45 Degrees North: One More Worry For Rural Elders And Caregivers

Disaster readiness can fall far down the list of priorities for rural elders and caregivers. When day-to-day challenges alone are overwhelming, it’s easy to put off preparations you hope will never be needed. But when everything takes more time and effort, planning to hustle one step ahead of a crisis isn’t much of a plan.

There are ways, though, to break readiness down into more do-able parts. Anything you can do before needing to evacuate or shelter in place can save precious minutes when every minute counts. Here are some suggestions:

The 3 Ps

Purse, prescriptions and pets: In an emergency, that may be all you have time to grab. Those are things you probably grab anyway when going to medical or veterinary appointments or on other outings, though. So start here.

Find a zippered bag that will hold medication containers and keep everything in that bag except when you’re filling weekly pill boxes. Add printouts of notes after doctor visits and hospitalization discharge papers, a toothbrush, a bottle of water, a pocket pack of tissues and wipes, and spare holders for hearing aids, eyeglasses, and dentures. Clip to the bag a short list of other bulky essentials to gather like incontinence supplies and portable oxygen.

Use a second zippered bag for pet essentials like a bottle of water, a baggie of kibble, poop bags, and printouts of immunization records and other pertinent veterinary records.

To each bag and purse add a few energy bars, a flashlight and extra batteries (preferably a small LED flashlight with a neck lanyard), and a card with your contact information and your emergency contacts. If you have a spare cell phone charger, pack that with prescriptions.

Keep bags together in a place that is easy to access and known to caregivers and family members or neighbors who might help with an evacuation. An old daypack is helpful, too, for anyone with the shoulder mobility to put it on: Put the 3 Ps inside and arms through the straps to free hands for using a cane or walker and navigating steps or uneven ground.

Go Bag

Pack an old suitcase or duffle bag with a few changes of clothing and find an out-of-the-way spot to leave it — hopefully forever. For elders who live independently and still drive, it might make sense to keep a bag in their vehicle rather than expect them to wrestle one from the bottom of a crowded closet as wildfire or floodwaters approach.

When my late parents were in an assisted living facility in Florida, they were required to have a packed bag ready to go during hurricane season. Rather than pull garments from Mom’s closet, I purchased several changes of clothes for her for 20 bucks at my local thrift shop. Include layers for a wide range of conditions. The church where they sheltered during Hurricane Irma was very cold from air conditioning until power was lost, and then it was hot. And in the dark, it was difficult to navigate to and from toilets. That’s why I now recommend a flashlight with a neck lanyard to free up hands for balance and navigation. I would also add a package of waterless shower wipes.

We never found the hearing aids Dad put in his shirt pocket during that evacuation , although he did get his eyeglasses back. Put identification labels on cases and devices, mobility aids, cell phones, chargers, and bags. Consider labeling with contact information for both the owner and another trusted person who might be easier to reach.

Now What?

Beyond the 3 Ps and a go bag, preparedness is best tailored to individual circumstances. This Disaster Preparedness Guide For Caregivers can help you assess current needs and project how those might change, make a plan that utilizes limited resources, and engage a support network to assist before, during and after a potential disaster.

It’s important that the support network be based in reality. You can’t really expect the person who isn’t reliable for everyday appointments to shine in a crisis. And support people need to be able to problem-solve on the fly as evacuation traffic is routed onto unfamiliar roads, gas stations sell out, shelters fill, and conditions change. However willing they may be, a caregiver who is permanently or temporarily limited in their physical strength, mobility, or cognition may not be able to meet the needs of evacuation caregiving or even sheltering in place. And there may be other resources.

A friend’s father had recently gone on home hospice when hurricane warnings were issued. Hospice personnel not only handled his evacuation to safer quarters (including moving the hospital bed), but also moved him back home when it was safe to do so.

Brutal Honesty

The difference between being able to manage a crisis independently or not can be a matter of weeks. Distant family members may not recognize or accept how much circumstances have changed, or be able to address crisis needs or preparations from afar on an as-needed basis. So it’s important for elders and primary caregivers to be proactive in both planning and implementing plans, and to be brutally honest about all the ways plans might fail.

Sometimes that requires caregivers, many of whom are also older, ill or disabled, to make hard decisions about what they can and cannot do. For example, a caregiver who can call a rural ambulance service for a lift assist after a fall is unlikely to get last-minute help from that service to move a wheelchair-bound family member into and out of the basement when there’s a tornado warning. Instead, they may have to plan to shelter that person in an interior room like a bathroom and use blankets to protect the wheelchair-bound person from debris while other members of the household go to the basement.

Emergency Alerts

Sheltering in the bathroom is the plan, for now, for a family member whose impaired mobility is relatively new (there’s more helpful information here on tornado survival for wheelchair-bound people). When she returned home after a long hospitalization and rehabilitation, the family addressed a long list of adaptations and concerns to help her live independently. I don’t recall asking if “tornado shelter” was on the list. If it was, we probably thought we could figure it out in March or April. And then, for the first time in Wisconsin’s recorded history, a February tornado touched down near where she lives. She wasn’t impacted, thank goodness. But tornadoes aren’t the only hazard for which we could have a better plan. For example, in a chemical spill scenario, road blocks could prevent family members from reaching her.

At the very least we could make sure the fire department knows she would be unable to evacuate without assistance. Her county uses a network of tornado sirens, and directs residents to use wireless weather alerts from the National Weather Service. I wish they used a mass emergency alert system like the one my county uses. It lets residents notify authorities about access or functional needs, including physical disabilities, electricity-dependent medical devices, intellectual or developmental disabilities, dementia, hearing or visual impairment, and no means of transportation. It can be delivered by landline phones as well as wireless text, voice and email.

Tough Conversations

It’s not any easier to begin conversations about potential wide-scale disasters than it is about personal disasters like no longer being able to drive. And for some, the heartbreaking reality is that an abstract possibility like a wildfire or chemical spill evacuation barely registers against an avalanche of daily losses. Some simply can’t imagine finding the energy to leave home for a crowded shelter or to impose on family or friends. Some genuinely would prefer to stay home rather than evacuate, no matter the consequences. But that choice can impact other people as well, including the first responders and law enforcement personnel tasked with evacuating residents of an area that is under threat.

As a first responder who has worked a couple of disasters in my own area, I’m torn about this. I really don’t want to think of finding neighbors who perished in their homes because they couldn’t or wouldn’t evacuate or get to the basement for shelter. Then again, I understood why my father swore he would never again choose to evacuate ahead of a hurricane.

Perhaps the best we can do is talk about what-ifs and imagine how we would respond given our current capabilities and as our options narrow.

Grace for Caregivers

One of the most capable people I know recalls how helpless she felt trying to get her toddler and her late mother-in-law (who suffered from dementia) to the basement ahead of a tornado. Sometimes the best you can do is get a person to sit on a chair near the steps while you pray. But even strong faith and a safe outcome are not quite enough to ease the pain of a memory like that. For many rural families, caregiving is a blessing, but it’s also hard. If you or someone you know is a caregiver in need of support, the Rosalynn Carter Institute For Caregivers is there to help. Text TOUGH to 741741 for free 24/7 crisis counseling.

Donna Kallner writes from Langlade County in rural northern Wisconsin.