(Email sent this evening to Clients, Families and Caregivers)

I hope you are having a lovely Christmas holiday today!

After yesterday's early storm"heads up", I'm back to encourage you in your plans to prepare households and our clients for what is now being talked about as a blizzard: up to 20" of snow and 50-60mph winds, beginning Sunday afternoon and into sometime Monday. This is being predicted to be "heart attack snow" -- meaning it's so heavy that people have heart attacks exerting themselves while clearing it. This kind of heavy snow might be hard to keep cleared from roads and driveways, and street plows when they pass by will deposit "cement-like" snow and ice at the ends of driveways.  High winds with heavy snow can also bring down power lines; power outages should be prepared for.

These are the kind of conditions where we should all be hunkering down before it gets bad and waiting for the roads to be opened afterward. I'm starting to position caregivers in households for Sunday overnight where the occupants will be the most in need if we can't get there Monday, or if there should be a power outage at any point.

I have a few preparedness recommendations to make, and they're based on my 10+ years as a volunteer doing emergency planning and response with the my town's public safety departments (caregivers: please consider these instructions from me if you are working during the storm).

1) Locate and find available flashlights and battery-operated radios.  Change batteries now if needed and have spare ones easily available. This is a great time to set the radio to local news. Caregivers: you might bring any extra flashlights, radios and batteries you have at home. These may not be easy to find in clients' homes, or at stores as they can be quickly sold out. Put batteries on the client's shopping list for next week to replace any used from your own supply.

2) Please do NOT provide light with open flames like candles should power be lost. Candles can be sweet and romantic, but it's too easy to start a fire with them.

3) Do NOT use bbq's and other propane or gas devices for heating inside should we lose power, unless the device is designed specifically to provide space heating.  They can be deadly sources of carbon monoxide.

4) Does the house have natural gas or propane heat? It's VERY IMPORTANT to check where the flue/vent is -- they are supposed to be no lower than 4-feet above the ground, but I've seen lower -- also, snowy shrubs in front of vents can interfere with them.  In heavily drifting snow, these flues can become blocked, sending dangerous carbon monoxide gas into the house. Caregivers, please find out the source of heat for the house you'll be in and if it's natural gas, find where that flue is located. This must be kept unblocked during any storm with high snow drifts. (Older natural gas heating systems will -- they are generally vented through the chimney. The type of vents/flues to worry about during snow are high-efficiency, newer models)

5)  Caregivers: be VERY careful clearing egress to/from homes. I know you want to help as much as possible (and we love you for that!), but if you become injured, chilled or exhausted from too much shoveling of heavy snow, you can't fully care for your client. Go easy... go slow!

6) Best to prevent hypothermia if heat is lost. If the stove is electric, find some thermoses you can fill with boiling water, and keep them filled for use if the power goes out.  Serve hot drinks regularly, which warm the hands when held and the body when consumed.   Don't wait until the client feels chilled to have them put on extra layers of clothing, including hats and gloves. Encourage the client to do some moving around regularly to keep their blood flowing and their hands and feet warm.

7) Caregivers: charge your cell phones NOW, and keep them charged in case landline communication is lost.  Data services like texting and email take a lot less power than voice phone; use this info to conserve power.  If it gets too cold, you may need to call that city/town's police department for info on warming shelters or other ways they are helping at-risk citizens -- why not program in their business number?   (warming shelter info might also be found on local news radio) Also client family phone numbers and email addresses. Keep an eye on your smartphone's email more than usual as it may be easier for us to communicate that way.

8) Start talking about the weather forecast with clients immediately. Be calm, but don't brush it off as a nothing: psychological preparedness is important and sets the groundwork for resilience and lower anxiety.  Ask them to recount experiences they've had in bad weather, and how they handled it.  Tell them about some of your stories! Talk together about some of the suggestions I've put down here, plus any that might be special to their particular situation. If they are anxious,  let them know that there are plans being put into place, and that everyone will be working to keep them safe and comfortable.  Caregivers: please speak with their family members, care managers and other members of their care team to make sure you get info about plowing services, any medication refills that MUST be picked up before the storm, and any other info needed. For example: are there neighbors with alternative heating sources (like wood stoves)? Might they have overnight space for an elder who is at high risk for hypothermia?

When all is said and done: I would prefer to find out that this storm system has "gone out to sea" and that we only get a dusting with light winds!  IF YOU HAVE ANY CONCERNS AT ALL: CONTACT ME! Everyone, please take extra good care!