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

Toni Morris-Oswald, University of Toni Morris-Oswald, University of ManitobaManitoba

John Lindsay, Brandon UniversityJohn Lindsay, Brandon University

May 7May 7thth 2007 2007

Understanding emergenciesUnderstanding emergencies

Understanding our hazards and our Understanding our hazards and our disastersdisasters

Vulnerability – at the heart of Vulnerability – at the heart of emergenciesemergencies

A brief comment on emergency A brief comment on emergency management in Canadamanagement in Canada

Finding a balance for safe Finding a balance for safe communitiescommunities

Hazards, disasters and usHazards, disasters and us

We must come to understand We must come to understand disasters as social ‘events’ during disasters as social ‘events’ during which communities’ normal which communities’ normal capacities are overwhelmed.capacities are overwhelmed.

This leads us to see hazards as the This leads us to see hazards as the potential interaction of our natural, potential interaction of our natural, social and built environments that social and built environments that can result in disasters.can result in disasters.

In both concepts it is our community In both concepts it is our community that is key, not the causal agent.that is key, not the causal agent.

Older persons and emergency Older persons and emergency planningplanning

……some prevailing viewssome prevailing views

1.1. Older persons are a homogeneous populationOlder persons are a homogeneous population The realityThe reality

Older persons are on a continuum of Older persons are on a continuum of abilitiesabilities

2.2. Emergency planning should be done Emergency planning should be done forfor older older personspersons

The realityThe reality-Planning should be done -Planning should be done with with seniorsseniors-Seniors can best articulate their needs-Seniors can best articulate their needs

Prevailing viewsPrevailing views cont’d cont’d

3.3. Emphasis on psychological recovery Emphasis on psychological recovery post-disasterpost-disaster

The realityThe reality--Need to also focus on Need to also focus on economic recovery where economic recovery where older persons fare worse older persons fare worse than the more youthfulthan the more youthful-Resources for recovery are -Resources for recovery are insufficientinsufficient

Better approaches to Better approaches to preparednesspreparedness

Evaluate capacities and needs of a Evaluate capacities and needs of a spectrum of older personsspectrum of older persons

Include older persons in emergency Include older persons in emergency planning and preparationplanning and preparation

Don’t make unsubstantiated Don’t make unsubstantiated assumptions – ask seniors and their assumptions – ask seniors and their care providers!care providers!

Contributions of older adults Contributions of older adults in emergency preparedness, in emergency preparedness, response, and recoveryresponse, and recovery

Older persons are able to assist in Older persons are able to assist in specific waysspecific ways

Identifying and assisting other at-Identifying and assisting other at-risk seniors risk seniors

Advocating for seniors’ needsAdvocating for seniors’ needs

Seniors’ contributions during an Seniors’ contributions during an eventevent

Delivering food, supplies, Delivering food, supplies, information and reassuranceinformation and reassurance

Peer supportPeer support Sharing life experience / perspective Sharing life experience / perspective ‘‘Community emergency response’ Community emergency response’

teamsteams

Characterizing emergencies Characterizing emergencies and disastersand disasters

Require action to protect people Require action to protect people and/or propertyand/or property

May require evacuation of high May require evacuation of high risk populationsrisk populations

Result inResult in Reduction in normal servicesReduction in normal services Limited resources/need for specialized Limited resources/need for specialized

resources resources New roles and responsibilities for New roles and responsibilities for

organizationsorganizations New communication patternsNew communication patterns Unexpected challengesUnexpected challenges

How can the needs of seniors How can the needs of seniors be addressed in such an be addressed in such an environment?environment?

Planning and preparedness Planning and preparedness beforebefore an eventan event

Planning at multiple scalesPlanning at multiple scales IndividualIndividualFamilyFamilyCommunityCommunityBroader societyBroader society

Individual preparedness and Individual preparedness and responsibilityresponsibility

Faulty assumptionFaulty assumption Emergency management organizations alone Emergency management organizations alone

can manage a disaster can manage a disaster

The realityThe reality Emergency preparedness and response plans Emergency preparedness and response plans

cannot cannot guarantee every individual’s safetyguarantee every individual’s safety predict how events will unfoldpredict how events will unfold function effectively without individual and function effectively without individual and

community assistancecommunity assistance

All persons, and particularly All persons, and particularly vulnerable persons, must knowvulnerable persons, must know what their own capabilities arewhat their own capabilities are what their specific needs are what their specific needs are the capacities of their local community the capacities of their local community

to assist themto assist them

Individual preparedness and Individual preparedness and responsibilityresponsibility

……in other words, a in other words, a fundamental level of fundamental level of preparedness lies with the preparedness lies with the individual individual

Personal emergency plans:Personal emergency plans: Individualized – particular needs identifiedIndividualized – particular needs identified Developed in consultation with Developed in consultation with

family or friends family or friends an involved agency (public /private)an involved agency (public /private)

Focus on existing resources and Focus on existing resources and independence independence

Prepare back up plansPrepare back up plans Adopt an ‘all-hazards’ approach Adopt an ‘all-hazards’ approach Try to anticipate needs and challengesTry to anticipate needs and challenges

Questions to assist older Questions to assist older persons in plan preparationpersons in plan preparation

Will you be able to receive warning in Will you be able to receive warning in a sudden emergency situation?a sudden emergency situation?

Can you manage if there is a power Can you manage if there is a power outage for several days?outage for several days?

If no evacuation required, do you have If no evacuation required, do you have the supplies you need to be self the supplies you need to be self sufficient?sufficient?

In an emergency, are there people In an emergency, are there people who will know to check on you?who will know to check on you?

If evacuation is necessary…If evacuation is necessary…

Have you developed an emergency / Have you developed an emergency / disaster ‘kit’ containing special disaster ‘kit’ containing special provisions and important papers?provisions and important papers?

Have you planned where you would go if Have you planned where you would go if you must evacuate or if you lose your you must evacuate or if you lose your home?home?

Do you have a plan to get to your Do you have a plan to get to your alternative shelter?alternative shelter?

Does the alternate shelter have what Does the alternate shelter have what you need? you need?

Questions Questions cont’dcont’d

If you were separated from loved If you were separated from loved ones, how would emergency ones, how would emergency personnel be able to get crucial personnel be able to get crucial medical and other information? medical and other information?

Is there someone else who is Is there someone else who is dependent upon you?dependent upon you?

Community responsibility for Community responsibility for preparedness of older personspreparedness of older persons

Vulnerable persons’ preparation is Vulnerable persons’ preparation is intimately tied to community preparationintimately tied to community preparation

It is a joint responsibility (individual-It is a joint responsibility (individual-community)community)

Effective emergency management Effective emergency management capitalizes upon:capitalizes upon: existing resources of the community (social existing resources of the community (social

resources, economic resources etc.)resources, economic resources etc.) local communication networkslocal communication networks

Emergency planning and risk Emergency planning and risk assessment is a community assessment is a community problem needing community problem needing community solutions!solutions!

Communities must identifyCommunities must identify

People - where they are and what People - where they are and what are their vulnerabilities?are their vulnerabilities?

What are the hazards with the What are the hazards with the greatest probability of occurrence?greatest probability of occurrence?

Planning for the elderly Planning for the elderly populationpopulationTo plan effectively to assist older personsTo plan effectively to assist older persons

Communities must work with emergency Communities must work with emergency managersmanagers

Get trained and sensitized to issues of the Get trained and sensitized to issues of the elderlyelderly

Determine which organizations can identify Determine which organizations can identify and assess which older persons are at riskand assess which older persons are at risk

Coordinate agencies to maximize resources Coordinate agencies to maximize resources and funding in planning and responseand funding in planning and response

Consider developing a registry of older Consider developing a registry of older persons as one option for tracking important persons as one option for tracking important information –- but who pays????information –- but who pays????

Planning activities at a Planning activities at a community levelcommunity level

In advance of an eventIn advance of an event Public education on preparation, Public education on preparation,

response and recovery processesresponse and recovery processes A registry of vulnerable citizensA registry of vulnerable citizens Prepare a database of key Prepare a database of key

information and requirements information and requirements (medications, medical needs, special (medications, medical needs, special needs, contact people)needs, contact people)

Utilize community organizations that Utilize community organizations that provide services to older personsprovide services to older persons

Local organizations serving the Local organizations serving the elderly needelderly need Continuity planning Continuity planning Recovery planningRecovery planning

Community level planning Community level planning cont’dcont’d

Communicating under a Communicating under a disaster scenariodisaster scenario

Technology use must be appropriate Technology use must be appropriate Information must be communicated Information must be communicated

in many ways / formsin many ways / forms Capitalize upon local Capitalize upon local

communication networks communication networks Cultural and language differences Cultural and language differences

must be addressedmust be addressed(in part after A. Cahill, (in part after A. Cahill, Planning tools you can use to meet the needs of people with 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 disabilities in an emergency: what to do, what not to do, and what difference does it makeit make, 2006 ), 2006 )

Communication strategiesCommunication strategies cont’dcont’d

Public service announcements to Public service announcements to encourage checks on vulnerable encourage checks on vulnerable neighbors / friendsneighbors / friends

Hotlines for older persons Hotlines for older persons specificallyspecifically

Lists of essential services made Lists of essential services made available to older personsavailable to older persons

Volunteers to follow up in-person Volunteers to follow up in-person with older persons with older persons

Older persons : lessons from Older persons : lessons from past disasterspast disasters

Identify the at-risk, especially socially Identify the at-risk, especially socially isolated / housebound isolated / housebound

Communication – must be timely, Communication – must be timely, appropriate; barriers must be overcome appropriate; barriers must be overcome

Challenges posed by low incomes / lack of Challenges posed by low incomes / lack of financial assetsfinancial assets

Evacuation a key problemEvacuation a key problem Lack of resources Lack of resources Knowledge of the evacuation process often Knowledge of the evacuation process often

inadequate inadequate Those with physical or sensory limitations Those with physical or sensory limitations

need particular assistanceneed particular assistance Transportation problems are multiple and Transportation problems are multiple and

increase vulnerabilityincrease vulnerability

Remaining at home during a Remaining at home during a disaster: challenges for older disaster: challenges for older adultsadults1) Power outages 1) Power outages

Impact life support equipment / electric Impact life support equipment / electric wheelchairs etc.wheelchairs etc.

Reduce access to potable water Reduce access to potable water Food safety compromisedFood safety compromised Communication issuesCommunication issues

2) Regular assistance/care is compromised2) Regular assistance/care is compromised(in part after L. Fernandez et al., (in part after L. Fernandez et al., Frail elderly as disaster victims: emergency management Frail elderly as disaster victims: emergency management

strategiesstrategies,, 2002)2002)

ResistanceResistance toto evacuationevacuation

Reasons older persons may resistReasons older persons may resist They need to believe that they will be They need to believe that they will be

supported in shelterssupported in shelters Fear loss of independence and placement Fear loss of independence and placement

in an institutional settingin an institutional setting Concern for pets and service dogsConcern for pets and service dogs Past experience impacts perception of Past experience impacts perception of

the riskthe risk Resist abandoning valued possessions Resist abandoning valued possessions Feel they can’t start over if they leaveFeel they can’t start over if they leave May have less information about the riskMay have less information about the risk

(in part after B. Phillips, (in part after B. Phillips, Evacuation :Evacuation : Why Don’t (or Can’t) People Leave?Why Don’t (or Can’t) People Leave? 2006)2006)

Evacuation challenges for Evacuation challenges for elderlyelderly Multiple changes in residenceMultiple changes in residence Confusion / disorientation with change in Confusion / disorientation with change in

surroundingssurroundings Language / cultural issuesLanguage / cultural issues Stress impacts resulting in irregular eating and Stress impacts resulting in irregular eating and

medicine schedulesmedicine schedules Daily needs not met – regular care – logistical issuesDaily needs not met – regular care – logistical issues

Older adults Older adults Need to be connected with community lifeNeed to be connected with community life Have a strong need for social support to mitigate Have a strong need for social support to mitigate

stressstress

SummarySummary

Emergency management system must Emergency management system must incorporate older vulnerable persons incorporate older vulnerable persons into planning at all levels – federal, into planning at all levels – federal, provincial and local governmentprovincial and local government

Individuals and communities must Individuals and communities must also preparealso prepare

Logistical issues must be addressed in Logistical issues must be addressed in advance of an event i.e. provision of advance of an event i.e. provision of needed supplies/services ; sheltering needed supplies/services ; sheltering of vulnerable populations etc.of vulnerable populations etc.

Biggest challengesBiggest challenges

Emergency management is not Emergency management is not popular popular

Lack of clarity around who is Lack of clarity around who is responsible and accountableresponsible and accountable

Who will demand improved Who will demand improved emergency preparedness and emergency preparedness and management for older persons? management for older persons?

$$$$ Who will pay?$$$$ Who will pay?

Shifting the Focus of Shifting the Focus of Emergency ManagementEmergency ManagementHazards/ ThreatsHazards/ Threats

ReactiveReactive

Single AgencySingle Agency

Science DrivenScience Driven

Crisis Management Crisis Management

Plan Plan forfor

Communities Communities Communicate Communicate toto

Communities Communities

VulnerabilityVulnerabilityProactiveProactive

PartnershipsPartnershipsMultidisciplinary Multidisciplinary Risk ManagementRisk Management

Plan Plan withwith CommunitiesCommunities

Communicate Communicate withwith CommunitiesCommunities

after Salter, cited in Pearce, L. 2003 Public Participation and Sustainable Hazards Mitigation

Emergency ManagementEmergency Management

Canada’s emergency management Canada’s emergency management system has been chronically under system has been chronically under funded and unsupported in pursuing funded and unsupported in pursuing these principles.these principles.

Federal efforts have been Federal efforts have been consistently derailed by consistently derailed by reorganization.reorganization.

Provincial and municipal activities Provincial and municipal activities are limited by budget constraints.are limited by budget constraints.

ExpectationsExpectations

There is an expectation gap between There is an expectation gap between what people expect the government what people expect the government to be able to do and what it really to be able to do and what it really can achieve in disasters.can achieve in disasters.

There is also a gap between what There is also a gap between what the government expects the public the government expects the public to take on by themselves and what to take on by themselves and what they are prepared for.they are prepared for.

Shifting ResponsibilitiesShifting Responsibilities

Emergency management has been Emergency management has been placing more emphasis on public placing more emphasis on public preparedness and individual preparedness and individual responsibility.responsibility.

There is also increasing attention There is also increasing attention focused on vulnerability or “special focused on vulnerability or “special populations”.populations”.

The challenge is to find a balance that The challenge is to find a balance that will see the right services meeting our will see the right services meeting our needs.needs.

Finding a BalanceFinding a Balance

RESPONSIBILITY

Government

Individual

Contributions

Dependence

Key referencesKey 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

Questions & Questions & CommentsComments

John LindsayJohn Lindsay

Department of Applied Disaster and Emergency StudiesDepartment of Applied Disaster and Emergency Studies

Brandon UniversityBrandon University

(204) 571-8555 lindsayj@brandonu.ca(204) 571-8555 lindsayj@brandonu.ca

http://www.brandonu.ca/academic/ADES/http://www.brandonu.ca/academic/ADES/

Toni Morris-OswaldToni Morris-Oswald

University of ManitobaUniversity of Manitoba

(204) 474-8373(204) 474-8373