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Safely Evacuating The Elderly In Any Emergency Takes Planning And Practice

Dec 28, 2018
Originally published on January 7, 2019 7:12 pm

The benefits of retiring in South Carolina's low country are clear to Joyce East. Her home, sandwiched between the Atlantic Ocean and downtown Charleston, overlooks 120 acres of lush marshland. Palm trees and Spanish moss dot the property.

But the drawbacks of retiring only a few meters above sea level have also become apparent to the 91-one-year-old retiree. Since 2016, her home within Charleston's Bishop Gadsden Retirement Community has weathered one snow storm, one ice storm and three hurricanes. She has had to evacuate twice in two years.

For East, these evacuations are just the cost of growing old on the coast. Three decades ago, East and her husband decided they wanted to retire somewhere warm on the waterfront. Four days after arriving in Charleston, the couple was forced to flee inland as Hurricane Hugo ravaged the coast. East would evacuate again for Hurricane Matthew in 2016, and once more for Hurricane Florence this past September.

Joyce East (right) with fellow Bishop Gadsden resident Sarah Darwin during their evacuation from their community on the South Carolina coast in September 2018.
Courtesy of Bishop Gadsen

"Now that we've done it this much, it's more of a routine," says East. She packs her belongings in a navy evacuation suitcase with her name printed on it in white lettering. "I have to kind of look at it as a mini-vacation now."

As unpredictable weather starts to feel inevitable, staff at Bishop Gadsden have worked to make evacuations feel as routine to residents as Monday night's pub trivia. This year's personalized suitcases were a new touch.

"Our planning is 24/7, 12 months a year," says Kimberly Borts, one of the staff members charged with ensuring Bishop Gadsden is ready to depart come hurricane season. "This isn't just let's get on a bus and go."

When Governor Henry McMaster mandated residents evacuate in the lead up to Hurricane Florence, he set in motion a sequence of events staff had spent the year fine-tuning. Ambulances arrived at 2 a.m. to whisk away the 14 seniors too frail to make the journey upright. The remaining 111 residents boarded buses bound for a mountaintop inn. A U-Haul was loaded up with walkers and a bus carted off residents' pets.

It's high stakes logistics. Any hiccup — too few oxygen tanks, lost medication — would have been disastrous. But even a well-executed journey carries risks for Bishop Gadsden's retirees, many of whom are accustomed to a regimented routine.

"When that schedule is altered, that's when you begin to have some challenges," says Borts. During this year's departure, she saw anxious residents who traditionally require one oxygen tank per day go through two tanks or more. As the seniors made their journey inland, Borts noted more upset stomachs and more bathroom trips.

Immediately after they returned from the shelter, Borts says staff began plotting how to make the journey smoother for their seniors — next year.

"We would sort of say to our fellow staff members, 'Well, next time we do this,' or 'Next year we need to do X,Y, Z,' " she recalls.

Statistics show there will be a next time. Far beyond the marshy coast of Charleston, emergency evacuations are starting to seem commonplace.

Susan Burns monitors evacuations for Sedgwick, a company that deals with insurance claims for senior-living communities across the U.S.

After nursing home owners made the fatal decision not to evacuate residents in advance of Hurricane Katrina, Sedgwick began offering to reimburse facilities for part of their evacuation costs. But, until recently, no facility had taken the company up on the offer.

"I had not seen this coverage triggered at all until last year," says Burns. She traces the uptick in recent claims to the "amazing number of natural disasters back to back" that have ravaged states like Florida, California and Missouri.

"They're just trying to recover some of the costs and lessen the financial blow," she says. This year, Bishop Gadsden spent $350,000 on shelter and transportation. The facility had shelled out a similar amount in 2016 for Hurricane Matthew.

And they're prepared to do it again.

"You take care of a residents during good times and bad times," says Borts. "The most important thing we can do is plan to do this again."

This story is part of NPR's reporting partnership with Kaiser Health News, an editorially independent news service of the Kaiser Family Foundation. Rebecca Ellis is a Kroc Fellow at NPR.

Copyright 2019 NPR. To see more, visit https://www.npr.org.

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.

(SOUNDBITE OF UKIYO'S "COLD FEET")

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

(SOUNDBITE OF UKIYO'S "COLD FEET") Transcript provided by NPR, Copyright NPR.