the report. "Now, with a greater understanding of everyone's needs, we have developed better solutions to care for our most vulnerable citizens."

The CDC determined that the elderly accounted 70 percent of the deaths in New Orleans from Hurricane Katrina, with at least 139 storm-related fatalities having occurred in nursing homes.

The key recommendations are:

  1. Nursing homes must be incorporated into disaster response systems at all levels--national, state, and local.
  2. Disaster response systems, including Emergency Operations Centers (EOCs), must designate nursing homes as "health care" facilities. These facilities must receive the same priority status for restoration of utilities (e.g., power, phone service) as hospitals, and may need enhanced police protection during community recovery.
  3. Shelter in place, when possible, and harden the physical plant to withstand hurricane winds and provide emergency power.
  4. Long-term care providers must know their storm surge/flood zone, the capacity of the facility's infrastructure to withstand hurricane winds, and must develop viable plans for evacuation or sheltering in place in accordance with their facility's risk.
  5. Transportation for the evacuation of long term care facilities must be incorporated into disaster planning efforts at the national, state, and local levels.
  6. Maintaining communications between long term care providers and EOCs is vital in a disaster. Satellite phones or ham radios are recommended for use in all facilities.
  7. The ability to share information and resources and coordinate evacuation and response efforts hinges on the establishment of compatible databases for shared use during disasters.
  8. Long-term care facility disaster plans must be tested with drills that include the identification and management of cognitively-impaired residents and those with special needs such as dialysis, ventilators, and oxygen.
  9. Long-term care facility disaster plans must include a plan for communicating with nursing home residents, families, and staff before, during, and after a disaster.
  10. Flexibility is a key determinant in successfully responding to disasters. Thus, nursing home and assisted living facility disaster plans are not, and should not be, considered set in concrete.

To view the report in its entirety, visit www.fhca.org.

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