Wednesday, January 18, 2006

(Great preparedness tips specifically to help those dealing with Alzheimer's or dementia: Safe Return(R)Program, additional emergency pack items to consider, how to respond in emergency to help reduce stress and confusion.)

Disaster Preparedness from the Alzheimer's Association

A disaster situation significantly adds to the stress levels and confusion of someone with Alzheimer's. In people with moderate to severe Alzheimer's, this can lead to risky and distressing behaviors, such as wandering off, agitation, and surprising emotional outbursts. People with Alzheimer's, including those who need nearly round-the-clock care, can easily get separated from the only caregivers who know about their condition.

To help people who are providing care for a loved one with Alzheimer's, the Alzheimer's Association is making available disaster preparedness tips specific to the needs of the individuals and families affected by the disease. These are meant to supplement the basic emergency information available from organizations such as the Red Cross and the National Hurricane Center. The tips were developed with input from caregivers and experts who have lived through multiple hurricanes and other emergencies.

For example, an Alzheimer's-specific "emergency kit" might include:

-- Easy-on flotation devices.
-- Velcro shoes/sneakers.
-- Incontinence products.
-- Pillow, toy or something else to hug.
-- Supplies of medication.
-- Copies of legal documents, such as power of attorney.
-- Copies of medical documents.

Twenty-four hours a day, every day, the Alzheimer's Association's Helpline and website -- 1.800.272.3900; -- provide assistance finding local resources for people with dementia and their caregivers, plus support to manage the stresses of caregiving.

In the earliest stages of the disease, people with Alzheimer's are very
independent. Problems can arise as the disease progresses. Alzheimer's disease symptoms occur on a continuum from unimpaired function to very severe cognitive decline, so each situation needs to be handled on an individual basis.

(Alzheimer's Association fact sheet)

What should a family who is caring for someone with dementia do in case of an emergency or natural disaster?

If you know a pending disaster is about to occur:

-- Get yourself and the person with Alzheimer's to a safe place.
-- Alert others (family, friends, medical personnel) to the fact that you
are changing locations, and give them your contact information. Contact them as regularly as you can as you move.
-- Be sure there are people other than the primary caregiver who have
copies of the person with dementia's medical history, medications, and physician information.
-- Purchase extra medications.

Advance Preparations

As a precaution, register your loved one in the Alzheimer's Association
Safe Return(R) program.

-- Safe Return(R) is an identification and support program that provides assistance for a person with Alzheimer's who wanders off and becomes lost, either locally or far from home.
-- If you are already registered in Safe Return(R), make sure personal
contact information, medicines needed, and doctor information are
updated with the program.
-- You can enroll in Safe Return(R) by phone, online or by mail. Call
toll-free 1.888.572.8566 or visit

Emergency kit

Consider preparing an emergency kit in advance. Keep it in a watertight
container and store it in an easily accessible location. Your emergency kit
might include:

-- Easy-on flotation devices, such as Floaties armbands.
-- Easy on/off clothes (a couple of sets).
-- Velcro shoes/sneakers.
-- Back-up eyeglasses.
-- Incontinence products.
-- Wipes.
-- Lotion (good for soothing the person).
-- Pillow, toy or something else to hug.
-- Favorite items or foods. Liquid meals.
-- Supplies of medication.
-- Extra identification items for the person, such as an ID bracelet and
clothing tags.
-- Copies of legal documents, such as power of attorney.
-- Copies of medical documents that indicate the individual's condition and current medications.
-- Copies of insurance and Social Security cards.
-- Zip-lock bags to hold medications and documents.
-- Physician's name, address and phone numbers (including cell phone).
-- Alzheimer's Association phone number and address. Alzheimer's
Association Safe Return(R) phone number.
-- Recent picture of the person with dementia.

More information on disaster preparedness from the National Hurricane
Center is at

Tips For When You Are Relocated

In an emergency, people with dementia and their caregivers may find
themselves uprooted or displaced to alternative living arrangements. Extra care and attention must be made to ensure the health and safety of the people with dementia. The change of location, plus unfamiliar noises and activities, may cause them increased stress and confusion. And, certain behaviors of persons with Alzheimer's may puzzle or alarm others.

Be calm and supportive

-- Remain flexible, patient and calm -- a person with dementia will
respond to the tone you set.
-- Respond to an emotion being expressed by the person. Ask, "Are you feeling frightened?" Offer your hand or a hug.
-- Offer reassurance, such as "I will take care of you." Or, "Don't
worry. You will have everything you need here."
-- Don't leave the person with Alzheimer's alone. Don't ask a stranger to watch the person. A person who doesn't understand Alzheimer's disease and its effects, and who doesn't know you or the person, won't understand how to react in a difficult situation.

Create a safe environment

-- Try to spend extra time with the person to help him or her adjust to the new environment.
-- As much as is possible, maintain daily routines from before the
disaster. For instance, accommodate familiar eating and bathing times.
-- Maintain regular times for going to bed and arising. Establish a
comfortable, secure sleeping environment.
-- If possible, label important areas -- such as the bathroom and
sleeping area -- to help the person become oriented to the new layout.
-- Use simple statements to indicate the need to stay where you are.
Divert attention to a new topic. For example: "I know you want to go home. For now, we need to stay here. Let's see if we can get some lunch."
-- As appropriate, inform people around you that the person has memory loss or dementia.
-- If you are in someone's home, arrange to make the house safer by
locking up medications, toxic household supplies, sharp objects,
alcohol and matches. Place nightlights throughout the house for
nighttime safety and orientation.
-- Limit news media exposure (TV, radio, computer) to the disaster.

Take care of your loved one

-- Ensure proper nutrition and hydration.
-- Make it a priority to find a doctor and pharmacy to provide for the
person's health needs. Be sure you have up-to-date medical information and a current list of medications.
-- Take time to reminisce, share family photos and stories.
-- Involve the person in daily activities.
-- Get daily exercise and get outside for fresh air and sunshine.

Take care of yourself, too

-- Take care of yourself by finding a good listener to hear your thoughts and feelings about the event or just take a moment to breathe, meditate, reflect. Seek spiritual support.

To learn more about Alzheimer's disease and the Alzheimer's Association,

Contact Center 1.800.272.3900
TDD Access 1.312.335.8882
Web site

(A good example from Dutchess County: Planning preparedness)

Disaster preparedness pays: Plans keep order during emergencies

Dover Supervisor Jill Way was sworn in to her first term in office on Jan. 1, 1996 — the day of one of the largest industrial fires in Dutchess County history.

The fire broke out at a tire recycling company in Wingdale. Five days later, the main fire had been put out. Flareups continued for another four days.

At the height of the blaze, 250 firefighters from 20 departments were on the scene.

"I went there and literally had an education in the field," Way said.

Dover's emergency operations plan led her through the process of coping with a disaster, from how to declare an emergency to how to contact key responders.

"It really is a triage system," she said. "It tells how to network with the other emergency agencies and get the resources you need in a timely fashion."

The value of having a disaster plan in place was brought home again recently by flooding rains in October. Planning for emergencies allowed municipalities to avoid the confusion that played out on a much larger scale on the Gulf Coast after Hurricane Katrina.

An emergency operations plan spells out the procedure a town supervisor must follow after declaring a state of emergency. Typically, contact information for fire and police departments is listed, along with responsibilities for key town personnel.

Once an emergency is declared, the supervisor or a successor has broad powers, including the ability to establish curfews, designate areas off limits for habitation and suspend the sale of firearms and alcohol.

A state of emergency also allows a supervisor to give public assistance to private homeowners, which is not otherwise allowed.

Wappinger Supervisor Joseph Ruggiero said a wind burst leveled trees in parts of town in June.

"It looked like a tornado had hit," he said. "Under normal law, we wouldn't be able to remove private property. Once the state of emergency was declared, we were able to help property owners remove trees."

Near-constant rain during the first week of October saturated ground in Dutchess County that was dry from weeks of no precipitation and filled streams and rivers.

That the ground couldn't absorb any more was proven Friday, Oct. 14, into Saturday, Oct. 15when up to an additional 12 inches of rain fell in parts of eastern Dutchess County.

"That Friday night, I got the call from Stanley (Whitehead, Amenia highway superintendent)," then-Supervisor Bonnie Hundt said. "He said, 'This is really bad.' "

Three town roads were damaged from the torrential rain, one was flooded and a couple of bridges were damaged.

"Stanley suggested we declare an emergency," Hundt said. "So we basically got out the plan and put it in motion."

Hundt said watching the chaos after the Katrina disaster made her feel as if she had made the right decision in updating the town's disaster plan after she took office two years ago.

"The worst thing that can happen is the perception that nobody is in control," she said.

Amenia was one of four Dutchess towns to declare emergencies that weekend. Dover, Washington and Union Vale also were operating under states of emergency. The Village of Fishkill declared an emergency for the Elm Street neighborhood.

Dover was the hardest hit, with 26 roads either washed out or flooded, and five bridges destroyed or damaged.

Union Vale lifted the emergency decree late in the day Oct. 15. Amenia and Washington's declarations expired after five days.
Dover extended the state of emergency another five days.

Towns have authority

State law gives towns the authority to draw up emergency operations plans to deal with natural or man-made disasters.

"Ethically and morally, public safety is a responsibility of the elected officials," said DeWitt Sagendorph, coordinator of Dutchess County's Department of Emergency Response. "Disasters start and end at the local level. The local governments need to respond to that."

Amenia's emergency preparedness plan was last updated about six years ago. The plan had not been updated since before the Sept. 11, 2001, attacks.

Hundt's assistant, Lana Anguin-Cohen, was appointed to lead the committee charged with updating the plan. She also serves as the emergency coordinator when the operations center is activated during a disaster.

Since there was already a plan in place, the committee wasn't in a hurry and could bring in experts to talk about security issues and disaster response.

Anguin-Cohen reached out to town businesses and organizations.
"Everyone had a chance for input," she said.

The results of nine months spent honing the emergency plan were put to the test in October.

Hundt called Anguin-Cohen Oct. 14 after talking with the highway superintendent. The emergency declaration was filled out and faxed to the proper authorities, including the county clerk and New York's secretary of state. The disaster isn't official unless these parties have been notified within 72 hours of a declaration.

States of emergency are declared for five days, and can be extended. They can be lifted at any time.

The next morning, Amenia's town hall was designated the emergency operations center, with the Wassaic firehouse as the secondary command center.

A quick meeting with the fire chiefs, a representative from the county emergency response department and other town officials helped establish priorities in dealing with the flood.

"We knew what we needed to do," Anguin-Cohen said.

Amenia's new supervisor, Janet Reagon, has reviewed the town's emergency guidelines and wants to have a meeting to review the
disaster response to see if the plan needs to be modified.

She also wants to do table drills where officials and first responders react to a mock disaster.

"It's very good to brainstorm a possible scenario, so you can see who does what and who goes where," Reagon said.

After the latest crisis, Way said the 10-year-old plan is probably due for a review.

Way, members of the town board and William Kelly, the highway superintendent, have discussed informally what was lacking in response to the October floods.

While cell phones were usable for the most part during the flood emergency, Way said the town should explore options.

"In a mountainous area, you have to have a secondary way of communicating," she said.

Fran Rimany's Dover Plains house wasn't damaged by the October floods, but she lost 18 feet of property along the Tenmile River from the rampaging waters. The response from the town during the crisis and afterward was helpful to her.

"This was a terrible situation," she said. "People from the town came by to see how we were doing."

Firefighters praised

Rimany can’t say enough about the members of the J.H. Ketcham Hose Co. They had been there the previous weekend pumping water in addition to Oct. 15-16. "They were fabulous," she said.

From the county’s point of view, the towns performed well under trying circumstances, Sagendorph said.

"There was a lot of water," he said. "They moved people and were able to take immediate action for public safety."

His office is always available to assist municipalities in planning for disasters, Sagendorph said. Plans can be reviewed to ensure compatibility with county and state guidelines, he said.

"We also offer model plans as a guidance tool to help towns modernize their plans and keep them up to date," Sagendorph said.

He said it is important for any town to have meetings with all the key players who might be needed during a crisis once a plan is in place or has been updated.

"You don’t want to be in the middle of whatever and say, ‘Who is that guy?’ " he said.

"Sometimes the planning process is more valuable than the actual document itself," Sagendorph said. "It brings those people together who will actually be involved."

Poughkeepsie Journal

Michael Woyton
January 16. 2006

Saturday, January 14, 2006

This blog was created to discuss emergency preparedness, survival kits, events, and the 1906 San Francisco earthquake centennial. Relevant articles, photos, and tips will be posted.