New Study Raises Concerns About Evacuating Assisted Living Facilities During Hurricanes

Researchers found an increased risk of emergency department and nursing home visits among AL evacuees within 30 days of Hurricane Irma’s landfall, possibly caused by the stress and disruption stemming from evacuation. Dosa and his team urge authorities to carefully weigh the potential harms and benefits of evacuating versus sheltering-in-place when planning emergency response. 

“Removing assisted living residents from their familiar environments, especially those with conditions like dementia or mobility limitations, can be incredibly stressful and disruptive,” said Dosa. “Our findings suggest that stress from evacuation may outweigh some of the intended safety benefits.”

At 90 days post-storm, researchers found no significant connection between evacuation and poor health outcomes for AL residents, which differs from the outcomes of nursing home residents. The difference may be due to AL residents being more capable of stabilizing after the storm or being less vulnerable to its long-term effects, the researchers note in their report, as AL residents generally have a lower prevalence of dementia and functional impairment compared to nursing home residents. 

Sheltering-in-place allows residents of AL communities to maintain continuity of care in familiar surroundings. But it also carries risks. Twelve residents of the Rehabilitation Center at Hollywood Hills died from heat exposure due to prolonged power outages when administrators opted not to evacuate during Hurricane Irma. Researchers therefore stress that the needs of residents, the structural integrity of facilities and the potency of hurricanes should be factored into decisions to evacuate.

AL communities, which house over 800,000 older adults nationwide, are less regulated than nursing homes in terms of emergency preparedness, which can lead to inconsistencies in how well these facilities manage during disasters. AL communities are similar to nursing homes, however, in that they have struggled with maintaining adequate staffing and keeping in touch with residents’ families during storm-related emergencies.

“Evacuation isn’t a one-size-fits-all solution; each scenario needs a tailored response,” said Sweta Patel BDS, MPH, contributing author and biostatistician in the Center for Gerontology and Healthcare Research. “Assisted living staff and emergency managers need to carefully evaluate factors like flood risk, backup power, and building integrity when making these critical decisions that impact so many lives.”