A 2006 survey of 20 Louisiana nursing home administrators (reported in the March 2007 issue of the Journal of the American Medical Directors Association) revealed numerous problems in evacuating residents before Hurricane Katrina and a lack of support from local, state, and federal officials.
In a follow-up survey, Blanchard and Dosa compared nursing home emergency preparedness before Hurricane Katrina and before Hurricane Gustav in 2008. Sixteen of the original 20 nursing home administrators participated in the follow-up survey.
According to survey respondents, only nine (45%) of the 16 nursing homes evacuated before Katrina, whereas all 16 evacuated before Gustav. Administrators acknowledged that they felt conflicted about evacuating before Gustav because of the anticipated challenges in providing quality care to patients outside the facility, but they felt pressured by officials to leave.
Although more than two-thirds (67%) of administrators experienced logistical problems having to do with transportation or shelter during evacuation before Katrina, less than half (44%) experienced similar issues before Gustav. However, evacuation before Gustav led to injuries: two hip fractures following falls, one cerebrovascular accident, and one fall requiring hospitalization.
When the administrators who participated in both surveys were asked to rate their level of confidence (on a scale of 1 to 10) in their facility's evacuation preparedness, their mean confidence rating was 8.3 for Gustav and 5.6 for Katrina. Nearly three-quarters indicated an improved collaboration with the State of Louisiana between Katrina and Gustav. And more than half indicated improved evacuation transportation, with the state proactively providing assistance.
While nursing homes and government officials were more prepared for evacuation before Gustav than before Katrina, several administrators noted that evacuation caused physical and emotional trauma to residents. The authors concluded that although public officials have become more prepared since Katrina, a further examination of the benefits of evacuating versus remaining is needed.-SDSJ