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The Evacuation of Older People: The Case of Hurricane Katrina
Published on: Mar 15, 2007

The evacuation of older people from New Orleans

How then was the evacuation of older people from New Orleans managed?

To date, there is little systematic information. Most of what I have obtained through the internet originates in eye-witness accounts produced, or collected, by journalists. As always of course newspapers have an eye for the 'good story' and age often features in these. Older people tend to be portrayed as victims rather than heroes.

These are the four settings from which older people had to be evacuated: from their own homes, from nursing homes, from hospitals and from other institutions.

I have limited evidence about evacuation from other institutions. The prime example, one that has recently been featured on British television, is the prison: the New Orleans Parish Prison. It was also investigated by Human Rights Watch in September last year. There would have been 7,500 to 8,000 inmates in the prison when Katrina struck. As it began to flood, it was abandoned by the guards. There were several reports of dead bodies being seen but, to date, no deaths have been officially reported. One month after Katrina struck, the Department of Corrections spokesperson reported that 517 inmates were still missing. The television film revealed a more phlegmatic and stoical response to the crisis from the older inmates.

Turning to the experience of older people living in their own home, there is little evidence, even anecdotal, of how they responded or of the sequence of decisions they may have faced in seeking refuge. All the internet offers are glimpses of how some people responded and coped.

Many older people will have escaped in advance of the arrival of Katrina. In the preceding week they will have travelled to stay with family in other parts of the USA. Others may have fled, perhaps with their family, over the previous weekend. Even though they were able to leave New Orleans behind, they may have found it a testing experience.

The restaurant critic of the New Orleans daily newspaper, for example, described how a well known restauranteur had set out with his wife, two children and 91-year-old mother-in-law to stay with his sister in Florida. The highway east was closed so they headed to his brother's farm in Alabama. That proved impossible so they landed on fellow restauranteurs in Jackson, Mississippi. There was no power there however, so they moved on to Oxford, Mississippi, joining other evacuees from what was described as ‘New Orleans' professional class’.   

Others had probably resolved to stay in their own home but, when the floodwaters began to rise, they either evacuated 'upwards' perhaps to be rescued from their roof, or they set out from their homes in search of safety:

As a blazing sun and stifling humidity took their toll, 65-year-old Faye Taplin rested alone on the steps of the Christ Cathedral  ... Rising water had finally chased her from her Central City home. She clutched two plastic bags containing bedding, a little food and water and insulin to treat her diabetes. 

There is some evidence that some older people were rescued by people passing by. One report describes how a truck had driven a couple in their 90s from eastern New Orleans and dropped them off outside a convention centre, one of the refuges of last resort. The husband however was already dead and his wife was sitting munching crackers, seemingly unaware of the tragic drama around her.

Other older people sought rescue alongside their neighbours. A newspaper reporter writing on the day Katrina hit New Orleans described how he had heard of a house where a dozen people including 'some elderly people and a pregnant woman' were desperate for help.

There is some limited evidence of how older people were denied places on buses. One man told a reporter that he had tried to get his parents on to a bus. His father was 78 and blind, and his mother 75 and crippled with arthritis

I couldn't get them on because the young people, the healthy people were pushing and fighting to get on the bus. I couldn't put them in that situation. 

This happened repeatedly as buses appeared, filled up, and left. And then, when a bus arrived that was designated for ‘the elderly and disabled’, he and his 62-year-old aunt were not allowed on to accompany his parents.

Many older people were bussed to the Superdome. A geriatrician working there speculated that those who had made it were ‘tough’. She suspected that many of the dead bodies would be “frail elderly who couldn't sit in the sun for 48 hours". The implication of this comment is that some will indeed have spent two days in the open air waiting to be rescued.

She described how many were in a confused state as they stepped off the buses. Some needed help to get to food or to a toilet. Some couldn't hear the loudspeaker announcements. Another evacuee, she said, “shepherded” older people to one area in the Superdome "so they could be together" and so social workers could check their needs.  

In contrast to evidence about how people were evacuated from their own homes, we are learning much about the plight of people who were in institutions when Katrina arrived. Legal action is being taken and, in that context, detailed if conflicting accounts are being reported.

Evacuation of nursing homes

The following are the key points about the evacuation of nursing homes in New Orleans.

  • Under-resourced homes
  • Unclear responsibilities   
  • Inadequate plans
  • Insufficient transport 
  • Unprepared refuges
  • Unexpected crises when forced to relocate

For several years the nursing home industry in Louisiana has been under attack. Recently, for example, the state was sued by nursing-home residents and potential residents who said they could live in their own homes with help. They claimed the state, by not providing community-based services, was unconstitutionally forcing them into nursing homes. This should be borne in mind in reflecting upon how these homes were evacuated.

Of all the 51 states in the USA, Louisiana has the highest rate of beds per 1,000 persons aged 85 or more – 550 per 1,000 – and a lower than average occupancy rate. Some homes in New Orleans were only half full. Indicators of inequality place Louisiana high in the rankings and so there will be nursing homes serving wealthy people that are well-resourced and well able to cope with crises. Several, for example, hired helicopters to evacuate their residents. Others however will have targeted the less wealthy market and it is likely that some of these homes will have been under-resourced and ill-prepared to deal with unexpected floods.

Although all nursing homes in Louisiana were required to have evacuation plans, it was unclear how these were supposed to relate to mandatory evacuation orders such as that issued by the Mayor. This touched on the delicate questions of timing, costs and responsibilities. Had the Mayor insisted on all nursing homes being evacuated then the costs to the authority could have been immense.

Out of 60 nursing homes in New Orleans, 21 had evacuated their residents in advance of Katrina. In fact, the first hurricane-related deaths occurred the day before Katrina struck when three residents died whilst being evacuated to Baton Rouge.

In contrast, over half the nursing homes in New Orleans decided against early evacuation. It was widely felt that many residents would not survive evacuation, and so no preparations were made. One, for example, unlike many others, had a back-up generator on its roof and plans for emergency power if needed. After two days however, it was clear that "things weren't going to get better soon", and it was decided to evacuate. In a similar way, all but three homes were 'forced to relocate' in the early aftermath of the storm.

A critical aspect of evacuation plans is transport and refuge. Too many homes, it was said, were contracted with the same bus companies. Homes had to wait, and then, when residents were bussed out, it was often to locations that were no better, if not worse, and, as with the Superdome, secondary evacuation became necessary.

One account, for example, describes how a party of people "in their 70s, 80s and 90s" had been found in a "school turned cesspool". They had been taken there and abandoned. They had medicines and oxygen and this suggests they had been bussed there from a nursing home. According to those who found them, most were unable to move without help. They were there for two nights before being rescued. This evidence suggests that buses being used to empty nursing homes rather than to provide a safe evacuation.

Allegedly, some residents were abandoned by owners and staff. The plight of residents in St. Rita's home, for example, created an early public outcry. Of 60 residents, 34 were found dead in the home. Neighbours described how they had rescued some of the residents by floating them away on mattresses. A report in the New York Times described how bodies were still in the home a week later; "draped over a wheelchair, wrapped in a shower curtain, lying on a floor in several inches of muck". The owner of St. Rita's has since been charged with negligent homicide.  He claimed that "most of the families had decided to keep their relatives there". One wonders at what point these decisions were taken and conveyed to the owner.

What this suggests is that most nursing homes had wholly inadequate plans for evacuation. One comment was that their state-mandated plans "fell spectacularly apart".