Natural Disaster Preparedness Study: Are you prepared, vets?

[Veteran Advisor]

Responding to Natural Disasters: Spinal Cord Injury and Disorders
Frances M. Weaver BA MA PhD
Edward Hines, Jr. VA Hospital
Hines, IL
Funding Period: June 2006 - September 2007

BACKGROUND/RATIONALE:
Individuals with spinal cord injuries and disorders (SCI&D) are particularly at risk during times of natural disasters due to their impaired mobility and other special needs such as power wheelchairs and ventilator-dependency. The purpose of this study is to use lessons learned from recent disasters to develop a toolkit or guide for facilities that care for veterans with SCI&D and for veterans with SCI&D and their families on how best to respond to a natural disaster.

OBJECTIVE(S):
Our objectives are: 1) To identify lessons learned from natural disasters that have affected veterans with spinal cord injuries and disorders (SCI&D), 2) To develop a toolkit focused on improving natural disaster preparedness for facilities caring for persons with SCI&D and individuals with SCI&D. Our long term objective is to develop a natural disaster preparedness plan for veterans with SCI&D that will be used nationwide, can be implemented quickly, and is applicable to other high-risk populations. This study will serve as the first step toward a larger study to implement best practices for disaster preparedness and evaluating readiness across the VA.

METHODS:
Thirty (N) telephone interviews were conducted. Providers (n=16) consisted of physicians, social workers, therapists, and care coordinators who worked in VHA for four to 25 years. The 14 veterans interviewed had been living with SCI for five to 43 years. Data were coded by two investigators using constant comparative analysis.

FINDINGS/RESULTS:
Most providers and patients had lived through at least one weather-related natural disaster. Veterans with SCI were typically evacuated to unaffected areas or were admitted to nearby SCI centers. Providers and veterans who had encountered prior disasters drew on those experiences to guide their actions. Other participants explained that many aspects of a response take shape “in the moment” and that pre-established plans serve as useful starting points. Social support from family and local agencies was critical for veterans to attain a sense of personal preparedness. Providers described the importance of understanding both the medical and living situations of SCI veterans so that those “at risk” could be identified. This information was used to develop tools like critical patient call lists, and to prioritize response efforts to ensure that high risk individuals were brought into a facility or relocated to safe areas.

Conclusions: Responding to natural disasters in high risk populations requires appropriate organizational and community resources, but also tailoring responses to address the unique needs of individuals with SCI. Integrating opportunities into the flow of routine clinical work where providers and patients can share information about disaster preparedness may facilitate optimal SCI care when such events occur.

IMPACT:
A natural disaster preparedness plan for veterans with SCI&D could be developed, that could be used nationwide, implemented quickly, and be applicable to other high-risk populations.

Taken from http://www.queri.research.va.gov/pro...UnderReview=no

[Veteran Advisor]

How many of you vets have faced a natural disaster/mass casualty event while in a wheelchair? What was the event and how did you handle it? Do you currently have an evacuation plan?

[Sue Pendleton]

Currently our plan is to head for a hotel as far away from the disaster as possible. We're no\where near a flood plane and all our utilities are underground in our "special assessment area". Only fear here is a tornado due to being on a slab or if an ice storm snapped lines leading into our area. We have a fireplace and the hallway is pretty well contructed for a tornado hit although those are also rare. Course anywhere we go our dog goes.

A friend of mine that just passed was stuck by an ice storm at her local high school. That was the shelter for those with disabilities in her area of Maine. She left for a hotel within 3 days. No one had planned for 1/2 hour + bowel programs, disposal of adult diapers or shower chairs. The disaster lasted 3 weeks before she had electric back. She was a high T para Viet Nam era.

[SCI-Nurse]

VA SCI Centers and support clinics are required to keep a list of their veterans who are at risk in the case of a natural disaster, and contact them in the case of such a disaster to assure that they have resources available to them as needed.

We have had to admit outpatients who were evacuated in our recent wildfires who had no other place to go. Most shelters are not accessible, and certainly don't have the services of caregivers. Paid caregivers are unlikely to show up for work in a widespread disaster, or may be prevented from entering the area.

As CARF accredited rehab facilities, VA SCI Centers are also required to work collaboratively with local disaster agencies to help identify resources and advocate for disaster resources for those with disabilities. We have recently been contacting our local agencies, including our ILC, and find that really no one is addressing this, nor are they inclined to see it as a need. We are continuing to work on this issue, and hope to engage the local PVA chapter in our efforts as well.

(KLD)

[Sue Pendleton]

I understand that the VA in Baton Rouge and the local PVA insured that not one registered vet died during Katrina. All that needed to be were evacuated. That's a very good start considering how many non-ambulatory people died in nursing homes and even a convent retirement home for nuns.

[betheny]

I once tried to get my local SCI group to work on this. They thought I was being a bummer. I thought I was being realistic, since I seem to spend a lot of time in the tornado shelter! Good work for the VA to do this.

I thought law enforcement should have a list of us. Some people feel that is more likely to make us targets than beneficiaries.

When the tornado blows away my chair, I'm gonna be in trouble...

[Sue Pendleton]

We were told in rehab to notify fire, the nearest police station and any separate county emergency services coordinator that there is a quad/paraplegic at such and such address, all phone numbers and where the injured person's bedroom or normal location is in the house. I notified the fire department because they always send at least one squad car and an ambulance on calls. My electric company also uses an electronic reader that tells the reader extra information like the home owner is disabled and has a very friendly dog with a very loud voice. I understand that if they feel the least bit suspicious they call the police to come take a look around and talk to neighbors. Like I always cancel papers before trips and we let at least one neighbor know we'll be gone. So if a few days papers stay on the drive someone would be checking on me.

[jody]

very real. I was very near the san fran quake. I was watching the ball game when it hit. The city was paralized for days It was feared the after shocks would cause majors faults to become active. we felt the after shocks for weeks. and later being on the east coast, with lots of neighbors who worked in the towers on 9-11, city was a wreck. I needed to go to the E.R to have a bamboo garden stake removed from my arm, They would not treat me at first because they were afraid of wasting a bed. I get in to the Er, and it is empty. staff milling around, people were in a panic and we were fours hours away, but they though the hospitals would be filling up with air lifted casulties. and then theres always katrina. now that was mess! and still is. it affected people all over the u,s, because many poeple had to be sheltered and cared for, so they were distributed into kind families all over. In cali we replaced emergency water and food every year. and renewed our meeting spots for extended family. where we would meet after a major quake, who we would contact. and were to look for messeges if we were seperated. do they still sell the little quake bags? they were yellow and filled with three days worth of packaged water, a first aid kit, emergency blanket a roll of tp, nutrition bars,trash bags, tablets to purify water, a flag to mark buried survivors a flag to mark the dead, weather resistant tape,a permanant marker and pencil, writing tablet, a surving a disaster book, with list for shelters and first aid stations, oh, and a wind up radio to listen for news and instructions. I think it just depends on where you live who takes preparedness seriously or not. the quake bags were always visible in drug stores and mini marts,7-11 but after the
san Fran and whittier quakes, there was a shortage. I had those bags in my trunk for many years. one for each family member and have often put it on my to do list to make up more. they used to cost 20 bucks not including the radio, that was the delux kit or sold seperatly. they made good christmas gifts.

[jody]

betheny maybe support from this group by adressing this issue, would affect how your local group responds to disaster preparedness. I would have been toast had I not been able to crawl out. replacing destroyed equipment has been a trial. and I dont know what we would have done without the red cross. they provided a motel, clothing, an food for three days.