Disaster Preparedness for a Care Recipient
Disasters present a special challenge for caregivers. Some care recipients fare as well as other family members during power outages and other disaster related disruptions. However, some care recipients require specialized care that is difficult to manage during a disaster situation. Additionally, if your family member is disabled, heavily dependent on others for care, or has Alzheimer's or dementia, the lack of control over the disaster situation can be particularly intrusive and can promote reactions based on fear.
Plan ahead and any situation becomes much more manageable.
Disability and Mobility Planning
Emergency Assistance Contacts
Identify Contingency Plans
Identify Needs
Identify Problem Areas
Preparing the Family
Special Needs Shelters
Special Needs Registries and Alert Systems
Identify Needs
| Need | Yes | No |
| Uses mobility device (walker, wheelchair, etc.) | ||
| Needs assistance with mobility | ||
| Uses transportation independently | ||
| Uses adaptive equipment for grooming (dentures, glasses, zipper pulls, tub-transfer device, tub seat, etc.) | ||
| Needs help with daily tasks (grooming, eating, toileting, etc.) | ||
| Uses special equipment for eating | ||
| Uses equipment that runs on electricity | ||
| Takes medication | ||
| Uses a service animal | ||
| Able to call outside the family for help |
These are generalized possible needs. For a more thorough assessment, try our assessment checklist.
When completed, take each need and imagine what difficulties you might encounter if there was a disaster.
- Imagine that you had no power for three days.
- Imagine no water or no hot water.
- Imagine no source of heat.
- Imagine no television or radio.
- Imagine no transportation.
- Imagine no open stores.
- Imagine no pharmacies.
- Imagine no gas stations open.
- Imagine your cell phone not working.
Hard to think about isn't it? Just remember that it will be harder still if you don't prepare now.
Identify Problem Areas
The next step is to take the completed needs assessment and find the areas where you may have trouble continuing proper care during a disaster. For example, if your family member uses oxygen would you be able to provide that if the power went out? Do you have several weeks worth of medication on hand? Will foods that cannot be prepared on the stove be appropriate for your family member to eat? Could your family member keep warm? Add to your family emergency response plan any items that you can easily resolve with pre-planning.
There are other considerations as well.
Water
When your power goes out, will the pump for your well go out? You may find yourself without water. How will you provide enough water for drinking, cooking, and limited bathing? If you plan to stockpile water beforehand, do you know how to keep it safe? Well water kept over time may promote bacterial growth that could be harmful. Do you know how to clean your bathtub so that you can store water in it? Do you know how to use stored water to flush your toilet during an emergency? Are there hygiene issues related to your family member where water is a critical component? If so, will you be able to use cold water? Can you ensure the safety of the water if you are using it to clean a wound or sore? These are the type water issues that you need to resolve beforehand.
Heat
Older adults are often very sensitive to cold. If your heat goes out and you have no other source of heat, will you be able to keep your family member warm with clothes and blankets? If so, are there hygiene issues that will need to be addressed and will your family member be sufficiently warm if you need to partially undress them to perform needed tasks? If you choose to use a kerosene heater, do you know the risks and do you know how to safely and properly use it? What would you do if the gas stations weren't open for you to get additional fuel during an extended outage? Do you know how to safely store kerosene? The same issues apply to other types of heaters that don't require electricity. What about fireplaces and woodstoves? Do you have an adequate supply of wood and kindling? Do you have a fire extinguisher? Do you get your chimney inspected and cleaned every year to prevent deadly chimney fires? Never burn charcoal grills or other types of outside grills inside! They emit carbon monoxide fumes which you will not be able to detect and which can kill you before you even realize that there is a problem.
Food
If the power goes out, the electricity to the refrigerator and freezer goes out. Food will only last a limited about of time without power before it can become deadly. Try to limit opening the refrigerator and freezer doors as much as possible. If you have advanced warning, fill plastic milk jugs with water and freeze them. Fill all the remaining space in both the freezer and refrigerator with these frozen jugs. That will give you more time before the food goes bad. If it is below freezing outdoors, it may be possible to safely store your food in a freezer outside. However, be very careful doing this! If the sun hits the cooler, it can substantially warm the food, even when it is cold outside. And, during the day, the outside temperature usually rises.
Generators
For those who can afford it, a generator may be a reasonable preparation for power outages. There are many models. Be sure to make sure that the model you choose will power what you want to power. Be realistic. Decide what you need most and what you can do without. Purchase a unit based on the minimum amount you will need. And, be sure to have an electrician properly install the unit and wire your home appropriately. Otherwise, the generator may send electricity back through the lines from your home which will endanger the power company crews who are trying to restore power. Also remember that the generators require gasoline. If gas stations are closed or you cannot leave your home, will you have enough gasoline to run the generator? Portable generators are noisy. Will your family be able to sleep with the noise they produce?
Communication
During a power outage, your regular phone may work. However, the answering machine will not. And, since phone lines are often strung with power lines, if the power lines go down, phone lines may too. Do you have cell phone capability? Is it charged to capacity? Do you have an adaptor that can be used in your vehicle to recharge the cell phone? Remember too that cell phone towers can run out of power as well. If that happens, your cell phone will not work even if you have it fully charged.It is always good to have a plan in place for how to communicate with family and friends. Think of how, in your situation, you could let family and friends know that you are fine or that you are in need. If you can't travel (downed trees, power lines, etc.) and you don't have phone capability and you had a need, what would you do? A good plan is to get to know your neighbors and to pre-plan for all your anticipated needs.
Identify Contingency Plans
What would happen to your family member if something happened to you during the disaster? Is there a back-up plan? Would your family member be able to manage to locate assistance on his or her own? What if you had to go out to find emergency food or water or gas... Would your family member be able to remain safely in the home without you? Is there a neighbor who could be "on-call" to help out if needed? Remember, other family members may not be able to get to your home to help out. These are the types of things that you need to realistically evaluate. Sometimes roads are impassable; sometimes stores don't have power so they can't open; you may not have enough gas to get where you need to go and there may be long lines at the pumps;.... Use your imagination to think of every possible scenario. How would you deal with each one if it became a reality?
Special Needs Shelters
Most people are familiar with Emergency Shelters that are opened during severe weather or other emergency situations. Shelters can be critical for displaced citizens or those who would be unable to weather a disaster event in their own home. Trained personnel organize and make available:
- meals
- emergency first aid
- potable water and ice
- a place to sleep
- a place to weather the storm or event
- emergency relief items such as clothes, as needed
- information on the event
- access to long-term disaster relief, if needed
- mental health counseling
- other services as needed
Shelter staff also assist with providing food for individuals not in shelters and who are unable to go to mass feeding sites.
In North Carolina, each county government funds the shelter, decides when and if an Emergency Shelter will open, and decides what agency will operate it. Usually, the local Department of Social Services is in charge of all shelters and they are assisted by the local chapters of the Red Cross. The state Division of Emergency Management provides guidelines for when to open a shelter, how to operate it, and what citizens can be appropriately served by the shelter. At one time, the Red Cross opened and operated all Emergency Shelters but their long-term goal was to help each state take over that role. They helped NC learn how to successfully operate an emergency shelter and they now provide technical assistance and volunteers for the shelters. |
Unfortunately, most Emergency Shelters are not equipped to assist individuals with specialized needs. There is another type of shelter that is designed for that purpose - the Special Needs Shelter.
These shelters are designed to offer more comprehensive service to individuals with special needs. They have a registered nurse on staff and have limited medications available. They coordinate with local aging and health agencies to be able to provide some services through these agencies. If available, a Special Needs Shelter is the best choice for an individual who cannot function independently.
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In North Carolina, these shelters are opened on a county by county basis. Each county decides whether or not they can afford to operate a Special Needs Shelter and whether or not there is a need for this type of service during a particular emergency situation. Each county determines what a Special Needs Shelter will be able to offer and who qualifies to be sheltered there. |
Counties often make the decision about whether or not to open shelters after a disaster strikes so that they can assess whether or not shelters are needed. Local radio stations, television stations, and newspapers are excellent choices for locating available shelters. They will let the public know about the shelters as soon as the decisions are made. Some counties offer transportation to the shelters for those with special needs and/or those with no transportation.
However, you may not have access to these sources at the time of a disaster. You should have with you, as part of your family disaster plan, contact information for your:
- local Department of Social Services
- local Aging Agency
- local Area Agency on Aging
- local Emergency Management
- local Red Cross
Be sure to check ahead of time to find out who is eligible to go to a Special Needs Shelter in your area and whether or not a family member or friend must accompany the person and what supplies must be brought to the shelter. These considerations are important to check out before a disaster strikes. Also, check to find out if transportation is provided to the shelter and whether or not there is a charge for this service.
If you feel that a Special Needs Shelter should be opened but find out that there are no plans to open one, consult with your local Department of Social Services for immediate needs. After the disaster event is over, contact your local county commissioners to help them understand the problems you encountered and why you feel that these specialized shelters should be opened.
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Find My Local Department of Social Services (or Human Services) |
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Find My Local Department of Social Services |
Special Needs Registries and Alert Systems
Some local agencies (aging agencies, emergency management, crime control and public safety, etc.) have a system in place to alert seniors and/or family caregivers of impending disasters. Call your local agencies to see if such a system is in place. You would register your family member with the agency and they would then have them (or you) on a list to receive either an automated emergency alert call or a call from a staff member to alert the family to an impending disaster situation.
Another local service sometimes offered is a Special Needs Registry. With this service, you would fill out a questionnaire with the provider agency that would specify what the particular needs and requirements of your family member would be in the event of an emergency (i.e. transportation, need for dialysis, vision problems, etc.). Then, should a disaster strike, the agency would know what the requirements were and could automatically check with you or your family member to ensure that the needs are met. For example, if your family member is frail and lives alone, they may need assistance getting to a shelter. Or, perhaps they are at home but have run out of their medication and they have no transportation to get more. These registries are not a substitute for pre-planning but they may be able to ensure that a family is able to protect their family member in need of care when a disaster strikes. These registries also help local agencies to plan what type of services to make available at Special Needs Shelters because they are able to evaluate community needs. They need to pre-plan as well. Another benefit to these registries is that they help counties to assess community needs which helps obtain the funding necessary to operate a Special Needs Shelter.
Think Creatively
If you determine that keeping your family member at home during a disaster situation will not allow you to provide adequate care, there are options other than shelters. As you may imagine, your family member probably will not want to go to a shelter. So, what are some other options?
Hospitals
Hospital emergency rooms need to be available for people with acute medical emergency needs. If citizens come to the emergency rooms with their family members who do not have acute emergency medical needs, it will greatly hinder the hospital staff from helping those who need treatment. Please do not plan to go to the hospital unless your family member has an immediate acute medical need appropriate for emergency room service.There is one exception. Some hospitals provide vacant hospital beds for respite service for caregivers. A caregiver pays for and schedules this service in advance so that they can know their family member is receiving quality care while they take a break from caregiving responsibilities. Before a disaster strikes, call your local hospital(s) to see if they have this type of service. You may be able to schedule a bed for your family member before an impending disaster should you know you will not be able to adequately care for him or her at home during a disaster.
Long-Term Care Facilities
Some long-term care facilities such as nursing homes and assisted living facilities will agree to shelter and care for an older adult with special needs during a disaster, for a fee. Of course, you would want to check out the facility to ensure that they provide quality care on an ongoing basis. You would want to make sure that they can provide the type care that your family member needs. And, you would want to make sure that the facility is able to generate power during a power outage. Power companies give priority to long-term care facilities when determining how to schedule repair crews. This alternative may help ensure that your family member is kept comfortable during a crisis. Ask to see their disaster response plan. How do they ensure that enough staff will be available to provide care? Ask questions that will help you to feel comfortable about their ability to provide quality service during adverse conditions. For example, some facilities have made arrangements with local hospitals to launder their bed linens during an emergency situation. How will the facility you are considering handle such everyday needs?Arrangements for care would need to be made prior to a disaster occurrence. Please note that care under disaster conditions may not follow the state guidelines.
If a facility usually provides quality care, you can be relatively certain that they will try their best to continue to provide quality care under any circumstances.
Family & Friends
Though not particularly creative, the best choice for an impending storm may be having your family member (and perhaps you too), temporarily stay with family or friends who have power. Do you have family or friends outside the scope of the impending disaster? Though storms do not always follow a set and predetermined path, you may be able to anticipate an area where the storm is not likely to hit. Pack a disaster suitcase to take with you and go before the impact of the storm is felt. If you cannot go with your family member, be sure that your family or friends are knowledgeable as to the needs of the care recipient and that they are willing and able to perform needed tasks.Hotels and Motels
Again, no so creative, but certainly a potential solution. Does the hotel have a generator? Will you or someone you trust be able to stay with your family member to provide care? Do they have food service? Will they take pets during an emergency situation?
