Bishop Gadsden Retirement Community in Charleston, South Carolina, was in the path of three hurricanes, one ice storm, and one snow storm, in the last four years alone, according to NPR. Residents living at the facility have had to evacuate twice in two years, and unpredictable weather now requires emergency planning to be included in basic routines for community members. Yet, despite the community's successful emergency protocol, managing safety for people who are elderly during an evacuation and storm procedures is a major undertaking for a senior care facility. Every decision - from transporting medicine or oxygen tanks, to making sure those too frail to travel have ambulance transport, is high-stakes.
It’s impossible to predict whether or not winter storms will be severe in 2019, but given the “new normal” in the wake of climate change, state and local governments have a responsibility to prepare for severe winter weather. In recent years, extreme winter weather plagued the United States, from Hurricane Stella dropping up to 18 inches of snow in Massachusetts in 2017 to the polar vortex which brought life-threatening cold temperatures in the Midwest in January of 2019. This year, forecasters predict an above-average snowfall, ice storms, and mixed winter weather events in the Northeast, and dramatic temperature fluctuations throughout the rest of the United States, according to Newsweek.
During recent winter seasons, unpredictable storms have posed a major challenge to state and local safety managers, who must ensure vulnerable populations, such as individuals living in senior-care facilities, have adequate resources. Many elderly people, who lose body heat at a higher-rate, may already struggle to handle severe-weather conditions, which can exacerbate medical conditions. For an older person, the risk of hypothermia is higher, and a body temperature of 95 degrees Fahrenheit or below can increase the risk of heart attack, kidney problems, liver damage, or other health concerns. In addition, many elderly people need round-the-clock medical attention, access to specific medications or technology, such as a ventilator, and may have physical concerns which make traveling more difficult.
Preparing Senior Care Facilities For Winter Weather
One of the most critical decisions a senior care facility manager can make during a winter storm is whether or not they should evacuate or shelter-in-place. During a hurricane, safety managers may want to evacuate to avoid high-winds and potential risk of property damage. Winter storms can make traveling particularly treacherous, and may be more conducive to a shelter-in-place scenario, but this means specific preparations must be made. Safety managers need to take stock of supplies, including food, water, and medication, and plan ahead to make sure all residents will be taken care of. Residents must be prepared for power-outages, and adequate supplies, including food, water, and medications, must be on hand.
Establish Shelter-In-Place Procedure. The American Health Care Association (AHCA) offers workers a valuable guide for senior-care facilities titled “Shelter in Place: Planning Resource for Nursing Homes” which helps with planning, training, preparation, collaboration, constant vigilance, and communication with local authorities. The resource walks senior care facilities through emergency preparation and procedure, offering a comprehensive checklist to ensure safety managers have everything they need to make sure the community is taken care of during a winter storm. Shelter-in-place decision-making, an emergency power plan, stocking food, water, and medications, and creating a comprehensive security plan are among the topics covered in the resource guide.
Prioritize Electricity. During a winter storm, ensuring senior residents have electricity is paramount. Every senior care facility should have a generator with capability to meet facilities specific power needs and enough fuel for four or five days. It’s important that the facility have a procedure in place for regular inspection and maintenance of the generator. Leaders at the senior care facility should also meet with local emergency management and the power company to discuss the power needs of the facility ahead of the storm.
In North Carolina, local lawmakers backed a bill to provide nursing homes, combination homes, and adult care homes with emergency electricity for use during power outages. The draft of the legislation proposed will require all facilities licensed by the state to have emergency electric to provide heat, light, and other essential services to required by the Medical Care Commission. During Hurricane Dorian, hundreds of facilities in Florida were not compliant with the emergency power plan, endangering residents living in senior care facilities, and the legislature was proposed in response to the incident.
Stockpile Critical Supplies. Each senior care facility should have a 5-7 day stockpile of food for maximum number of patients and employees. Every center should also have an appropriate amount of drinkable water, as well as water for hygiene and cleaning. Emergency food supplies should be regularly inspected and rotated as needed, and facility managers should maintain active contracts with food suppliers in the area in case of an emergency. Medications are important to keep in supply as well. In addition managing 5-7 days worth of medications for patients during a winter storm, senior care facilities should have extra IV fluids and communicate with pharmacy partners to manage refills following the storm.
Budget For Evacuation Transport. For senior-care facilities, a shelter-in-place scenario may be preferable during a winter storm. However, safety managers must prepare for a worst-case scenario, which in rare circumstances include implementing evacuation procedures. Facilities must include evacuation costs as part of an annual budget. In 2018, Bishop Gadsden Retirement Community spent $350,000 on evacuation transport, as per NPR. The facility spent a similar amount evacuating residents during Hurricane Matthew in 2016. Bishop Gadsden partners with a company that manages insurance claims for senior-living communities, and receives partial reimbursements for evacuation costs as part of a program established after Hurricane Katrina.
Manage Emergency Communications. During a winter storm, it’s critical that senior care facility employees or physicians are able to reach local law enforcement or first response teams. It’s equally critical for workers to be able to communicate internally, especially emergency planning stages or during a shelter-in-place scenario. In case of a security breach or another concern, a plan to communicate the situation and initiate lockdown or evacuation procedure, even for those residents most vulnerable, is important.
Technology can play a critical role in managing.a winter storm in a senior care facility. A mass notification system can help manage emergency communications throughout a winter storm. The tool can help senior care facility managers reach employees before, during, and after the storm, confirming each worker’s availability to help residents during the winter weather.
Vulnerable Needs Database Registration. In recent years, ensuring vulnerable residents, such as people who are older or people with disabilities, has become paramount. A vulnerable needs registry is essential for emergency managers hoping to better understand the unique needs of their community, and foster communication during a disaster. By leveraging a vulnerable needs database, safety teams will be able to collect citizen provided-data for analysis, planning, and emergency response, and give access to administrators to communicate an actionable message to residents based on their individual needs. For example, senior care facility managers would be able to list the residents living in their community, and with each patients’ permission, the specific medical needs or care that individual requires. During a winter weather emergency, first responders will be able to answer emergency calls with the appropriate medication or resources needed, shortening critical response time, even given snowy or icy weather.
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