"Safely Evacuating The Elderly In Any Emergency Takes Planning And Practice"

ARI SHAPIRO, HOST:

Natural disasters pose a particular risk for the elderly regardless of whether they leave for safer ground or stay put. Researchers in Florida recently found that seniors who evacuated for a hurricane were more likely to end up hospitalized than those who never left their nursing homes. But sometimes a storm is coming, and residents just need to get out of its way. That's been happening a lot in Charleston, S.C., Carolina as NPR's Rebecca Ellis reports.

REBECCA ELLIS, BYLINE: Ninety-one-year-old Joyce East can't quite recall when the hurricane season in Charleston got so bad.

JOYCE EAST: In 2016 I believe. No, what was it?

ELLIS: East lives in a retirement community called Bishop Gadsden, which is located on a barrier island three miles from downtown Charleston. In the last three years, the community has weathered one snowstorm, one ice storm and three hurricanes. Kimberly Borts has worked at Bishop Gadsden for 11 years. She and East reminisce on the latest string of storms.

EAST: Last year...

KIMBERLY BORTS: Sixteen, we went to - for Matthew.

EAST: Sixteen was for Matthew.

BORTS: And then '17 - Irma.

EAST: And then Irma.

BORTS: And we stayed.

EAST: Yes.

BORTS: And then Florence was this year.

EAST: And then Florence - this last one.

ELLIS: Here on on James Island, evacuations had become a yearly consideration. Again and again, extreme weather has forced the staff to weigh moving their 115 frail residents to higher ground. Bishop Gadsden is spread out over a hundred acres of marshland. East adores the landscape, which is dotted with oaks and palm trees and Spanish moss. But like many senior living communities on the coast, Borts says the area is vulnerable.

BORTS: We are in what we call the low country of Charleston, S.C., and that is literally the truth.

ELLIS: Twice in two years, the governor has mandated that residents evacuate. By now East as a seasoned evacuee.

EAST: Now that we've done it this much, it's more of a routine.

ELLIS: Nearly 30 years ago, East and her husband decided they wanted to retire someplace warm on the waterfront, so they moved from St. Louis to a retirement community on Charleston's Seabrook Island. Four days later, Hurricane Hugo struck the coast. There was no evacuation plan in place. The couple was just told to hit the road.

EAST: It was absolute chaos because we were on highway 26 leaving Charleston along with I think everybody in Charleston.

ELLIS: Twenty years later, East moved to Bishop Gadsden, where evacuations are planned down to the luggage residents bring with them. East now has a special navy evacuation suitcase with her name stamped on it.

EAST: It's unbelievable. It must take them a year to plan.

ELLIS: Borts says that's about right.

BORTS: We sort of plan 12 months a year.

ELLIS: This year, getting residents away from Florence and safely into their shelter, a lakeside inn on the mountain tops, was a time-intensive $350,000 operation. Staff arranged for ambulances to take seniors too frail to sit up straight. They had a bus to carry the 18 pets of Bishop Gadsden and another one filled only with oxygen tanks. During evacuations, Borts says nervous residents who normally need one oxygen tank a day will go through two tanks or more. She says that's because seniors are particularly vulnerable to changes in routine.

BORTS: When that schedule is altered, that's when you begin to have some challenges. And that, again, could be an increase in oxygen needs or an increase in, you know, frequency of going to the bathroom, a potential for increase in falls.

ELLIS: Residents who had risen in the same bedroom for decades were waking up in strange rooms, disoriented. Borts recalls many upset stomachs. When the staff returned home, they met to recap the evacuation. Without intending to, Borts says staff was already planning for what they expect to come in 2019.

BORTS: We would say to our fellow staff members, well, next time we do this or next year, we need to do X, Y, Z. And we kind of said it repeatedly.

ELLIS: These evacuations are happening far beyond the marshy coast of Charleston, says Susan Burns.

SUSAN BURNS: There definitely has been an uptick.

ELLIS: Burns works at Sedgwick, a company that deals with insurance claims for senior living communities across the U.S. After nursing home owners in Louisiana made the fatal decision not to evacuate residents in advance of Hurricane Katrina, Sedgwick decided to begin reimbursing facilities for part of their evacuation costs. But until 2017, Burns says not a single facility had filed an evacuation-related claim.

BURNS: Since I have worked at Sedgwick, I had not seen this coverage triggered at all until last year.

ELLIS: She thinks these new claims from Florida, California, Missouri means facilities are being hit with new vigor.

BURNS: In 2017, we had an amazing number of natural disasters back to back and then again in 2018. It's like there was a repeat.

ELLIS: For residents like Joyce East, this is just the reality of retiring on the coast.

EAST: I have to kind of look at it as a mini vacation now.

ELLIS: She already knows what suitcase to pack in. Rebecca Ellis, NPR News.

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SHAPIRO: That story is part of a reporting partnership with Kaiser Health News.

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