By that headline, I don’t mean, “Be ready for the dementia to progress.” Nor do I mean, “Wait until ‘Disease X’ gets worse.” I mean, “Be ready for disasters: earthquakes, hurricanes, tornados, floods, heatwaves, blizzards, wildfires.”
As most of us realize, we are living in an era in which we can expect increasingly severe weather. And if you’re living in California, earthquakes are always a possibility. This week, unusually heavy rain and wind are presenting us with challenges.
I can’t emphasize how important this is. When Hurricane Katrina devastated the Gulf Coast in 2005, nearly 70 percent of those who died were elderly.
If you’re caring for an elder who has dementia, or other serious health concerns, this may feel like overload. You already have so many things to worry about, and now you’re being asked to worry about disaster preparedness as well? But think how much worse things could get if a disaster hits, the power and water go out and you have no access to transportation. How much worse will things get then?
Just think of one thing that many of my patients use: An aero-mattress that changes pressure to prevent bedsores. These mattresses depend on electricity. If the electricity goes out, then those patients—who are likely to be frail and to have very delicate skin—suddenly find themselves lying on a hard bed frame. You can imagine all sorts of other problems that might beset elderly patients: running out of medicine, no access to the correct food for a special diet, no way to reach out to neighbors or nearby friends to help is the elder does not have 24-hour care, inadequate bedding if the elder needs to leave their home.
There are some basic preparations that all first responders recommend:
• Have enough food, water and medication on hand to last at least 72 hours. Make sure to set aside a can opener, and an alternative way to cook, such as a charcoal grill or a camp stove. In hurricane-prone areas, authorities recommend storing two-weeks worth of supplies. Each person needs one gallon of water per day, at a minimum.
• Set aside a flash light, a First Aid kit, an extra set of car keys and house keys, sunscreen and insect repellent, and a camera for photographing damage. Include water purification tablets (available at camping stores) in case water remains an issue for more than three days.
• Include some basic tools: rope, shovel, broom, heavy gloves, adjustable pipe wrench for turning off gas and water, handsaw, and an axe.
• If you can’t get your health insurance provider to cover an emergency supply of medicine, make sure to always refill your prescriptions on the first day allowed, rather than waiting for them to run out. That way, you’ll always have a little extra. If you’ve forgotten to do this, don’t forget that the federal government has an Emergency Prescription Assistance Program that covers prescriptions for folks who live in a federal disaster area.
• Have extra blankets or a sleeping bag on hand, in case you need to leave your home for an emergency shelter.
• Set aside three days worth of clothes, including warm jackets and sturdy shoes. After many disasters, streets are filled with sharp, irregular rubble. Your shoes should protect you from this.
• Keep an emergency radio, either battery operated or powered by a hand crank.
• If you have a cell phone, be sure that you have a charger that can be plugged into the lighter socket in your car’s dashboard. You may also want to invest in one of the solar-powered charging docks, such as the Eton Soulra, that can charge all your devices from solar panels.
• Make sure you have an extra pair of eyeglasses, if you wear them. Just stash away your last pair. They may no longer be a perfect prescription, but if your current pair gets broken, they’ll do in a pinch.
• Have copies of all your important personal documents, including health insurance cards, passports, wills, advance directives, photocopies of all current prescriptions and so on, stashed away in a Ziploc bag. Or, you can upload copies to Google Docs (or ask someone to do so), or you can store them in the US Bar Association app I wrote about recently.
• Get together a stash of toiletries—toilet paper, toothbrushes, soap, shampoo, eyeglass or contacts cleanser, Depends, handi-wipes, anything you use regularly—and have a three-day supply ready to go.
• Set aside a small amount of cash, $50 to $100. ATM networks often go down in an emergency.
• Put all these supplies in a backpack, or a roll-aboard suitcase, so that you can just grab and go if you need to leave quickly.
• Designate two out-of-state contacts. If caregivers, family members and elders get separated, everyone should know to call these people outside the disaster zone.
Here are things that I think apply especially to elders:
• Some elders get overwhelmed at the prospect of planning for everything. So think about what disasters are most likely to happen in your area. Here in California, earthquakes are an ever-present threat. If you live in the Midwest, it may make more sense to prepare for blizzards, heatwaves and floods. In Florida, people need to be ready for hurricanes. And in places likely to be targeted by terrorists, like New York or Washington DC, authorities recommend setting aside plastic sheeting and duct tape, so that windows and doors can be sealed in case of a chemical attack.
• If you think you are going to have trouble carrying all these supplies—the water is especially heavy—put everything in a rolling suitcase, or in a “granny cart,” one of those rectangular, wheeled shopping baskets. Make sure to store this kit where it will be easy to find.
• Put a security light in each room. These lights turn on automatically if the power goes out.
• Especially with elders who are very frail—or who still live alone—it is important to identify a support network. Is there a neighbor who could help? If the elder has care for part of the day, or 24 hours, make sure that the caregivers can move the patient out of their home. Or, if this is not possible and the elder is frail, talk to neighbors and friends about helping in an emergency. Make sure to make it clear to these helpers that they need to reach out to the elder in an emergency. Elders sometimes get overwhelmed and forget what they need to do in disaster situations.
• If the elder has dementia, make sure to have papers explaining the elder’s condition, or conditions, and also where to find personal documents such as ID, advance directives, prescriptions and wills. Put these papers in a Ziploc, and put them where they will be found easily by anyone trying to help.
• If you have to evacuate, leave a note telling others where you’ve gone.
• If the patient has specialized equipment—a motorized wheelchair, oxygen, a service animal—make sure to have extra supplies ready: extra wheelchair batteries, extra oxygen tanks, food for the service animal and so on.
• If the medical equipment requires power, you might consider investing in a small, battery-powered emergency generator. A small generator may cost only $100 or so, a larger generator may run $500 to $800 or more. You can see some options here.
• Make sure your elder has signed up for electronic payments from Social Security. That means that once the ATM network is back up and running, your elder will still have access to income. A new law that requires electronic payments went into effect in 2013, but not all elders have signed up for it. To make the switch, call 1-800-333-1795 or visit godirect.org.
• If your elder is in a skilled nursing facility or a nursing home, be sure to ask the managers there what their emergency plans are. And don’t hesitate to prepare a disaster kit that is tailored to your elder’s particular needs. In a federal disaster zone, authorities usually set up “Special Needs Shelters” for very ill people who have nowhere else to go. Ask about these.
You can find links to many more tips on the Centers for Disease Control website here. Don’t put off preparing for a disaster. None of us want your elder to become a statistic!
Elizabeth (Dr Liz) has over twenty years of experience in providing medical care to the elders. She is board-certified in Internal Medicine, Geriatric Medicine and Palliative Care Medicine. Dr Landsverk founded ElderConsult Geriatric Medicine, a house calls practice, to address the challenging medical and behavioral issues often facing older patients and their families.