Emergency preparedness: What to seniors say? What do they (and we) need to know?

1. Emergency preparedness:What to seniors say? What do they (and we) need to know? Toni Morris-Oswald, University of Manitoba John Lindsay, Brandon University May 7th 2007

2. Understanding emergencies • Understanding our hazards and our disasters • Vulnerability – at the heart of emergencies • A brief comment on emergency management in Canada • Finding a balance for safe communities

3. Hazards, disasters and us • We must come to understand disasters as social ‘events’ during which communities’ normal capacities are overwhelmed. • This leads us to see hazards as the potential interaction of our natural, social and built environments that can result in disasters. • In both concepts it is our community that is key, not the causal agent.

4. Older persons and emergency planning …some prevailing views • Older persons are a homogeneous population • The reality Older persons are on a continuum of abilities • Emergency planning should be done for older persons • The reality -Planning should be done with seniors -Seniors can best articulate their needs

5. Prevailing views cont’d • Emphasis on psychological recovery post-disaster • The reality -Need to also focus on economic recovery where older persons fare worse than the more youthful -Resources for recovery are insufficient

6. Better approaches to preparedness • Evaluate capacities and needs of a spectrum of older persons • Include older persons in emergency planning and preparation • Don’t make unsubstantiated assumptions – ask seniors and their care providers!

7. Contributions of older adults in emergency preparedness, response, and recovery Older persons are able to assist in specific ways • Identifying and assisting other at-risk seniors • Advocating for seniors’ needs

8. Delivering food, supplies, information and reassurance Peer support Sharing life experience / perspective ‘Community emergency response’ teams Seniors’ contributions during an event

9. Characterizing emergencies and disasters • Require action to protect people and/or property • May require evacuation of high risk populations • Result in • Reduction in normal services • Limited resources/need for specialized resources • New roles and responsibilities for organizations • New communication patterns • Unexpected challenges

10. How can the needs of seniors be addressed in such an environment? • Planning and preparedness beforean event • Planning at multiple scales • Individual • Family • Community • Broader society

11. Individual preparedness and responsibility • Faulty assumption • Emergency management organizations alone can manage a disaster • The reality • Emergency preparedness and response plans cannot • guarantee every individual’s safety • predict how events will unfold • function effectively without individual and community assistance

12. All persons, and particularly vulnerable persons, must know what their own capabilities are what their specific needs are the capacities of their local community to assist them Individual preparedness and responsibility

13. …in other words, a fundamental level of preparedness lies with the individual Personal emergency plans: • Individualized – particular needs identified • Developed in consultation with • family or friends • an involved agency (public /private) • Focus on existing resources and independence • Prepare back up plans • Adopt an ‘all-hazards’ approach • Try to anticipate needs and challenges

14. Questions to assist older persons in plan preparation • Will you be able to receive warning in a sudden emergency situation? • Can you manage if there is a power outage for several days? • If no evacuation required, do you have the supplies you need to be self sufficient? • In an emergency, are there people who will know to check on you?

15. If evacuation is necessary… • Have you developed an emergency / disaster ‘kit’ containing special provisions and important papers? • Have you planned where you would go if you must evacuate or if you lose your home? • Do you have a plan to get to your alternative shelter? • Does the alternate shelter have what you need?

16. Questions cont’d • If you were separated from loved ones, how would emergency personnel be able to get crucial medical and other information? • Is there someone else who is dependent upon you?

17. Community responsibility for preparedness of older persons • Vulnerable persons’ preparation is intimately tied to community preparation • It is a joint responsibility (individual-community) • Effective emergency management capitalizes upon: • existing resources of the community (social resources, economic resources etc.) • local communication networks

18. Emergency planning and risk assessment is a community problem needing community solutions! Communities must identify • People - where they are and what are their vulnerabilities? • What are the hazards with the greatest probability of occurrence?

19. Planning for the elderly population To plan effectively to assist older persons • Communities must work with emergency managers • Get trained and sensitized to issues of the elderly • Determine which organizations can identify and assess which older persons are at risk • Coordinate agencies to maximize resources and funding in planning and response • Consider developing a registry of older persons as one option for tracking important information –- but who pays????

20. Planning activities at a community level In advance of an event • Public education on preparation, response and recovery processes • A registry of vulnerable citizens • Prepare a database of key information and requirements (medications, medical needs, special needs, contact people)

21. Community level planning cont’d • Utilize community organizations that provide services to older persons • Local organizations serving the elderly need • Continuity planning • Recovery planning

22. Communicating under a disaster scenario • Technology use must be appropriate • Information must be communicated in many ways / forms • Capitalize upon local communication networks • Cultural and language differences must be addressed (in part after A. Cahill, Planning tools you can use to meet the needs of people with disabilities in an emergency: what to do, what not to do, and what difference does it make, 2006 )

23. Communication strategiescont’d • Public service announcements to encourage checks on vulnerable neighbors / friends • Hotlines for older persons specifically • Lists of essential services made available to older persons • Volunteers to follow up in-person with older persons

24. Older persons : lessons from past disasters • Identify the at-risk, especially socially isolated / housebound • Communication – must be timely, appropriate; barriers must be overcome • Challenges posed by low incomes / lack of financial assets Evacuation a key problem • Lack of resources • Knowledge of the evacuation process often inadequate • Those with physical or sensory limitations need particular assistance • Transportation problems are multiple and increase vulnerability

25. Remaining at home during a disaster: challenges for older adults 1) Power outages • Impact life support equipment / electric wheelchairs etc. • Reduce access to potable water • Food safety compromised • Communication issues 2) Regular assistance/care is compromised (in part after L. Fernandez et al., Frail elderly as disaster victims: emergency management strategies,2002)

26. Resistancetoevacuation • Reasons older persons may resist • They need to believe that they will be supported in shelters • Fear loss of independence and placement in an institutional setting • Concern for pets and service dogs • Past experience impacts perception of the risk • Resist abandoning valued possessions • Feel they can’t start over if they leave • May have less information about the risk (in part after B. Phillips, Evacuation :Why Don’t (or Can’t) People Leave?2006)

27. Evacuation challenges for elderly • Multiple changes in residence • Confusion / disorientation with change in surroundings • Language / cultural issues • Stress impacts resulting in irregular eating and medicine schedules • Daily needs not met – regular care – logistical issues Older adults • Need to be connected with community life • Have a strong need for social support to mitigate stress

28. Summary • Emergency management system must incorporate older vulnerable persons into planning at all levels – federal, provincial and local government • Individuals and communities must also prepare • Logistical issues must be addressed in advance of an event i.e. provision of needed supplies/services ; sheltering of vulnerable populations etc.

29. Biggest challenges • Emergency management is not popular • Lack of clarity around who is responsible and accountable • Who will demand improved emergency preparedness and management for older persons? • $$$$ Who will pay?

30. Hazards/ Threats Reactive Single Agency Science Driven Crisis Management Plan forCommunities Communicate to Communities Vulnerability Proactive Partnerships Multidisciplinary Risk Management Plan withCommunities Communicate with Communities Shifting the Focus of Emergency Management after Salter, cited in Pearce, L. 2003 Public Participation and Sustainable Hazards Mitigation

31. Emergency Management • Canada’s emergency management system has been chronically under funded and unsupported in pursuing these principles. • Federal efforts have been consistently derailed by reorganization. • Provincial and municipal activities are limited by budget constraints.

32. Expectations • There is an expectation gap between what people expect the government to be able to do and what it really can achieve in disasters. • There is also a gap between what the government expects the public to take on by themselves and what they are prepared for.

33. Shifting Responsibilities • Emergency management has been placing more emphasis on public preparedness and individual responsibility. • There is also increasing attention focused on vulnerability or “special populations”. • The challenge is to find a balance that will see the right services meeting our needs.

34. Finding a Balance Contributions Government RESPONSIBILITY Individual Dependence

35. Key references Cahill, A., 2006. Planning tools you can use to meet the needs of people with disabilities in an emergency: what to do, what not to do, and what difference does it make. Working Conference on Emergency Management and Individuals with Disabilities and the Elderly, Washington. June 28-30, 2006. http:// www. add-em-conf-com/presentations.htm Fernandez, L., Byard, D., Chien-Chien, L., Benson, S., Barbera, J.A., 2002. Frail Elderly as Disaster Victims: Emergency Management Strategies. Prehospital and Disaster Medicine Vol 17, No.2. Gibson, M..J., 2006. We Can Do Better: Lessons Learned for Protecting Older Persons in Disasters. AARP Public Policy Institute. Washington, D.C. http://www.aarp.org/research/assistance/lowincome/better.html Lindsay, J., Hall, M., 2006. Older persons in emergency and disaster: a case study of the 1997 Manitoba Flood. Department of Applied Disaster and Emergency Studies, Brandon University. Pearce, L. 2003. Disaster Management and Community Planning, and Public Participation: How to Achieve Sustainable Hazard Mitigation. Natural Hazards 28 (2-3), 211-228. Phillips, B., 2006. Evacuation :Why Don’t (or Can’t) People Leave? Working Conference on Emergency Management and Individuals with Disabilities and the Elderly, Washington. June 28-30, 2006. http: //www. add-em-conf-com/presentations.htm

36. Questions & Comments John Lindsay Department of Applied Disaster and Emergency Studies Brandon University (204) 571-8555 lindsayj@brandonu.ca http://www.brandonu.ca/academic/ADES/ Toni Morris-Oswald University of Manitoba (204) 474-8373