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Elderly Affected Most by Hurricanes, Senators Told
By Bob Dart, Cox News Service
USA
October 6, 2005
With bodies of the elderly still unburied - and even undiscovered - in the aftermath of two historic hurricanes, rescuers have learned that they must know where seniors are located before disaster strikes and evacuate them earlier, witnesses told a Senate panel Wednesday.
Older Americans were among the hardest hit by hurricanes Katrina and Rita, the senators and witnesses agreed.
The abandonment of residents of St. Rita's Nursing Home in Louisiana's St. Bernard Parish was cited as an example of what can happen to the elderly during a disaster. The 35 old folks "left to die" as Katrina approached was "the most disgraceful" episode in all the tragedies on the Gulf Coast, said Sen. Gordon Smith, R-Ore., chairman of the Special Committee on Aging.
"Countless seniors were abandoned in nursing homes, hospitals and health care facilities and we may never know how many were left in their homes without any support," said Sen. Herb Kohl, D-Wis., the ranking minority member of the committee.
"We must ensure that the tragedies we have witnessed in recent weeks never happen again," Kohl said in a written statement.
But the elderly were victimized again by Hurricane Rita as 24 residents of a Texas nursing home in the Houston suburb of Bellaire were killed when their evacuation bus exploded - the flames fueled by portable oxygen tanks some of the riders carried to help their breathing.
The elderly make up more than half of all fatalities in natural disasters such as hurricanes, floods, tornadoes and earthquakes, said Carolyn Wilken, an associate professor and cooperative extension specialist in gerontology at the University of Florida.
While many old people die as a result of the direct impact of the natural force or already existing medical problems, the reasons for the disparity in deaths are complex, she said.
The elderly, "particularly the very old, tend to respond differently to disasters than the general population," she said. Often they aren't as willing to flee impeding danger.
"Refusal to evacuate may be based on fear of the unknown," she testified. "At home, they can manage their physical health and functional disabilities such as incontinence. For many, the prospect of living in close quarters with strangers and using a public bathroom which may be located several yards from the older adult's designated sleeping area is more terrifying than the prospect of dying at home."
Others are fatalistic and refuse to leave, she said, expressing views "such as 'This is my home. This is where I raised my kids. My wife died here and all my memories are in this house. I prefer to stay.'"
Emergency planners from several states testified about what their communities are doing to protect senior citizens from tragedies such as those that befell them in Louisiana and Texas.
In Georgia, "area agencies on aging" have already identified at-risk older and disabled people in the communities that they serve, said Maria Greene, director of the state's Department of Human Resources Division on Aging Services.
"These individuals would need assistance to evacuate in an emergency or will need medical assistance for health related problems and have no immediate family caregiver to aid them," she said. The list of at-risk people is updated quarterly and shared with local law enforcement agencies and emergency medical services so the people can be evacuated when the time comes, she said.
Nursing homes and similar facilities are also required by the state to have emergency plans, she said.
But "time is of the essence," she said. Warnings must be heeded and evacuations begun early enough to get out not only the elderly but also their wheelchairs, medications and records.
In the aftermath of the Gulf Coast storms, "Georgia has the third largest number of evacuees in the nation," Greene told the committee. Her agency has learned from dealing with these visitors.
"During the time of crisis, so many people are at their best, but others are at their worst," she said. Elderly evacuees have been preyed upon by crooks.
"As a result of consumer fraud and exploitation, the increased need for elderly legal assistance has become very apparent," she said.
The need for electronic medical records for the elderly has also been dramatically illustrated, she said. When the evacuees arrived, "professionals were available to offer mental health crisis support, but the knowledge of someone's dementia or Alzheimer's was unknown," she said.
Florida's preparation for natural disasters is considerably better due to Hurricane Andrew in 1992 when "things didn't go so well," acknowledged Sen. Mel Martinez,
R-Fla.
And the state has had plenty of recent practice - with seven hurricanes and two tropical storms in the past 13 months, he said.
Jeffrey Goldhagen, director of the Duval County Health Department, testified about plans for dealing with a hurricane in his jurisdiction, which includes Jacksonville. He emphasized that the primary early response will always be up to the local community.
In Duval County, he said, the elderly and others with special needs are identified either through registration forms mailed with their utility bills or by social agencies and doctors that serve them. These people are located on a map to determine if they live in an area subject to storm surges and are asked to provide permission for rescuers to enter their homes to look them should they be unable to answer a phone or knock at the door. A detailed electronic database is maintained on these people - including information on their doctors, medications, pharmacy, relatives and special needs such as wheelchairs.
"The database allows us, long before the projected arrival of gale force winds, to determine the number of people needing hospital and special needs shelter placement" and their transportation needs, said
Goldhagen.
He said the federal government needs to stop tying the funds it provides local communities to their plans for bio-terrorism or similar dangers.
An "all-hazards" approach is needed for the funding, he said. "Perhaps the most important lesson learned from hurricanes Katrina and Rita is that we can't afford to focus on just terrorist threats."
Two of Jacksonville's hospitals are located beside the St. John's River, he said. Their emergency generators and electric switches are located on the first floors.
The plight of hospitals in New Orleans showed the need for continued power when patients are "evacuated vertically" to higher floors, he said. But federal emergency planning funding would not pay for putting emergency generators on top floors, he said.
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