On Day 4 without power following our recent late-October snowstorm, a woman in her 90s slowly rolled into a municipally-run emergency shelter at a nearby metro-west Boston town.  Leaning heavily on her walker, she looked at the shelter manager wearily and said, "I'm cold. I want to sleep here tonight."  Her caregiver interjected quickly, "I have to get back home,” eyeing the exit.

The shelter manager quizzed them about the elder's ability to function independently.  How much care was needed, and what type?  It turns out that the caregiver came 3-4 days a week; the senior was a bit confused, not fully independent in several of the activities of daily living, nor could she manage her own medications safely. Just not handling her medications independently was enough of a deal breaker, according to the manager. "I'm sorry, but this shelter cannot accommodate you," said the manager. "You'll have to find somewhere else to stay."

The manager was not without pity: she found neighbors with power the elder knew slightly. With reluctance, they took the senior into their home.  The only other options were to send the woman back home, and/or call the daughter in California and strongly recommend she fly out to take care of her mother.

Are you surprised this happened? I’m not. In my 10 years as a volunteer with disaster sheltering, I've become familiar with Red Cross and town shelter operation.  I would have expected this outcome, but of course the general public would not.

Most people do not realize that only medical shelters accept someone not fully independent. Since 90% of shelters opened are not medical shelters, this means that very few will take in anyone who regularly needs assistance in activities of daily living, or who has a medical condition that requires ongoing care the person cannot perform for his/herself. Yes: the very people who are most vulnerable during a disaster may be the ones who cannot find a safe place to shelter.  Ill, elderly, and the disabled dependent upon ongoing help would need other options.

If you know someone elderly, ill, or disabled who depends upon family, friends, neighbors or professional caregivers to make it through the day, then you should be prepared to deal with both local and widespread emergencies – and it is especially vital for these groups. At a presentation by the Massachusetts Office on Disability I attended, the message was clear: if you are ill or disabled, you should be putting into place the ability to deal with emergencies, including by making your home ready to shelter you during any disaster – should it be safe to remain there.  Do not expect emergency shelters to be ready or able to meet your special needs. Staying home may be the most comfortable place for you.

With the cold upon us (and given how wacky our weather has been), here are some questions I believe every family with an elder or disabled loved one should be asking themselves – questions for which you need realistic, sensible answers. (I provide brief suggestions of how I would begin to address such issues.)

Maintaining Ongoing Care:  Who is caring for the elder? What is the caregiver's plan to cover emergency contingencies? Before each storm, if your loved one cannot go without care for a day, a caregiver may need to be dispatched ahead of the storm and outside normal schedules so that dangerous or impossible driving during storms is eliminated.  Depending upon how nearby other family members are, there may need to be back-up caregivers placed on call.

Managing Without Power: How would your elder loved one get through a period of no electricity? How could they stay warm or cool? What would they and their caregiver eat, drink, and how would they cook? (For reference, you may want to see preparedness instructions to our caregivers and client families such as these: http://blog.caringcompanion.net/?p=649)

Keeping Lines of Communication Open: How would you communicate with your loved one to know if they were ok? Can they reach neighbors easily without leaving the house in bad weather, or if they have mobility problems? If you have a landline phone that is not a hand-held or internet-dependant, consider a hard-wired, line-based phone. Plan to keep cell phones charged and use texting or email as they are more likely operational in an emergency.

Deborah

It seems difficult to fathom that ill, frail or dependant elders would not be accepted into 90% of emergency shelters during a disaster. Changes to this situation need to happen at a systemic level where the realities of the probably are truthfully and fully embraced. Federal, State and municipal priorities, practices and funding will need to be thoroughly reconsidered. In the meantime, you will need to make and be ready to carry out realistic plans for your elder loved ones.

Deborah Bier, PhD, is director of Caring Companion Home Care's Metrowest Boston office, headquartered in Concord, MA (www.CaringCompanion.Net).  She holds a doctorate degree in counseling, and is certified to both educate dementia caregivers and coach families of dementia patients.  She can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it. . To find more emergency information for households with elders, subscribe this blog, as we will have periodic articles on this topic.