-Barbara Dunn, MSN

Editor's note: This is the first in a three part series telling you how to begin devising an emergency evacuation plan for the elderly.

Hurricane Katrina dramatically illustrated the importance of planning the safe evacuation of older adults. Unfortunately, both communities and families often overlook evacuation planning for older adults. This series of articles aims to raise the awareness of family members about the need to have an evacuation plan in place and to identify a few key measures to increase the older adult's safety and comfort should an evacuation be necessary.

This is a big topic. I'll show you how to get started. In this issue of Elder Law Update we'll discuss a few preliminary considerations. In the next two issues I'll review important and very specific areas to address with your older loved one.

First, draft an evacuation plan with your older adult loved one, making sure his or her wishes are included in the plan. Make sure the loved one has a copy of the plan and schedule time to review it periodically. Many older adults say they won't evacuate. Don't be deterred;forge on with planning.

Increasing your loved one's comfort and safety during an evacuation begins with a written evacuation plan, that reflects the older adult's unique evacuation needs. The four critical areas to address are mobility needs, communication needs, medication needs, and, yes, pet needs.

Evacuations tend to be "equal opportunity events" leaving all of us subject to whatever comes our way-especially without prior planning. "My parents will never go to a shelter" or "my aunt will not evacuate on public transportation" are not wise positions to take. A life could be in jeopardy. Emergencies by their very nature come unannounced and are chaotic. Many will be forced to rely on public transportation and shelter.

Further, older adults often have no family members nearby, leaving others to plan for their well-being during an evacuation. Remember, if you don't plan for the older adult in your life, someone else may and you may not be happy with the outcome. Last, even if you live near your loved one, don't assume you will be able to reach him or her. Be prepared for everything and anything.

In the next issue of Elder Law Update I'll show you how to plan for mobility needs, communications needs, and medications. If it looks like Coastal Georgia or the Carolinas may be visited by a hurricane before the next issue, we'll complete this article in a special alert.

Barbara Dunn, MSN, is owner of Elder Care of Coastal Georgia, as well as Chair of the Disaster Services Committee of the Savannah Chapter of the American Red Cross. You may email comments and questions to Barbara by clicking HERE.

 

Throw Mama from a train, if you must, but don't throw her in the front seat of a Buick.  I often am asked by families how to assess whether an elderly parent or grandparent should be driving or asked to do the difficult task of taking away his or her driving privileges.  It is never an easy job, but it is one of immense importance.

The ability to drive is one of the most tightly held freedoms we in America, especially rural America, hold.  It can be the difference between being able to continue to live independently or having to go into senior housing or to depend totally on friends and neighbors.  Giving it up can result in a total change of life circumstances.

But driving it not a right, it is a privilege - a privilege available only to those physically and mentally capable of the task.  Here are some of the parameters that must be met in order to maintain that privilege.  If you have an elderly relative teetering "on the brink," read on carefully.

• Vision must be adequate to see road signs and obstacles.  This can be an issue during the day, but even an elderly person who sees adequately during the day can have more difficulty at dusk, in inclement weather, or at night.

• Hearing must be adequate to pick up the sounds of trains or emergency vehicles that can be heard before they are seen.

• Physical strength and agility must be adequate to perform emergency road maneuvers quickly.  The reflexes of many elderly can be slowed to the point that this is not feasible.  Severe arthritis or cardiac conditions or debility after a stroke can also affect these skills.

• Mental faculties must be present enough to allow split-second decisions.  I was behind an elderly lady at a road construction site once who, when faced with the workman flagging her to stop, forgot for a moment what that meant and plowed right through several orange barrels, some roadside equipment, and a few construction workers.  Her family admitted in the emergency room that Grandma's memory had been lagging a bit, but they didn't see the harm in her driving 2 miles to the grocery store.  After all, she'd been doing it for 60 years.  Another elderly gentleman of my aquaintance got into his truck to drive half a mile down a straight road to his daughter's house.  The police found him two and a half hours later in a town 70 miles away after he ran a red light and caused a major traffic accident. 

If it is clear to all that Uncle Frank shouldn't be buying a new Mustang, but he refuses to adhere to the doctor's recommendation, the doctor is legally bound to write a letter to the DMV, who will then send Uncle Frank a notice stating he has to have some medical forms filled out in order to keep his license.  If the physician's answers on the forms are concerning, the DMV will revoke or limit driving privileges, as indicated.  If Uncle Frank ignores the letter from the DMV, his driver's license will be revoked automatically. [Editor's note - Dr. Hodges wrote this article for use in North Carolina. In Georgia a physician may, but need not, make a confidential report of a patient's impairments to the Georgia department of Drivers' Services on form DS-274. The department may then require the driver to submit to further testing which could result in revocation.]

Helping your older family members make this difficult transition is not easy, but please remember:  It can be the difference between life and death - and not necessarily theirs.