It’s well known that older adults are more vulnerable in times of natural disaster. But there’s nothing like a storm the size of Sandy to drive this point home.
In the past week, we’ve read about New York City hospitals and nursing homes that decided to wait out the storm rather than evacuating. Sheri Fink, who won a Pulitzer Prize for her report on decisions made at Memorial Medical Center in the wake of Hurricane Katrina, got out ahead of Sandy and talked to city and state health officials as well as facility executives. Her ProPublica story is must-reading for anyone who wants to understand the thinking of officials responsible for preparing for the storm.A take-home point: Evacuations can be extremely difficult for frail seniors living in nursing homes. Balancing the potential impact of displacing residents against the potential impact of sheltering in place during a storm isn’t easy.
I hope that reporters writing these kinds of Sandy-related stories take this into account. For another look at decisions made by city and state decisions vis a vis nursing homes, see this piece by Ben Hallman in the Huffington Post. Kudos to this reporter for going out during the storm and going to a site where nursing home residents were being sheltered.
(A quick Twitter search using the key words “nursing homes Sandy” turned up another location where nursing home residents were riding out the aftermath of the storm – the Park Slope Armory in Brooklyn.)
While the fate of older people living in institutions is clearly a concern, so is what’s happening to older people residing in the community. With Sandy, untold numbers of seniors were trapped in apartments in walk-ups or high-rises, many without electricity or running water, many without working phones, and many needing some type of medical assistance. (Not to mention emotional comfort in the midst of what was surely a terrifying situation.)
John Leland of The New York Times examined how home health agencies were trying to help seniors in this situation on Friday. The commitment of home health workers is inspiring. I wonder, however, how many older adults not already connected with home health care found themselves in need of services or assistance without any way to make those needs known.
This is another takeaway message I’d like to emphasize: As people decide to age in place in their communities, all kinds of new issues arise such as how to reach them and remain in touch with their needs during disasters like Sandy. Most communities haven’t figured this out yet, but it’s sure to be an important issue in the future.
As for resources, see this post I wrote for The New York Times’ New Old Age blog earlier this year for a review of nursing homes and how well prepared they are for disasters. Lisa Brown of the School of Aging Studies at the University of South Florida has been heading up a special interest group of the Gerontological Society of America focused on disasters and older adults.
(Her email is lmb@usf.edu and she’ll be chairing a symposium on this topic at the Society’s upcoming November meeting. Another group leader is Maggie Gibson, Ph.D., Veterans Care Program, St. Josephs Health Care London; Aging, Rehabilitation and Geriatric Care Research Program, Lawson Health Research Institute; Department of Psychology, University of Western Ontario; London, Ontario, Canada, maggie.gibson@sjhc.london.on.ca)
The CDC writes about how disasters affect older adults and their families here. Don’t forget the mental health consequences of disasters; the Geriatric Mental Health Foundation looks at the issue here. For a more in-depth look at this topic, see this study from the U.S. Substance Abuse and Mental Health Services Administration.
This should be enough to get you started. Remember, if you talk to older adults who’ve been traumatized by Sandy, you need to be especially sensitive in your questioning. Go slow. Follow their lead. Don’t press if you sense resistance.
Redirect your questioning to something that feels safer to talk about, then gradually come back to what their experience was during the storm. Ask about simple concrete things: “Did you have water?” “Were you able to see in your apartment?” Watch carefully to see how they’re responding to your questioning. Probe only if you sense that the older person really wants to talk about it. If not, be respectful of their defenses and their privacy and find someone else.
