A matter of preparedness: Emergency Preparation For Those Who Are Disabled or Elderly

It isn't something we like to think about or even really plan on, but there comes a time when we have to think outside of our comfort zone. Most of us envision ourselves and our loved ones to essentially be fully functional....all the time. The reality is that there is nothing further from the truth.

Emergency Preparedness for Those Who Are Disabled or Elderly

Some of us either currently have or will be responsible for loved ones who cannot fully care for themselves. This requires support not only from you, but from the community as well. If an Emergency (either natural or man-made), arises, there are many considerations and plans that need to be in place to successfully care for these individuals. In this post, we will examine many of these considerations. As you will see, planning is essential for these individuals who may be compromised and not be in a position to care for themselves.

Ambulation

If an emergency arises, the need to move quickly is often necessary. What if your loved one could not ambulate or required special consideration to move and transport. What if your loved one required equipment to move from one place to another.

Determine, ahead of time, what their ambulation needs are. This includes the vehicle needed to transport them and their devices if needed. Things to consider could include one or more of the following:

Prosthetic devices
Extra wheelchair batteries for a Powered Wheelchair
Collapsible Wheelchair
Walker
Crutches
Canes
Motorized Scooter
Specialized Stroller

Also, be aware of your loved one's endurance and abilities. Can these individuals (who are walking either with or without any type of assistance) negotiate stairs or uneven surfaces (rocks, grass, hills, etc). If your loved one has seen or is seeing a Physical or Occupational Therapist, ask permission to talk with them about recommendations they would make in regard to your loved one's abilities and endurance.

Medication

Chances are that someone with special needs also requires medications as well. This requires not only understanding dosages and schedules, but also having those medications available. Often, but not always, special needs individuals have ongoing medication needs.

It is important to have a current list of these medications. There are apps and websites that can be used to track them. Here is a link to make your own wallet-sized card to carry with you or with the special needs individual. You can enter your information and print out your individual card at Healthcare Ready. I was pleased to see this site state that they do not save or store your information.

When Hurricane Katrina occurred, local pharmacies were really out-of-order. Within 3 weeks reportedly some medical professionals attempted to set up a website for Katrina victims to help provide information about their medication needs etc. because so many of these folks were shipped all around the country. Later an attempt was made to have a national website that allowed for interested individuals to enter their personal medical information. The thinking was that if you were relocated, the medical professionals in your new area could access your information and dispense your needed medications. The name of the Website reportedly was ICERx.org. The letters stand for "In Case of Emergency Rx". From my research, neither this website nor it's accompanying telephone number are functional. I share this with you all in the hopes that those who may have registered will know that it may not be as accessible as you once thought that it might be.

So, what do you do besides skipping a dose? Here is a suggestion that was given to a loved one in my family by his pharmacist. If you receive your medication by mail, order a refill when you have used two-thirds of your medication. This is reportedly allowed. This gives you a small window to access and store medications for emergencies.

Also, there are many apps like "Carezone" that allow you to scan your medications and it keeps a list for you. Since so many of us are so attached to our Smart phones, this may be a very viable option as long as you have power for your phone.

Finally, check with your state to see if there are circumstances that allow for you to get emergency medications. In Florida, for example, they have provisions that allow you to refill your prescription early before a hurricane. Additionally "Pharmacists are permitted to dispense an emergency 72-hour supply if they are unable to quickly get an approval from the doctor for the refill. It’s important to discuss this now with your doctor and pharmacist so that you are prepared for emergencies." You will need your prescription bottle to access this service.

You will have to have your insurance card ready and available for any prescription medication.

Consider scanning your Medication bar codes and keeping them on a USB (key ring or bracelet for your loved one).

Finally, some medications require refrigeration, syringes, etc. Make arrangements for all of these. This cooler can be plugged into the power port in your car. This allows me to keep things cool as we travel, including medications.

Insurance

You will need to have your Insurance information available to access healthcare for you or your loved one. You often can get extra copies of your Health Insurance card on request. This allows the caregivers and the special needs person to have a copy with them particularly if they get separated from each other.

Be knowledgeable about your deductibles, copays, and know what your Insurance plan covers. If you have not met your deductible for the year, you will be responsible for the entire bill until you have met this financial threshold. Also, be aware that you may have different copays for a traditional practitioner versus a specialist. Paying the copay may be difficult if you are counting on digital payment sources in an emergency. Carry cash to make these impromptu payments if your loved one needs to seek medical services in an emergency. Although an emergency room cannot deny services, the bill may be astronomical without your insurance information.

Consider scanning your Insurance cards and including them on a USB (on your key ring or as a bracelet on the special-needs individual.

Oxygen and Medical Devices:

Oxygen is a tricky subject in an emergency. During Y2K, I was an administrator of a large Skilled Nursing Facility (SNF). All SNF's were required to demonstrate that they were ready for midnight on 1/1/2000. This meant I had to have agreements and a 'plan' from every provider we ever worked with. Let me just say there are many. By the time I completed this task I had two 3 inch binders full of these agreements. These service providers provided us with everything from medication, sanitation, food, utilities, etc and Oxygen. Can I just say that this was the biggest Preparedness Project I ever had to do as I had 116 residents and about the same number of employees. We had to be in a position to provide for all of these individuals for 72 hours in case of the worse happening.

Oxygen in this situation was a big concern. We chose to use Oxygen Concentrators versus Oxygen Tanks. These devices transform room air and provide concentrated Oxygen to the patient. They can be large and also small for transport. However, they needed power. We had back-up generators in place should things have gone south, but thankfully they did not.

An Oxygen Concentrator is a viable solution for an individual who is dependent on Oxygen as it does not run out like an Oxygen tank could. However, the Oxygen tank does not require power, but you would need have a large enough supply to last you for an unknown period of time.. If your loved one requires Oxygen, check with your Oxygen provider and discuss options. No matter whether you use traditional tanks of Oxygen or a Concentrator, your need access, storage (there are requirements to safely store Oxygen in tanks), and in the case of a Concentrator....you need power. A generator or solar source will be critical.

Additionally, have a list of style and serial numbers of medical devices your loved one uses. If you have a hard time remembering where you put something in your house at times, consider how much harder this would be when the pressure is on during an emergency. It also helps if you need replacement devices.

Shelter

If you think of Natural Disasters, evacuation may be recommended. Prepare ahead of time to know where you can go in case of emergency. Often city buildings, schools, or even churches are designated as shelters. Contact local authorities (in person, by phone, or on-line) to determine the closest shelter.

If you have to shelter in place, have a plan for heat, food, cooking, medication, hygiene, etc. Hygiene can be very tricky if your sewer system is not operable and you are caring for an individual who is incontinent or vomiting. Consider having some of the following on hand:

Hand Sanitizer
Disposable Gloves: Consider the type of glove you purchase. Some folks are allergic to Latex. Also, consider getting gloves that are powdered on the inside particularly if you will be changing them often and will be in a humid environment.
Chux (disposable pads to place under an individual to catch bodily fluids).
Wipes, and lots of them. I purchase baby wipes by the case from the Big Box store.
Lotions and special creams to protect the skin. Ask you healthcare provider to recommend specifics for you.
Contractor grade garbage bags to dispose of the used items. These bags bags are usually 2.7 or 3.0 ml thick and resist tearing.
Have a supply of Over-The-Counter medications
Have a supply of soaps and shampoos.
Have a system to clean soiled clothing and the detergents to go with it.
Optional: Consider purchasing this personal protective equipment which includes masks, gowns, booties to cover your shoes, caps, and masks.

Diet: If you loved one has a special diet, be knowledgeable in how to prepare their food for them. Store foods that can be made for them and have powerless means to make them. This includes having powerless devices to chop, mix/beat and cook foods as well.

If you have a loved one who has a tube feeding, you either need to have a supply of their formula on hand or be in a position to provide a blendarized diet if your physician clears you for it. For information on home blended tube feeding diets, please see this link.

Finally, if you do have to shelter-in-place, see this list to ensure you are in a position to do so.

Evacuation

There are times that evacuation is necessary. Planning is often needed for special-needs individuals. Can they sit? Do they need to recline? If they have to sit for a long period of time, are there concerns with skin integrity? This means ensuring that they can manage the pressure on their skin (while sitting or lying down for long periods of time because they are secured with a seatbelt) without sores or skin tears. They may require gel pads, specialized car seats etc. Practice getting your loved ones in and out of the vehicle you plan to use in an efficient manner.

What if your loved one lives out of town and is required to evacuate? Elderly parents may easily fall into this category. Check with the local and State agencies to see if they provide services to help evacuate special needs individuals. For example, Florida has a "Special Needs Registry" that can list individuals who require transportation to Shelters or Medical Facilities. This service only works if you have registered well ahead of time.

Power

As noted above, some individuals with Special Needs require devices or treatments that require power. The following suggestions come from New York City (Actually this entire document is excellent and can help you organize your information in case of an emergency):

If you rely on electric medical equipment, contact your medical supply company for information about backup power.
Ask your utility company if you qualify as a lifesustaining equipment customer, and see if you can sign up for priority power restoration.
If you rely on oxygen, talk to your oxygen supplier about emergency replacements.
If you receive treatments such as dialysis or chemotherapy, know your provider’s emergency plan.

No kidding, if you are near a Hospital or Skilled Nursing Facility, you will have your power restored more quickly than if you do not live near such a place. If you do not, notify your power company of your special needs individual so that you power restoration to their home becomes a priority.

You really should consider having an alternate source for power. If you are wondering what you can run on a Generator, please see this post to help you determine your needs. If you do have a Generator, secure it to your home with a hearty chain so that it cannot be stolen. Additionally, consider having a supply of various batteries. In an emergency you quickly be amazed how many little devices require them like Glucose monitors, Pulse oximeters, Hearing Aides, etc.

Legal Documents

If you are responsible for another individual, you will need to have several documents with you in case of an emergency.

Advanced Directives: Each state has their own version of Advanced Directives. This document directs the medical team in the type of care you receive if you are not in a position to verbalize your wishes. If you are caring for another individual, you will need to have these with you particularly if significant medical attention is warranted. You should take a copy of this document with you every time you are admitted into a hospital for a procedure. Here is the link to find the forms that are associated with your state.
Power of Attorney: If you are caring for an individual who cannot make decisions for themselves, you really should have a document entitled a "Power of Attorney". This gives you the right to make medical or financial decisions for the impacted individual. As a SNF Administrator, I was appalled to see families literally fighting over the bed of the health-compromised family member because this step was not taken. I have had to threaten to call the Police if family members who were vigorously fighting did not step out of the room and discuss their concerns in a more appropriate manner. There is really no easy way to get this document in the throws of an emergency. Sometimes you may have to have a Legal Judgement made to give you the Power of Attorney if the individual is not competent to give permission for you to fulfill this role. See an Attorney and make arrangements for this critical document. For the Elderly, an Elder law Attorney is uniquely qualified to help you.

Communication

Have an out-of-town contact person that you communicate with. They can be the point person to let others know how you and your special-needs loved one are doing without taking your time during an emergency.

Consider keeping your landline phone. In an emergency, they usually work. Our family has benefitted repeatedly from this tried and true technology after a natural disaster. This was particularly true after the Category 5 Hurricane, a Flood, and the a Volcanic Eruption that we have lived through. The landline worked when our cell reception was compromised.

Summary:

This post is by no means an exhaustive source of information. However, it is my hope that you will think differently about those you may have stewardship for in the event of an emergency. Careful planning can make the difference for you and the loved one when minutes and seconds count.

If you have additional suggestions, PLEASE SHARE THEM WITH US IN A COMMENT. We all can learn from each other.

September is National Preparedness Month and The Prepared Bloggers are at it again!

It's safe to say that our ultimate goal is to help you have an emergency kit, a family plan, and the knowledge to garden, preserve your harvest and use useful herbs every day – without spending a ton of money to do it. Luckily that’s obtainable for every family and a journey we would love to help you with. This year we have posts about food storage, 72-hour Kits & Bug Out Bags, and every aspect of preparedness, from water storage to cooking off grid. You’ll also find many ideas to help you be more self-reliant. Look for information on the big giveaway we've put together for later in the month. Be sure to visit our sites and learn as much as you can about being prepared. We'll be using the hashtag #30DaysOfPrep for these and many other ideas throughout the month of September, so join in the conversation and make 2015 the year you become prepared.