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Hurricane Aftermath
By Lise Olsen and Roma Khanna, Houston Chronicle
USA
November 28, 2005
Marty Sachs, 70, who lived at Maison Hospitaliere in New Orleans' French Quarter, plays his keyboard at Gulf Healthcare Center in Port Arthur. Sachs misses the French Quarter, where he would regularly play in some of the bars and clubs. (Sharon Steinmann: Houston Chronicle)
Fleeing the storms was just the start of troubles for the elderly, as many are isolated from their families and have no home left.
After killer hurricanes struck the Gulf Coast this year, more than 30,000 elderly and disabled people in 400 nursing homes across Texas and Louisiana were left scattered and scarred, thousands forced to flee by bus, cargo plane and helicopter to destinations in at least 19 states.
For years, hurricane planners and experts on aging had pondered the seemingly impossible scenario that some day a monster storm could force a mass and deadly displacement of the elderly.
But when the unthinkable happened, no one was prepared for the epic fallout - or the stunning number of people it would render helpless.
For some, it was a double disaster. At least 1,000 already storm-shocked Hurricane Katrina nursing home evacuees had to be moved not just once, but twice when Hurricane Rita threatened their refuge.
Amid chaos, gridlock and ambulance shortages, they and elderly Texans were herded onto cargo planes at airfields in Beaumont and Houston and were temporarily lost by authorities who shipped them out before Hurricane Rita roared ashore.
At least 10,000 nursing home residents once lived in the hardest-hit coastal counties in Louisiana and Texas. In the aftermath, thousands remain isolated from families who have lost everything and many have no home to return to.
These estimates of the staggering impact of the elderly come from a Houston Chronicle analysis of evacuee data and nursing home licensing information from Texas and Louisiana.
The price many paid to reach temporary safety has been high: separation from all things familiar, increased confusion, medical crises or even death. Many suffered intensely from a lack of basic supplies such as water, food, medicine and air conditioning on their way out.
"I think people were complacent about this before," said Max Rothman, executive director of the Center on Aging at Florida International University in Miami. "There was not enough appreciation on many levels of the special needs of elderly people in the context of this kind of disaster."
For some - because of age, illness and uncertainty - the effects of the storm paled in comparison to the threat posed by chaotic evacuations.
"We're not spring chickens anymore," said John Johnson, 72, a nursing home evacuee from Baytown. "I'm still not over it - the stress and the emotion. What they have done to me is bad enough. But what they've done to the (most fragile) is hard to fathom. It was inhuman."
'I can't take no more'
The spiraling effect of the storms started in New Orleans: In the rush to remove elderly nursing home residents from the flooded city, at least 1,000 people were bused to other vulnerable coastal nursing homes - about 700 to Lake Charles and 300 to Gulf Coast Texas cities and towns.
More than 60 residents of Maison Hospitaliere were among those who fled the flooded French Quarter by bus and ended up temporarily stowed in a Houston Holiday Inn.
In an act of post-storm goodwill, the owners of the Gulf Health Care Centers in Texas City, Galveston and Port Arthur agreed to take in all the residents. Initially, it was welcome news. Then those same cities became potential danger zones when Hurricane Rita neared the Texas coast less than three weeks later.
"Why did the storm have to come here? We'd just gone through Katrina," said Pearl Haley, 53, a New Orleans native transplanted to Port Arthur, to Georgia and then back. "I couldn't stand it. I can't go on like that. I can't take no more."
All of the movement has taken its toll, former Maison residents said. All are more confused and tired and some have been hospitalized or even died.
Marty Sachs, a 70-year-old musician, said his health dramatically declined during the exodus, culminating in a recent five-day stay in a Port Arthur hospital. All the journeys blur together, but he says he won't forget how a woman died during the first endless bus trip out of flooded New Orleans, her face pressed against the glass of the window as if she was asleep.
Transportation woes
Hundreds of those double evacuees, as well as other nursing home residents from the Golden Triangle area, ended up being airlifted out of Beaumont and Port Arthur just ahead of Hurricane Rita because of a massive ambulance shortage and traffic jams that had created gridlock on all major routes to safety.
Many of the elderly arrived at their destinations without being tracked by authorities and spent days or weeks out of touch with family, friends and caregivers, according to nursing home administrators, emergency management workers and others who tried to find them.
Ouida Richardson, a 92-year-old Alzheimer's patient from Port Arthur who can no longer tell people her name, was shipped out on a stretcher inside the belly of a cargo plane Sept. 22 without family or caregivers and arrived without her medical records. Her frantic daughter finally found her several days later at a nursing home in Oklahoma City. It took a month of negotiations with FEMA to get her home via air ambulance.
"I said, 'Do you know you're home? This is your daughter - Betty Ann,' " Betty Ann Stidham of Nederland recalled of the day her mother finally made it back.
"She opened her eye and kind of looked at me and half-grinned. I said, 'It's true. You're home.' "
Stidham thought things had gone well - then she received a bill showing her mother had been hospitalized in Oklahoma. She still doesn't know why.
Complicating the evacuations was the fact that Beaumont and Port Arthur simply did not have enough people to register the 5,000 evacuees shipped out by air before Hurricane Rita.
Tracking them down
But some of the same problems occurred with Houston-area nursing home evacuees shipped out from Ellington Field in the days before the storm struck - even though emergency officials in Houston sent along detailed manifests. The federal patient system that was supposed to be in place to track them simply failed, said Doug Havron, a Houston-area hospital employee who was one of the people who prepared the manifests.
The problem forced individual nursing home administrators, corporate employees, state regulators and nursing home lobbyists to turn detective to track down thousands of evacuees.
Weeks after Hurricane Rita, some remained lost.
A database used by the state Department of Health to help relatives find nursing home and hospital patients shows that Texas authorities had no idea, in most cases, which facilities people had left. Even two months after the storm, the state had that information for only 4,503 of the 11,347 hospital and nursing home evacuees tracked from Texas to 10 separate states.
Some remain lost
The same database indicates only an arrival city - but no specific destination - for 80 Texas evacuees. Fifteen others are listed under "destination unknown." More have vague entries such as a "shelter in Georgia" or a "FEMA site."
For the two months after Rita, officials said they continued to field calls from frightened families and from out-of-state nursing home administrators struggling to identify elderly folks who either could not talk or could not recall their names.
In Louisiana, officials say some nursing home residents remain lost, possibly dead, and hundreds more will never be able to go home.
The evacuation odyssey for about 40 seniors and staff from St. Rita's in St. Bernard Parish, La., had only begun when they escaped floodwaters that claimed 35 lives after Katrina hit. They were scattered from Florida to Colorado after spending days in way stations including a jail, a school, hospitals and a swath of asphalt beneath a highway overpass.
Survivors ended up dispersed to at least 28 facilities and homes in eight states, many of them separated from other patients, according to residents and staff.
Gene Alonzo, 56, saved his brother, Carlos, from St. Rita's and led him on a three-day journey to safety without medication, clothes or diapers. The brothers traveled first to a school where they picked up children's Mardi Gras costumes for dry clothes. Later they joined hundreds of people waiting under a highway for buses out of New Orleans.
"A bus would pull up and be full before we could make our way to it," Gene Alonzo said. "They would drop off water, but I was just so scared to leave Carlos for a second in that crowd that I never could get any."
They waited nearly 24 hours before boarding a bus to Lafayette, where Carlos Alonzo's wife, who thought they were dead, picked them up.
Still tallying deaths
The problems of St. Rita's residents, like others from the hardest-hit coastal counties, are compounded by how much their families have lost.
John Denton, a slight 66-year-old, wonders about friends whose names he can't remember and misses a home that never again will be his.
The only St. Rita's survivor in a Hammond, La., home, Denton is surrounded by a sea of unfamiliar faces. He is far from his son, who also lost his home in Katrina and has been unable to visit. He has resigned himself to staying in Hammond.
"What choice do I have?" he said. "They say there's nothing to go back to - that everything was destroyed. But if I could take care of myself, I'd be there."
St. Rita's is known for being the home where more people died than in any other.
But more than two months after Hurricane Katrina, Louisiana officials still are tallying the number of nursing home deaths. Efforts are being complicated by overwhelmed morgues and gaps in the reporting of deaths during or after evacuations.
No official total has been released, though reporting by the Houston Chronicle has identified at least 139 storm-related fatalities from nursing homes.
No one in Texas is even attempting to tally the evacuation-related deaths so far.
Officials acknowledge evacuation deaths that occurred outside nursing homes - in shelters, on the road or out of state- might never be reported at all.
The only confirmed Rita-related nursing home deaths came when 23 Bellaire nursing home patients were killed as a bus evacuating them caught fire and exploded near Dallas.
The final blow?
Although nursing homes do report fatalities to the state, it can be difficult to determine how much the stress of evacuation contributed to the passing of someone already affected by age and illness.
Laura Breaux, 102, had survived two world wars and the Great Depression, but family members said the Hurricane Rita evacuation finally killed her in the end.
Breaux's journey out of Port Arthur was complicated after the ambulance she was supposed to ride to safety in Austin was diverted for the airlift.
Rather than load her in a plane bound for who-knows-where, her family took her in their car.
She died shortly after her return to Port Arthur.
"That was a nightmare," said her son-in-law A. J. Weber Jr., his wife weeping beside him as Breaux's body was wheeled away. "But I'm happy for her. At least now, she's in a better place."
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