SPECIAL NEEDS
Challenge
A major earthquake has struck your community. Roadways are so badly damaged that you are unable to evacuate. You have three children and an infirmed, elderly neighbor who are depending on you. What special needs do they have, and how will you meet those needs?
From the very beginning, this handbook has focused on addressing family preparedness needs. Most of the topics presented thus far affect everyone equally—we all have to eat, drink, and stay warm. The only exceptions are the two chapters targeted at adult concerns, specifically Chapter 12 and Chapter 14. This chapter addresses the special needs of the elderly, people with disabilities, children, pregnant women, and pets. The goal of the chapter is to motivate you as a responsible family member and citizen to be aware of, and try to assist with, any special needs others may have.
Be careful not to stereotype people.
Many people have family members, neighbors, or friends with special needs. This could range from the elderly neighbor who requires nightly help preparing his meals, to the child born with a hearing disability. For purposes of identifying unique concerns, those with special needs have been grouped here into four categories: the elderly; people with disabilities or other medical needs; children; and pregnant women. This is not to suggest that these people are any less capable of caring for themselves than anyone else. Rather, it is simply a method of sorting a collection of preparations that may be useful in assisting others. The reader is strongly cautioned to avoid stereotyping any group of people.
The definition of “elderly” is neither exact nor uniform in this country or anywhere else in the world. Certainly there are eighty-year-old people who run marathons or hike mountains and suffer no physical limitations. For purposes of this discussion, however, an elderly person will be defined simply as someone whose age introduces limitations in their ability to handle disaster situations.
Special needs of the elderly (Wikimedia Commons/Chalmer Butterfield)
This section is divided into two parts. The first is targeted to elderly readers; the second is for those wishing to assist an elderly person during a time of crisis.
Every person's capabilities are unique, and those in their “golden years are no exception. Whether you climb mountains or are confined to a wheelchair, there are steps that you can take to better cope with a disaster. Begin by recognizing that regardless of age, nearly every topic in this book applies directly to you. You still need food, water, clean air, and life's other basic necessities. In order to be properly prepared, you must make the preparations outlined in the preceding chapters. However, as a senior, you should also recognize that you may have a few additional unique considerations.231,232
Start by answering a few questions to help you identify any limitations that you or your spouse may have.
• Medical Conditions—Do you have any existing medical conditions that might require immediate attention during a disaster? Do you have an adequate supply of medications? How will you get to the hospital in an emergency? Are others aware of your medical conditions?
• Personal Care—Do you need assistance with bathing and grooming? Do you use any personal care equipment to help you bathe or get dressed? What will you do if your care provider is no longer available?
• Water Service—Do you have access to purified water, or if not, are you able to safely boil water?
• Food Service—Can you prepare your own meals, or do you rely on services such as Meals on Wheels? How will you eat if your food service is interrupted?
• Feeding Devices—Do you use any special devices or utensils to eat? What will you do if one breaks and you cannot quickly get a replacement?
• Electricity-Dependent Equipment—Do you rely upon medical equipment that requires electricity? Do you have a backup power supply, and if so, how long will it last? Is the electric company aware of your dependency?
• Transportation—Do you require a specially equipped vehicle to travel? Can you safely drive at night or in bad weather? Do you need assistance entering or exiting your vehicle? Can you travel alone?
• Mobility—Do you use a wheelchair or walker? Can you navigate your house if it becomes cluttered with debris? If your wheelchair or walker is damaged and inoperable, how will you evacuate your home?
• Errands—Do you need others to run errands, such as obtaining groceries and medications? What will you do if the person you rely on is unable to reach you because roads are impassible?
• Building Evacuation—Can you evacuate your home or office independently and without assistance? Are you able to cope with debris that might block your exit? Can you reach and activate an alarm? Do you need an elevator to evacuate?
• Calling for Help—Can you call for help by shouting as well as using a telephone? Do you require hearing aids to communicate? If your hearing aid becomes lost or inoperable, how will you communicate?
• Service Animals/Pets—Will you be able to care for your service animal or pets during and after a disaster? Do you have appropriate licenses and certificates for your service animal such that you can keep it with you at an emergency shelter?
Once you have identified any personal limitations or concerns, take the steps necessary to minimize their impact. Below is a list of recommended actions that might be applicable to an elderly person.234 Many of these suggestions are also applicable to a person with a disability or serious medical condition.
• Identify and stock any special backup supplies that you may need, such as spare oxygen bottles, wheelchair or hearing aid batteries, medications, and eyeglasses.
• If you are dependent on electricity for medical needs, notify your local power company. Also, equip your home with a backup power supply.
• If you receive periodic medical treatments or services such as home health care or food delivery, talk to your providers about their ability to continue services during an emergency.
• Wear medical alert tags or bracelets to help others quickly identify your disability or medical needs. Alert bracelets may be found online at www.medids.com.
• Consider getting an emergency medical alert system that allows you to call for assistance should you become immobilized.
• Compile a folder of your medical information. Give a copy of this information to a DP network member or trusted friend who lives outside your home. The folder should include:
A list of prescription medicines, including dosages
Descriptions of your medical conditions
Allergy information
Copies of your medical insurance and Medicare cards
Descriptions of your medical devices, including models and serial numbers
A list of contact information for your doctors and care providers
• Teach others in your home to operate your wheelchair. This will allow them to more easily transport you, should you become incapacitated.
• When making an emergency call, try to use a conventional landline rather than a cell phone. The landline will enable the dispatcher to more quickly identify your location. Be prepared to provide clear, specific instructions to rescue personnel. Equip your home with several phones or keep one with you at all times.
• Be careful about getting too hot or cold. Elderly people are more susceptible to temperature-related injuries.
• Millions of children live in households headed by grandparents. If you are raising grandchildren, be sure to consider their special needs as well (see “Children” later in this chapter).
• Don't forget the needs of your pets (see “Pets” later in this chapter).
• Establish a support network with your family, friends, neighbors, doctors, and so forth. Keep their contact information handy, and don't hesitate to call on them.
• Give a spare house key to someone in your local network. This will allow them to better check on you, as well as to keep an eye on your house in the event you have evacuated.
• If you decide to evacuate, let numerous people in your network know where you are going. Contact them once you arrive safely at your destination, and continue to stay in contact with them throughout the disaster.
• If you receive federal benefits, sign up for electronic payments, which are paid directly from the government to your bank account or a debit MasterCard. Disasters can disrupt the mail service for days or even weeks. Direct deposit also eliminates the risk of anyone stealing your benefit checks. You can sign up for direct deposit of federal benefits by calling 1-800-333-1795, or visiting www.godirect.org. Electronic payment will be required for all recipients beginning March 1, 2013.235
• Following a disaster, beware of fraudulent home repair contractors. Don't hire a contractor who comes to your door and solicits. Rather, find a reputable, insured contractor through the Yellow Pages or other conventional methods. Get more than one estimate for the repairs. Only deal with a contractor who is willing to put everything in writing, including firm repair costs. Ideally, pay for the work only after it has been completed.
The elderly are particularly susceptible in the event of a disaster because many have medical conditions or physical limitations that make it more difficult for them to evacuate or perform rigorous activities. Some elderly people may be unwilling to leave their home for fear of having their belongings stolen or destroyed. They may also be reluctant to reach out to others because they don't want to be seen as a burden. As a good citizen, you are encouraged to assume some responsibility for caring for the elderly in your community. Below is a list of things you can do to help the elderly during a crisis:231,232
• Get to know the elderly in your neighborhood. Don't be offended if they seem suspicious of your intentions. The elderly are often the victims of scams (see Chapter 12). Be patient and understanding of their caution.
• If you see a disaster coming, approach your elderly friends and neighbors beforehand, and let them know that you will be checking in on them. Ask if there are any preparations that you can help with, such as refilling prescriptions, picking up a few extra groceries, and removing any home hazards. Make it clear that you don't want payment for your assistance. Leave your phone number, and ask them to call you if they need anything.
• When a disaster does occur, periodically check on the elderly. Make sure that they have the necessary supplies to meet their needs, including food, water, medication, and heating/cooling.
• Continue checking on them after the disaster passes. Studies have shown that the elderly often have more economic and health-related issues after a disaster than younger people.
• If it is clear that an elderly person is suffering from a health problem, help him or her to seek medical attention.
• Help them to register for disaster recovery assistance should they require it.
• Keep an eye out to make sure they don't become targets of a fraudulent contractor. Intervene on the elderly person's behalf to let the perpetrator know that you are scrutinizing his activity.
• Don't treat the elderly as helpless! Many elderly people are perfectly capable of caring for themselves, so don't stereotype anyone.
• Encourage elderly people to receive electronic deposits of any federal benefits they may receive. Disasters can often disrupt the mail for days or even weeks. This also eliminates the risk of anyone stealing their checks. People can sign up for direct deposit of their federal benefits by calling 1-800-333-1795, or visiting www. godirect.org. Note that all federal benefits recipients will be required to use electronic payments beginning March 1, 2013.235
Medical ID tag (courtesy of MedIDs.com)
The term “people with disabilities” is very broad in scope. The Americans with Disabilities Act defines a person with a disability as:236
• anyone with a physical or mental impairment that substantially limits one or more major life activities; or
• someone with a record of a physical or mental impairment; or
• any person who is regarded as having such an impairment.
People may suffer from physical disabilities, requiring a wheelchair, cane, prosthetic, or other device. Or they may suffer from mental or cognitive impairments, including autism, psychiatric disabilities, speech impediments, and learning disabilities. As a result, providing a single set of general disaster preparedness recommendations is simply not possible.
Evacuating people with disabilities (photo by FEMA/Win Henderson)
From a preparedness point of view, the challenges facing people with disabilities are often comparable to those facing the elderly, since many of these challenges result from limited mobility or impaired senses. For this reason, much of what has been written earlier, including the “Personal Assessment Questions,” “Recommended Actions,” and “Assisting the Elderly,” directly applies to people with disabilities or other serious medical conditions. The extent to which the particular recommendations apply largely depend on the type and severity of a person's disabilities.
For a person with a disability, being ready for a disaster is another aspect of maintaining personal independence. They face the same needs as every other citizen, including food, water, shelter, protection, and the like. Each individual must answer, and subsequently address, how their disability might introduce special needs in the event of a catastrophe.
Having children in your home requires you to make some special preparations. There are differing points of view regarding the best ways to handle dangers faced by younger family members. Many experienced parents would probably agree that children respond better to honest, clear discussions about threats—whether it is a neighborhood sex offender, the school bully, or—more suited to this discussion—the approaching tornado.
Openly discuss the disasters that can affect your area. Explain the likelihood and expected impact of each. Encourage your children to think about how your family should prepare. Actively solicit their inputs, giving each suggestion the appropriate level of consideration. At no time should you make the discussion frightening. Instead, try to make this a positive, bonding experience in which everyone feels that they have contributed part of the solution. Explain to your kids that not everyone prepares adequately, but by doing so, you can not only help yourself but also those who are less prepared.
Teach your children not to panic. Kids mimic what they see. If you are calm and in control, they will draw strength from you. Practice emergency situations. This might include such things as sheltering in place, evacuating your home, and functioning without electrical power. Make sure that they know how to call 911. Practice how they would interact with the dispatcher. Role-play to make this both informative and fun.
Children will mimic what they see, so act accordingly.
Teach your children how to evacuate from every room in the house. Most important, show them how to escape from their own bedrooms in case they should ever become trapped by a house fire. If old enough, teach them to use a fire extinguisher (see “Using an Extinguisher” in Chapter 4). Finally, if your children will ever be exposed to firearms, teach them to handle them safely.
For younger children, consider providing them with comics, games, and coloring books that relate to disaster preparedness (found on FEMA's Ready Kids website at www.ready.gov/kids).237 These materials strive to make learning fun while still providing accurate and useful information.
Older children might find the discussion of disaster types found at www.fema.gov/hazard/types to be more interesting. Consider assigning a project, such as assembling a small disaster kit, or writing a report on the dangers of a specific threat relevant to your area.
Children coping with disaster (photo by FEMA/Andrea Boohers)
When a disaster occurs, children may feel even greater stress than their parents. At the root of their anxiety, is a loss of control and normalcy. Daily routines are disturbed. Friends may not be accessible. Sleeping conditions may have changed. Food and water may be in short supply. Worst of all, they may have witnessed devastation, physical injury, and emotional trauma. All this can add up to terrible anxiety. As an adult, you are able to put logical bounds on how bad things can get. You can see beyond the immediate chaos to a longer term solution. Children, on the other hand, may feel their world has been turned upside down, uncertain that it will ever right itself.
Every child reacts to stress differently. Some may grow irritable, while others may become clingy, emotionally upset, or withdrawn. The best way to help them is to be calm and reassuring. Talk to your children about what they are feeling, and work to address their concerns. But don't lie to them. Trust is something that is difficult to regain once it is lost. Below are a few additional suggestions regarding helping children to cope with stress:238,239,240
Be honest with your kids; trust is very hard to regain once lost.
• Be mindful of your behavior. Children watch their parents for clues on how they should act. If you begin shouting and acting frantic, they may become frightened. Put on a brave face, and let your children know that you will keep them safe.
• Try to understand your children's fears, and provide the necessary reassurance. These fears often center around three concerns:
The disaster will never end
Someone they love will be killed or injured
They will be separated from their family
• Give each child a specific job, and praise their efforts when they rise to the challenge.
• Establish a routine. Children and adults alike are able to adapt to new conditions, and routines help to relieve the stress that uncertainty brings.
• Maintain discipline. Allowing your children to turn their anxiety into disrespect or argument can make the entire family less functional and heighten the level of stress.
• If possible, allow them to have contact with family or friends.
• Demonstrate your love. Give your children plenty of pats, hugs, and kisses. Physical contact can be very reassuring. Spend extra time with them, perhaps reading a book or playing a game. It is during times of greatest stress that love can shine the brightest. How you treat your children in these times of crisis is what they will remember their entire lives.
Once the disaster has passed, children may display very different reactions. FEMA provides the following descriptions of common reactions based on a child's age:240
• Birth to 2 years—Children who are not yet able to effectively communicate may become irritable, upset, or clingy. When they grow older (perhaps years later), their games may involve acting out elements of the traumatic event.
• Ages 3 to 6 years—Preschool children often feel helpless, small, and unable to protect themselves or others. This may cause intense fear and insecurity when separated from their parents. Preschool children generally cannot grasp the concept of permanent loss. In the weeks following the traumatic event, their play may involve reenacting the incident.
• Ages 7 to 10 years—By age seven, children have the ability to understand permanent loss. Some kids may become preoccupied with the details of the disaster. This preoccupation can interfere with their school or other activities. They may also display a wide range of reactions, including sadness, fear, anger, and guilt.
• Ages 11+—Pre-adolescent and adolescent children will have a more sophisticated understanding of the disaster event. Some may become involved in risk-taking behaviors, such as alcohol or drug use. Others may become fearful and avoid activities they were previously comfortable doing. They may also have difficulty expressing their emotions and worries.
If your children attend a public or private school, contact the school administrator and ask a few basic questions about their emergency plans:
• How will school officials communicate with families during an emergency? Do they have your emergency contact information, including work, home, and cell phone numbers? What will they do if you are unreachable?
• Does the school store food, water, and other basic supplies?
• Is the school prepared to shelter-in-place?
• What are their evacuation plans?
In cases where schools institute procedures to shelter-in-place, be aware that you may not be permitted to pick up your children. Even if you go to the school, the doors may be locked or inaccessible for safety reasons. Also, if you want someone else to have the authority to pick up your children in case of an emergency (such as a grandmother or close friend), sign the necessary release paperwork with the school ahead of time.
The needs of pregnant women (or people with other medical conditions) during a disaster can be very unique. The suggestions given below are tailored to pregnant women, but most can be easily modified to fit people with other medical conditions.241
If you think you might need to evacuate, contact your health-care provider ahead of time and get copies of your prenatal records. Also, let your doctor know the specifics of your new location. If you are close to your delivery date, or have a high-risk pregnancy, ask your caregiver for guidance as well as a referral for a doctor in the evacuation area. Also, compile a list of your medications, both prescription and non-prescription.
A time for special care (photo by USDA/Ken Hammond)
If you decide to evacuate, take an adequate supply of medications and prenatal vitamins, as well as your prenatal records and health-care provider's contact information. If you are traveling by car, be sure to stop periodically to stretch and walk around. Wear and pack comfortable clothing and shoes. Also, take along some healthy snacks and water, so you won't have to survive on roadside junk food. Be extra careful about not consuming food that might be contaminated or spoiled.
Try to get adequate rest and relaxation. Avoid overexerting yourself or getting too hot. The bottom line is to give yourself permission to take it easy. Even though it might be difficult given the circumstances, try to keep your stress level down. If you feel anxiety, consult a trusted friend, family member, or clergy member.
Inform emergency personnel or relief services that you are pregnant before receiving any immunizations, medications, or x-rays. If your health care provider closes or becomes inaccessible, contact a local hospital or health department about receiving prenatal, delivery, and medical care.
Inform emergency personnel of your pregnancy before receiving any medical treatment.
Americans have over 360 million pets, and that does not include exotic or wild animals. The simple truth is that people all over the world love their pets. A dog, cat, bird, horse, or even a turtle can feel like part of the family. Unfortunately, some disasters leave pet owners with very difficult decisions to make if prior planning was not done.
#1 Rule: Don't leave your pets behind.
The starting point to pet planning is to do everything possible not to leave your animals behind. History tells us that animals left behind will suffer terribly, with many perishing. You certainly don't want to be responsible for the death of your animal companion. Fortunately, proper planning can help. A very useful video regarding pets in a community emergency is provided online by Oak Ridge National Laboratory.242 Every pet owner is encouraged to watch the video (see Bibliography for the web link).
The two basic disaster scenarios to consider are: (1) you must immediately shelter in place—perhaps due to a biochemical threat, or (2) you must evacuate—perhaps due to an approaching wildfire or hurricane.
Evacuating with pets (photo by FEMA/Leif Skoogfors)
In the case of sheltering in place, you would normally just take your animals into your home's makeshift shelter (see Chapter 4). If the animals are too large, you will need to make other accommodations, perhaps a barn, basement, or garage. The important thing is to get them out of harm's way.
If you decide to evacuate, take your animals with you. If that is not possible, shelter them in a safe location, such as a friend's house or boarding kennel. In 2006, the Pets Evacuation and Transportation Standards Act (PETS) was passed, mandating that communities have plans for evacuating, transporting, and sheltering animals. However, don't expect extensive assistance from government officials. They will have their hands full with many other pressing needs. The responsibility ultimately falls on you as the pet owner to ensure your pet's well-being.
This section is divided into three time frames: before a disaster arrives, when the event is occurring, and after it has passed. The material draws heavily from FEMA's guide, Information for Pet Owners and the American Veterinarian's Medical Association's guide, Saving the Whole Family.243,244
The time to take action to ensure that your pets will be properly cared for is before a disaster strikes. There are numerous preparatory steps to consider:
• Understand your local risks. Every region faces different hazards, ranging from flooding, to extreme weather events, to wildfires. Consider how these threats will affect your pets.
• Take clear photos of each pet. If your animal ever becomes lost, you can use the photos to create posters or show them to shelter workers.
• Make certain that your pets have up-to-date identification tags. If you know where you will be evacuating to, put that location and a phone number on the back of your pet's tag or on the collar using duct tape. Microchips placed under the skin can also greatly assist veterinarians or shelter workers when trying to reunite lost pets with owners.
• Locate a place to board your pet. This could be a professional boarder, veterinarian, or friend not affected by the disaster. For health and safety reasons, most emergency shelters will not accept pets. The one exception to this is service animals. By law, service animals are allowed into emergency shelters if the owner has proof of a medical need and the pet's current vaccinations. Some hotels and motels will also allow pets, but you should confirm this ahead of time. Your local animal shelter may also be able provide information regarding available shelter and boarding locations.
• If you decide to evacuate your pets with you, take adequate pet food, water, medications, veterinary records, vaccination certificates, litter, clean up material, muzzles, tie out materials, and other supplies that might not be available during transit.
• Take pet carriers, leashes, and harnesses as appropriate. Pet carriers should be large enough to have a small water bowl and a litter pan (for cats), and must have your contact information on them.
• Supplement your first aid kit with any additional specialty supplies needed for your pets. See FEMA's Information for Pet Owners for a complete listing of first aid supplies for various pet types and sizes.243
• Don't leave your pets unattended in your vehicle in hot weather. Temperatures can become far hotter in the car than outside and can quickly kill your animals.
• If you have livestock or other large animals, work with local and state authorities to evacuate them. During some emergencies, state authorities may not allow large animal trailers on the roadways.
• Identify a trusted neighbor or friend who will serve as the designated caregiver for your animals in case the emergency happens while you are away from home. Give him or her a spare key and simple instructions on how to care for your pets.
• Understand that it may be impossible to take any animal (except service animals) on a plane, bus, or train. Plan accordingly.
If you absolutely have no choice but to leave your pets behind, there are a few precautions you can take to improve their chances for survival:
1. Confine your pets to a safe area inside the home. Do not leave them chained or tied up.
2. Leave plenty of food and water.
3. Remove the toilet tank lids, raise the seats, and brace the bathroom doors so they can drink from the toilets as needed.
4. Leave a notice on your front door that details what types of pets are inside, their names, where they are located, and when you left them. Also, provide your contact information and that of your veterinarian.
5. Return to your pets as promptly as possible. If you will be delayed, have someone else check on them.
Understand that these steps will not ensure your pets’ survival, only help to give them a fighting chance. Leaving a pet behind should always be considered a last resort.
If a disaster is imminent or underway, you need to take immediate action to protect your pets:
• Bring them inside to a safe, manageable area of your home. If you have an indoor kennel, you may wish to keep them in it for their protection and comfort. If the animals are too large to be brought indoors, accommodate them in a barn, basement, garage, or other structure.
• If you have different types of animals (such as a cat and dog), keep them separated. The anxiety of an emergency situation can cause them to act dominant and aggressive.
• Provide reassurance to your pets. If you have children, ask them to help comfort the animals. This will help your pets relax and give your kids a sense of participation.
• Be sure to have adequate food, water, and cleanup supplies available. Consider feeding moist food to reduce your pet's additional water needs. Don't overfeed your pets in an effort to keep them happy.
• Clean up any animal urine or feces immediately and thoroughly.
Once the disaster passes, take a few final precautions to ensure your pets’ safety:
• Begin by assessing if there are any immediate threats to your pets. These could include rising waters, downed power lines, roaming animals, and debris. If threats exist, keep your pets on a leash or indoors until the dangers subside.
• Recognize that your outdoor animals may act strangely or try to wander off because of new smells and sounds. Keep a close eye on them until things return to normal.
• If pets were left behind, they may require additional care. This may include professional decontamination, especially if they were exposed to high waters. Discuss your pets’ needs with local emergency management officials or your veterinarian.
• Discard any contaminated pet supplies, including food and water bowls, bedding, and toys.
• If your pet is lost, check with animal control, local shelters, and veterinarians daily to see if it turns up. Also, put up missing posters, and ask neighbors to be on the lookout for your pets.
• Animals left unattended during a disaster may become violent and dangerous. If you see signs of personality changes in your pets, seek counsel from your veterinarian.
Those with special needs may include the elderly, people with disabilities or medical conditions, pregnant women, and children.
Elderly preppers should assess their physical limitations, if any, and take steps to minimize the impact of those limitations. Such steps may include stocking medicines or medical equipment, compiling medical information, and establishing a trusted network of supporters.
From a preparedness point of view, the challenges facing people with disabilities are in many cases similar to those facing the elderly since challenges often result from limited mobility or impaired senses. However, every case is unique, and needs must be addressed with individual consideration.
Children respond better to honest, clear discussions about threats. Don't frighten them, but don't lose credibility either.
When around children, be mindful of your behavior. Kids watch their parents for clues as to how they should act. Put on a brave face, and let your children know that you will keep them safe. Maintain discipline and work to establish a daily routine.
Contact your children's school administrator and ask about their emergency plans. Be sure that they have your current emergency contact information.
The time to prepare for your pets is before a disaster strikes. Do everything possible not to leave your animals behind. If you must evacuate with your pets, take adequate supplies to care for them.
