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Emergency: Is evacuation the best choice?

August 2, 2017
by Pamela Tabar, Editor-in-Chief
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Emergencies and disasters involving senior residents are always frightening and dangerous. But in situations where sheltering in place is a valid option, not evacuating may be the safer choice, new research suggests.

A new literature review published in JAMDA, the Journal of Post-Acute and Long-Term Care Medicine examined 10 different studies published between 2010 and 2015 that discussed nursing home disasters and resident deaths following an emergency evacuation. About half the studies were from the United States. Researchers noted how each study dealt with disaster preparedness, response, recovery and mitigation.

Averaged across the studies, the risk of death increased by about 10 percent within the first 30 days after the evacuation, from 0.03 percent to 10.5 percent. But researchers noted the risk of death continued long after the emergency: mortality rates were a whopping 15 percent higher up to three months after the emergency and were still about 2 percent higher even six months later.

Residents considered most vulnerable are those over age 80, those who are frail or dependent and male residents with multiple comorbidities, according to the reviewed studies.

The findings may encourage nursing home administrators to enhance preparedness and safety measures for emergency evacuations and step up their policies and preparedness for sheltering in place instead of leaving the premises. In some cases, more preplanning and better supply strategies would allow residents to stay put safely rather than being transferred to another location.

“There is little research on the effects of evacuation on nursing home residents, which is surprising considering the elevated risk of mortality postevacuation,” the review authors write. “Evacuation seems to have a negative effect on the survival of nursing home residents independent of the effect of the disaster. Standard evacuation procedures may be less applicable to this vulnerable population because of extra challenges they face in disasters.”

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