LeadingAge Magazine · January/February 2012 • Volume 02 • Number 01

Providers Become Go-To Shelters in Harsh Conditions

January 17, 2012 | by Arlene Karidis

Last fall’s storms in the Northeast hit some providers hard, but they proved themselves valuable community assets nonetheless.

The year 2011 will be long-remembered at The Amsterdam at Harborside, Port Washington, NY—not just because it was when the continuing care retirement community first opened its doors—but because the brand-new community nearly tripled its admissions overnight thanks to Mother Nature.

Tropical Storm Irene led to The Amsterdam’s new Tuttle Center becoming a valuable shelter to residents of neighboring communities.

“We were hearing about the storm all week, and it was projected to go straight through our town,” says Margaret Minchini, executive director of the community, with a 10-acre campus on Long Island’s north shore, 17 miles east of New York City.

A few nights before Irene’s estimated arrival, Minchini purchased inflatable beds for staff and guests who would stay overnight to help, or to avoid dangerous driving conditions. Dining staff made sure the kitchen was well-stocked and ensured all emergency food supplies were in place.  The plant operations team checked equipment, staged flashlights, stocked extra batteries, and tested the generator.

“The south shore of Long Island and barrier islands along the coast had to be evacuated, including quite a few nursing facilities. So there was a need for safe harbor for frail residents in those areas. Because we were new, we had available beds and took in 38 skilled nursing residents,” says Minichini.

Staff  were ready and waiting for the flood gates to open, so to speak—an additional 15 dining, housekeeping and maintenance employees plus another 10 nursing staff were on standby. They were expecting their guests by seven p.m. Friday, Aug. 26.

“We were told everyone would be here by that time, but the first group came at 11 p.m. They kept coming until three in the morning, and the rest of the residents filtered in by Saturday afternoon,” recalls Anthony Comerford, health center administrator.

Nursing worked from a staging area, checking in frail guests with wrist bands, assessing for acuity and needs. Additional med and treatment carts were set up, and finally the lobby and halls were quiet and clear as the last of the arrivals settled into their rooms. Luckily, the center never lost power. The newcomers adjusted well, and by Sunday afternoon the seniors from residential living were out walking their dogs.

LeadingAge NY has compiled an interesting special edition of its newsletter, Advisor, for Autumn 2011.  It includes the stories of 22 LeadingAge NY members hit hard by two hurricanes in 2011.

  Like Long Island, Connecticut was also hard hit in 2011, in this case by Storm Alfred, which struck on Halloween weekend.  Hebrew Health Care in West Hartford, with  287 skilled nursing beds, 108 assisted living units and 45 hospital beds, went without power for nine days, running with an emergency generator supplying essential power for its residents. Hebrew Health Care’s home health and hospice agency, located in a neighboring town, was also affected.

“The day of the storm we fielded more than 50 calls from individuals, from other facilities, and from home hospice programs, seeking shelter and care for frail elders at risk in the community,” says Bonnie Gauthier, president and CEO of Hebrew Health Care.

Downed trees and wires, and power outages in their own homes, made it difficult for staff to get to work, not just during the storm but for days afterwards. Those staff who made it in performed their usual jobs but also chipped in as needed to assure services and care were delivered to residents. Hebrew Health Care served over 1,700 meals to staff alone in just over a week, with administrative staff working without computers or light, and nursing taking care of their own residents as well as additional hospice patients temporarily admitted to the hospital unit and respite patients they welcomed into the skilled nursing units. Hebrew Health Care’s home health and hospice agency opened its doors to the community as a warming and charging station once power was restored.

The Department of Public Health (DPH) called regularly to check on the status of power, to see if Hebrew Health Care was still on generator, and to confirm census. Communication was further bolstered through the Long Term Care Mutual Aid Plan (LTC-MAP), written by local long-term care providers, DPH and Russell Phillips Associates, emergency management experts that serve health care facilities. The plan assured communication through e-mail, phone and Everbridge, a disaster communications system.

“Oh, there are many stories that came from this event,” reflects Gauthier. “Our home health staffer who drove on sidewalks to get to her patients in the community; the man from Texas who found our website and called to find out how to get help for his elderly mother in West Hartford; and the couple who occupied the guest suite at our assisted living who decided after their five-day stay to move in.”

Not too far away, Duncaster Retirement Community, Bloomfield, CT, was also feeling the effects of Alfred. The community was hit with a foot of snow, and without power for eight days. Fortunately there was lighting in the common areas and halls and heat in the main building thanks to emergency generators.

"We're located in the suburbs of Hartford, and our community sits on 87 acres in a country setting with lots of trees," says Michael O'Brien, president and CEO.

"We had some good-sized trees and ornamental plants damaged, uprooted and knocked down to the ground. And there were power lines all over the streets and nearby properties," says O'Brien.

But once past the front door, little upheaval was felt due to good preparation.  The director of operations mobilized a disaster planning team with representatives from all departments, and the dining staff did not miss a beat in the kitchen.

Alfred changed the heartbeat of Duncaster, transforming it to a vibrant social hub.

“The dining room was standing-room-only for hot breakfasts and stayed packed till past sundown. Residents hung out in the halls talking, playing cards and doing puzzles in the common areas because they had no lights to be able to read and couldn’t watch TV in their apartments. Their children and grandchildren were here because they had no power. And we set up activity areas for staff’s children who were out of school. It was like a big, fancy shelter,” says O’Brien.

Meanwhile, Duncaster's conference room was packed with neighboring long-term care administrators on their laptops and cell phones. The facility had volunteered to serve as a command center, opening this space and facilitating this operation with support from these providers to ensure all the region's aging services communities were safe.

  What lessons can those who experienced this major and unexpected great storm share?

“Have all your emergency and food supplies in place and regularly test your generators. Have a disaster planning process with one point person to ensure [that] the right staff are in the right place, and who is available to troubleshoot,” says O’Brien. “Stay in constant communication with residents. We held meetings and depended on our in-house phone systems and TV systems to get announcements out, and the residents had a buddy check system.”

If you will be giving shelter to frail elders from other communities, set up communication with their managers as soon as possible for a smooth transition.

“In some cases the residents’ meds and the information we needed were sent over in a rush. It was helpful for us on the receiving end when the meds came clearly labeled in sealed envelopes along with medical and contact information. And when necessary send feeding pumps or other needed equipment,” says Comerford.

Authorities learned that there were more frail elderly people in their communities, without support, than they had realized. Hebrew Health Care has begun a dialogue with town officials, hoping it will lead to a better understanding of aging-services needs in emergencies.

Like the other providers, Gauthier emphasizes communication. “How to best ‘talk’ to each other during a prolonged event is simply, frequently and face-to-face,” she says. “Our management team met every morning to answer two questions:  What do you need to get your job done today, and what can you offer to help someone else?

“And while this may sound syrupy, every day as the power outage went on, as staff had nowhere to shower, no place to do laundry and worked long hours, we reminded ourselves, we would get through this for those in our care, their families, and ourselves. And the way we’d do it was to be kind to one another,” says Gauthier.