For some community-dwelling older adults, attempting to prepare for an emergency or disaster can come with barriers. For example, characteristics of older adults such as impaired mobility, weakened sensory awareness, multiple chronic diseases, and social and economic limitations can put them at greater risk of illness or death during an emergency. The events from Hurricane Katrina brought these barriers to the forefront when the Centers for Disease Control and Prevention (CDC) noted that 70 percent of those who died as a result of the hurricane were elderly. To help local health departments (LHDs) address these barriers, NACCHO, with support from CDC, funded three LHDs to implement and test recommendations in CDC’s Identifying Vulnerable Older Adults and Legal Options for Increasing Their Protection During All-Hazards Emergencies. Developed in 2012, the guide suggests recommendations that can be implemented at the community, regional, tribal, state, and national levels to better identify vulnerable adults and plan for their needs during an emergency. The selected LHDs tested the feasibility of realistically implementing the guide’s strategies by characterizing their community-dwelling older adult populations; and determining whether gaps existed that could be filled by additional guidance.

Building an Emergency Registry in Alameda County, CA

In early 2013, the Alameda County Public Health Department piloted a project to develop public health risk-reduction strategies, which included how to reach the most vulnerable members of the population during emergencies. Alameda County Public Health Department used recommendations from the CDC’s guide to expand its risk-based pilot project to develop an emergency preparedness registry. They focused on engaging and building partnerships with community-based organizations (CBOs) that serviced older adults, including senior centers, senior residences, and adult day cares. Each of these partners, as well as other CBOs, played a crucial role in project’s success through the following examples:

• Raising awareness of the project among service providers
• Providing information and referrals on all services in the county
• Helping individuals and organizations sign up for the registry
• Providing 27/7 emergency information to registrants
• Providing an on-the-ground perspective of the emergency preparedness challenges of older adults living in the community
• Educating seniors on what to do during emergencies and how to avoid fraud during the response
• Identifying safe locations for clients to shelter if they must leave their home

Alameda County Public Health Department then identified target populations for the registry and the threats most likely to affect this population. The leadership team addressed what resources were available in the county and worked together to understand the vision of the registry. The project coordinator explained, “The goal is not to register as many vulnerable people as possible but to account for as many vulnerable people as possible. If we do that on an individual basis and/or through the CBOs, that is the goal.” After building the registry, the project team provided short trainings on preparedness, which incorporated information about the registry. Moving forward, the LHD plans to engage additional partners, continue distributing the CDC’s guide to additional senior centers, translate the registry sign-up form in to other languages, and incorporate geographic information systems to map the location of registrants.

Tornado Spurs Actions to Prepare Seniors in Laurel County, KY

In March 2012, a tornado ripped through Laurel County destroying mobile homes, crippling a poverty-stricken portion of the county, and killing six people, three of them over the age of 60. The Laurel County Health Department launch the Community-Dwelling Older Adults Project to work with community partners to protect older residents from being victims of future emergencies. Under this project, the Laurel County Health Department established a cross-sector leadership team composed of volunteer departments, Kentucky State Police, and local representatives from school districts, law enforcement, emergency management, and faith-based organizations to create opportunities for older adults to learn and prepare for emergencies and disasters. Like Alameda County, Laurel County characterized the community-dwelling older adult population and the most common threats to the jurisdiction.

For this project, the Laurel County Health Department collaborated with partners by providing project updates and education on the many challenges faced by community-dwelling older adults through ongoing planning meetings. Laurel County also traveled to the different nursing homes and senior living apartments during National Preparedness Month to train the older adult population and their caregivers for emergencies by teaching them how to do the following:

• Write personnel preparedness plans, including plans for dependent children, pets, and instructions for caregivers
• Customize to-go kits by adding specific items such as extra batteries for hearing aids
• Create lists of medication, key contacts, and emergency numbers
• Store copies of vital documents in sealable bags to protect them from the elements

On the one-year anniversary of the tornado, the Laurel County Health Department hosted an education and training session for community-dwelling older adults with representatives from the local office of the National Weather Service who programed individual weather radios, taught participants important weather terminology, such as the difference between a tornado watch and warning, and provided instructions on how to create preparedness plans and go-kits. By using the CDC’s guide, Laurel County was able to train over 173 community-dwelling older adults and caregivers.

Promoting an Expanded Registry in Suffolk County, NY

Suffolk County is on an island that has fallen victim to coastal storms and hurricanes. In 2011, Hurricane Irene swept through the county followed by Superstorm Sandy one year later. These two events prompted emergency planners and organizations to rethink emergency and evaluation plans for older adults. Suffolk County Department of Health and Human Services decided to strengthen its Community-Dwelling Older Adults Project which raises awareness of the existing Suffolk County Emergency Preparedness Registry and other preparedness resources. Similar to the other two counties, Suffolk County leveraged existing partnerships by forming a cross-sector leadership team. As the project coordinator explained, “In an emergency, that’s the biggest problem we face – how to reach people. By going to folks who deal with the target population on a daily basis, that gives us almost immediate access.”

Since Suffolk County established a volunteer registry system more than a decade ago, the health department focused on transitioning the registry to one that includes all vulnerable populations and allows individuals to register electronically. Next, they collaborated with partners to promote the Suffolk County Emergency Preparedness Registry and accomplish the following initiatives:

• Grassroots movement to raise awareness of preparedness among the community-dwelling older adult community
• Education on how to access resources in an emergency, create a plan for obtaining help from family members, and how to prepare a go-kit for evacuations

In the fall of 2013, the health department conducted a series of public service announcements (PSAs) that encouraged individuals to sign up on the registry, as well as educated them about preparedness topics. The PSAs aired about 40 times a week on a number of different stations including a country, classic rock, and a Spanish language station.

As the nation’s population ages, older adults will comprise a greater proportion of the residents in every community. In comparison to the general public, older adults have a higher prevalence of chronic health conditions, physical disability, and functional limitations increasing their vulnerability during emergencies. Since many older adults live independently in the community, they rely on family, friends, and neighbors to assist them. During emergencies, this assistance may be disrupted placing them at an increased risk. As LHDs work to create and update emergency preparedness plans, they may want to consider the strategies used by Alameda, Laurel, and Suffolk counties when planning for the needs of community-dwelling older adults.

For the full NACCHO Report on Action Options to Improve Preparedness for Community-Dwelling Older Adult Population, download the issue brief. For more information on CDC’s Identify Vulnerable Older Adults and Legal Options for Increasing Their Protection During All-Hazards Emergencies, download the Guide.

Is your local health department considering strategies when planning for the needs of community-dwelling older adults? Let us know if the comment section below.