What a deadly fire is really like for the most vulnerable

As smoke blankets my white clapboard home in Palo Alto, California, thoughts of disaster are hard to ignore.

The Camp Fire in Butte County and Woolsey Fire outside Los Angeles have consumed more acres in California than the size of Chicago and Boston combined. Weeks into the disaster, it’s clear who was the hardest hit: the elderly.

{mosads}Going about my daily work of meeting with families caring for aging loved ones. I get on my bike, sporting an N-95 mask, imagining the car next to me bursting into flame, lungs burning as I surge past. For the elderly, especially those with dementia or Alzheimer’s, the anxiety is much more acute. 

Many elderly and disabled residents were unable to evacuate on their own and make up the majority on the list of those missing. They’re one of the most vulnerable groups during a disaster, and as extreme weather events and disasters seem to hit at a quickening pace, it’s critical for seniors and those caring for an older loved one to have a plan in place.  

Elderly deaths have been disproportionately represented in natural disasters around the world, according to a United Nations report. In the United States, most of the 1,330 people who died in Hurricane Katrina in 2005 were older people. About half of those who died in the wake of 2012’s Hurricane Sandy were 65 and older.

Older people are especially vulnerable for a number of reasons: They may have health conditions or impairments increasing the risk for injury and are more sensitive to environmental pollutants. Many may no longer drive, depending on public transportation. Limited mobility makes it harder to evacuate and may pose a challenge when emergency shelters have physical barriers. 

It is not surprising that most of listed missing in the Camp fire are 65 and older, according to Karen Lincoln, Ph.D., an associate professor of sociology at the University of Southern California.

“The evacuation order came after the fire was already consuming the area,” Lincoln said. “In these circumstances, one has to have the ability to move very quickly. Many older adults have mobility problems, chronic health conditions, rely on assistive devices such as canes and walkers, or just move more slowly.”

Many people who have other challenges associated with being older, Lincoln says, have hearing or vision problems and cognitive impairment which would make it difficult to access, understand, and act on evacuation instructions. In addition, some older adults might be more resistant to leaving a home or community where they’ve resided for decades, especially if their home is all they have or if they’ve survived other tragic events in the past.

Moreover, seniors who live alone at home may not have the social infrastructure to respond in an emergency. Social isolation is a major risk factor for older adult, and social connections are the most important asset especially during crisis, regardless if it’s a neighbor, family member, friend, colleague or caregiver. Working in this space as co-founder of a senior companionship service, a woman told me she was worried about her friend who recently retired to an area near Paradise. She didn’t know any family or friends nearby who could help or be contacted. Other stories have emerged of seniors being alerted to evacuate by their neighbors, saving their lives.

Most nursing homes have a plan for evacuating residents in the event of emergency. One senior living community was able to relocate its residents away from the fire to other facilities, some hundreds of miles away. Nonetheless, families worry about caregiving staff having to make the difficult decision of staying with a loved one or evacuating for their own safety. It’s a conversation families should have with caretakers well in advance of a disaster striking. 

Some local governments and organizations have created emergency plans for seniors. San Francisco has a list of partners to respond to vulnerable populations and has offered emergency training to 10 community members and staff who can assist seniors. Avenidas Village, an aging-in-place community in Palo Alto, called a meeting recently to update its plan to prepare its senior members for disaster. 

Even with trained service providers, Maureen Heath from the City of Los Gatos Senior Commission says, “There is only so much first responders can do in a fast moving fire situation, and it’s hard to identify those seniors to begin with who are living alone in the community.”

{mossecondads}According to a study published Rand Health Quarterly, “The increasing frequency and intensity of weather-related and other disaster events combined with the growing proportions of older adults present a new environment in which public health programs and policies must actively promote the resilience of older adults.”

Beyond agencies and senior institutions, there’s more that all of us can do to help our elder neighbors and fellow citizens, like connecting seniors with others in their community. At moments like these those connections can be a lifeline.

Soon, older people will outnumber children for the first time in U.S. history, and many more of us will need to consider how to maintain and activate important social connections, good for overall health and especially in times of emergency.  

Joy Zhang, an Encore Public Voices Fellow of The OpEd Project, is co-founder of Mon Ami, an online marketplace that provides companionship services for aging seniors in the San Francisco Bay Area.