Many nursing home residents have health challenges-such as physical frailty, greater reliance on supportive care, cognitive impairment, and a lack of mobility-that are exacerbated during disasters. Noting the recent increase in the severity and frequency of natural disasters, the researchers sought to determine the risk associated with mortality in this population within six months of an evacuation.

This systematic review of 10 original research studies previously published in peer-reviewed journals is believed to be the first such analysis of mortality in nursing home residents after disaster evacuation. Demographic characteristics were similar among the studies: most nursing home residents were women, were over 80 years of age, and had multiple comorbidities and cognitive and functional impairment. The investigators found greater mortality rates at one, three, and six months after evacuation, compared with the rates before evacuation and the rates of people who were not evacuated. According to the researchers, it may be that the vulnerabilities of these already frail patients are compounded by the physical stress of evacuation. They concluded that nursing home residents have an elevated risk of mortality that is associated with evacuation during a disaster and that appears to be independent of the effect of the disaster.

Their findings suggest that evacuation may not always be the best strategy to prevent death in nursing home residents, and that the option to evacuate should be chosen only if sheltering-in-place or arranging for family to pick up and evacuate with the resident, for example, are not feasible options.

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