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After our last hurricane, it took weeks for many of our patients with Alzheimer’s disease to recover. The chaos, fear, isolation and deprivations knocked out the underpinnings of their fragile worlds.
We all know we need to plan ahead during hurricane season. It is even more crucial for people who are caring for someone with Alzheimer’s disease and other dementias.
We don’t need to reinvent the wheel. There are terrific resources on hurricane preparedness (see below). But we do want to share the experiences of patients and families and perhaps ease another caregiver’s stress. And we need to set the record straight on a few common misbeliefs.
Example 1: If we get stuck in a dangerous situation, we’ll just call 911.
During a hurricane, first responders may not be available because it is not safe for the teams to go out. Not to mention that you may not have phone service since cell towers go offline and power poles get knocked down.
Example 2: The neighbors will take care of me.
More than likely, the neighbors are struggling with their own preparations and may have their own medical needs. Often, neighbors have evacuated, and calling or venturing next door for help isn’t an option anyway because of hurricane damage.
Example 3: We’ll just go to a hospital and they have to take us in.
Hospitals are not shelters. They have limited resources and are trying to care for critically ill patients as well as feed and house the staff who must stay there for several days. And no, you can’t get “admitted” just because you have chronic medical illnesses.
Example 4: I’ll just go to one of those special needs shelters if I think I need it.
There are many misconceptions about special needs shelters.
First, you must preregister for a special needs shelter through Brevardfl.gov or by calling (321) 637- 6670. They are not, as some people think, a cross between a hotel and a hospital with separate rooms, special diets and round-the-clock nursing care. The shelters are set up in public buildings that have open space, a kitchen and bathrooms.
You must bring your own bed (cot, air mattress), bedding, a two-week supply of medication, medical supplies such as walker/wheelchair, oxygen, adult diapers and any special dietary foods or nutritional supplements (Ensure, Glucerna) as well as clothing and hygiene items.
Pets are not allowed, although you can prearrange care for them at one of the County Animal Services Care Centers as part of the registration process.
Special needs shelters are lifesavers as far as providing water, food and reliable electricity for lights and medical equipment. The staff includes trained volunteers to assist caregivers and medically compromised persons.
But even the Florida Department of Health website recommends them as “a last resort” that may be “crowded, noisy, and boring,” and caution anyone going there to “be prepared to be self-sufficient” during their stay.
What’s a caregiver to do?
Caregivers need to start preparing several weeks in advance and have a plan, but they also need to be flexible. Here are some common scenarios.
When the patient is at home with a family caregiver.
What most caregivers need is time. In order to complete the necessary tasks, the caregiver may have to take their loved one to adult day care, hire an aide to sit with them at home or pay someone else to do the prep work.
They may want to take advantage of grocery delivery — especially for cases of water and extra non-perishables. They should also get an emergency supply of prescription medications. This is covered by Florida statute and insurances must waive any restrictions if your county is under a hurricane warning or there is an official declaration of emergency.
The patient may need a prescription for an anxiety medication during the event. The preparation process, the storm itself, the disruption of the usual routine, the cleanup afterward and the awareness of the caregiver’s angst can trigger severe agitation and distress.
There are many lists of “must have” items for sheltering at home (see list). Mine includes: a four-pack of small LED lanterns, which are very bright and easily carried from room to room; a battery-operated radio; and a battery-powered coffee maker that can heat water for hot beverages and instant soup.
When the patient is in a facility
Most assisted living facilities and nursing homes will evacuate their residents in anticipation of a weather emergency. They generally move them to a sister facility and try to take as many staff along with them as possible. Even then, the patients are in a new environment with different faces, food and schedules.
We recommend that families learn what facility the loved one will be going to and then arrange for someone to stay nearby and provide daily reassurances. Make reservations in plenty of time since hotel rooms may sell out.
Sometimes, families choose to take their loved one home for a few days to ride out the storm. One caveat — it is usually better for someone with Alzheimer’s disease to stay in an unfamiliar place that has electricity and water than in a familiar home that is dark, shuttered and with limited water and food options.
Even if things are almost the same, the patient may not recognize their own home.
When the patient is home alone
A fair number of senior citizens with mild dementia are living in their own homes but are dependent on paid caregivers and other services to provide meals, medications, personal care and safety. Most likely, these lifelines will not be available during a hurricane. Programs such as Meals on Wheels and Seniors at Lunch are put on hold, and many private-duty caregivers simply cannot leave their families to check up on their clients.
It is simply not safe for a dependent patient to be home alone. This is where an option like a shelter or staying with family or friends is a necessity.
Should we stay or should we go?
It’s been our experience that the patients who did the best were those whose regular caregivers accompany them to another location a few days in advance of the hurricane. They were able to travel safely, arrive before the traffic got too heavy, get settled and establish a new routine.
Whether at a hotel or a relative’s home, other family members could rally to help keep the patient distracted and busy.
Of course, in any scenario there is a risk of the patient wandering away out of fear or because they are looking for a familiar face or place.
A bracelet or other device that helps track someone may prevent a tragedy, and having a recent photo handy is a must.
Hurricanes are destructive to property, to health and to peace of mind. People with Alzheimer’s disease and other dementias must be in the safest and most secure setting, and caregivers need the knowledge and resources to help make that happen.
Pamela Tronetti DO, AGSF, and Janet Rooks MA, CDP, provide care and support for patients with dementia and their families at the Parrish Senior Consultation Center and Parrish Senior Solutions.
For more information on hurricane preparation:
https://www.floridadisaster.org
https://www.Floridatoday.com/news/hurricane/
https://www.Brevardfl.gov/EmergencyManagement/Preparedness
https://www.ready.gov/hurricanes
“Must haves” for a hurricane emergency
• Copies of important papers and documents, including ID, insurance card and Do Not Resuscitate order if applicable.
• Cash, especially in small bills (many stores will not be able to process credit and debit cards).
• An updated list of medications and medical provider information.
• At least two-weeks supply of medications, an extra pair of eyeglasses, dentures, hearing aids with batteries (and cases for all of the above).
• Over-the-counter medications, including pain relievers, antacids, cough and cold pills, anti- diarrhea meds, etc.
• Extra batteries (Keep a list of which items require which size batteries in the same place you store batteries.)
• Flashlights, penlight.
• LED lanterns (pack of four)
• Blankets, pillows, folding chairs, air mattress
• Several sets of easy-on-and-off clothes that can be hand washed and drip dried. Label them for easy identification at a shelter or other group setting.
• Sturdy shoes, nonslip socks for night wear.
• Clothespins/plastic hangers.
• Paper plates, plastic silverware, napkins.
• Ziploc bags and aluminum foil.
• Duct tape, scissors.
• Non-electric can opener.
• An emergency medical kit, including Band-Aids, antibiotic ointment, gloves and masks.
• Hygiene products, such as hand sanitizer and dry shampoo.
• Pens and paper (post-its, list, notebook).
• Cell phone charger.
• Matches.
• Battery-powered fan.
• Battery-powered coffee maker.
• A portable grill with fuel (outside use only).
• Grab-and-go snacks and foods.
• A recent picture of your loved ones, in case you get separated.
Read or Share this story: https://www.floridatoday.com/story/life/wellness/2019/07/23/detailed-plan-must-when-prepping-dementia-patients-hurricane/1793333001/