My 95 year-old mother-in-law, Lillian, was one of the fortunate New York City seniors during Hurricane Sandy. She had her family to help her during the crisis. Not all seniors were so lucky.
Lillian is in the mid stages of Alzheimer’s disease. She is legally blind and practically deaf. With help, she is able to live in a rental apartment on the upper west side of Manhattan subsidized by SCRIE (Senior Citizen Rent Increase Exemption) program. She also qualifies for Community Medicaid and has a home health aide who stays with her every day for 10 hours. However, like many clients who receive Medicaid services, we didn’t know how Hurricane Sandy would impact her care; at least not until the last few hours.
When Sandy hit the city, my husband and I were sitting by the radio, listening closely to reports of the hurricane’s progress. When Mayor Bloomberg announced that the subway would shut down at 7 p.m. that evening and remain closed the following day, we immediately called Lillian’s home care agency. Lillian’s caregiver is scheduled to be with her from 10 a.m. through 8 p.m. every day. We wanted to know how the agency was handling this crisis.
The agency told us the home health aide would leave early that day so she could get home before the subways shut down. We were now responsible for Lillian until public transportation was returned. My next question was, “What if we lived in California and had no backup services for her?” We were told that my mother-in-law would be taken to a local hospital and remain there until after the crisis.
Fortunately, my family was able to hire someone to stay with Lillian through the next two days of this crisis and she was able to remain in her home. Lillian did just fine during the hurricane. Her only complaint was that she was not able to buy candy for her security stuffed animal, Tampa.
Like most families caring for aging parents, we had not thought about what happens to Lillian’s care in case of a disaster. What would have happened if we lived far away or if we could not afford to pay for a private aide? This situation made me start thinking: What happens to frail seniors in case of a crisis?
I spoke with Carla Holub, Co-owner and Vice President of Select Care, a private home care agency based in Manhattan. Ms. Holub is an active member of the Executive Committee of the Home Based Care Alliance (HBCA), a voluntary organization of home care agencies recognized by the New York City Office of Emergency Management (OEM) and NYC Department of Health and Mental Hygiene (DOHMH).
According to Ms. Holub, the New York State Department of Health (NYSDOH) requires that all Certified Home Health Agencies, Long Term Home Health Care Programs, Licensed Home Health Agencies, and Hospices be responsible for the insuring the safety of their clients in case of an emergency. However it does not state how each agency must carry out this requirement. It could mean that a nearby family member, friend, or possibly a hospital or care center must take on the responsibility.
The safety plan for every patient is determined even before a patient is assigned to an agency. The nurse who is assigned to assess each case must evaluate the safety network for each patient and assigns each patient a priority code. The code level indicates the degree of care a client must receive from the agency in case of an emergency. This information is kept in the patient’s chart along with each patient’s medical record.
A Level 1 patient requires twenty-four hour care and an agency must insure that an aide is available for any crisis, along with any relevant supplies. A Level 2 patient is rated as a “moderate priority” which indicates that his/her services may be postponed until the end of the crisis. My mother-in-law is categorized as a Level 3, or a “low priority” patient. That means she can “safely miss a scheduled visit, with basic care provided safely by family or other informal support or by the patient personally.” So we were responsible for her care. Fortunately we were able to rise to the occasion.
If you or your loved one is dependent on daily home care, I advise you to determine what your circumstances are prior to another emergency situation before hiring the agency. Ask each agency you interview to explain their patient coverage policy during a crisis and request a copy of their policy. If you are already receiving service through an agency, you should ask what your loved one’s classification is before another Hurricane Sandy occurs and to specifically explain what type of care the agency must provide in case of emergencies or disasters. If you feel the plan is not acceptable, ask the agency to reassess the case. Hopefully we will not have another situation like Sandy, but at least you can be prepared if it does happen.
How you can assist in your loved one’s emergency preparations.
- Update your contact numbers with the agency on a regular basis. Inform the agency staff if you are going on vacation or out of the area for long periods and who is designated as the contact person. Alternate ways to contact such as email.
- Exchange contact numbers with your loved ones neighbors, doorman, superintendent.
- Traditional telephone landlines work when power is out. Have a simple phone ready to plug in a wall socket. Cordless phones run on electricity
- Make copies of insurance cards, identification, wills, Health Care Proxy, Power of Attorney bank information and keep them with a family member in the event the originals are lost or misplaced. Visit your OEM website for the complete list of documents.
- Have alternate places to stay at if the patient is evacuated and alternate transportation plans if you do not want your parent to stay in a public shelter (a local car service or taxi number).
- Assist the agency in obtaining and monitoring emergency supplies such as extra food, water, batteries, flashlights, medications in the event the patient and caregiver have to stay in the client’s home. (visit the OEM website for a complete list of emergency preparedness items at www.nyc.gov/oem)