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Objectives To examine the hospitalization rate and mortality associated with forced mass transfer of nursing home ( NH) residents with the highest levels of functional impairment. Design Retrospective cohort study. Setting One hundred nineteen Texas and Louisiana NHs identified as being at risk for evacuation for Hurricane Gustav. Participants Six thousand four hundred sixty-four long-stay residents residing in at-risk NHs for at least three consecutive months before landfall of Hurricane Gustav. Measurements Using Medicare claims and instrumental variable analysis, the mortality (death at 30 and 90 days) and hospitalization rates (at 30 and 90 days) of the most functionally impaired long-stay residents who were evacuated for Hurricane Gustav were compared with those of the most functionally impaired residents who did not evacuate. Results The effect of evacuation was associated with 8% more hospitalizations by 30 and 90 days for the most functionally impaired residents. Evacuation was not significantly related to mortality. Conclusion The most functionally impaired NH residents experience more hospitalizations but not mortality as a consequence of forced mass transfer. With the inevitability of NH evacuations for many different reasons, harm mitigation strategies focused on the most impaired residents are needed. [ABSTRACT FROM AUTHOR]

The article outlines the immediate medical needs of older people during disaster in New Orleans, Louisiana. It revealed that Hurricane Katrina brought significant damages not only to physical properties but to lives of people as well. Figures show that 70% of fatalities resulting from the storm were people age 60 or older. Such age group is particularly vulnerable to disasters and much of them utilizes healthcare resources. They should be given immediate health concern because they are at very high risk for adverse outcomes including worsening disability, immobility, delirium, dehydration, malnutrition, pressure sores and side effects or withdrawal from medications.

The article discusses the significance of nursing homes and assisted living facilities in ensuring the safety of older adults during disaster in New Orleans, Louisiana. If such facility is not properly managed during times of calamities, it could result to a significant number of deaths. Facts gathered after Hurricane Katrina and Rita show that poor management of evacuation efforts contributed to a significant number of deaths among older adults. Because of such damage, it is suggested that these facilities should consider several factors including transportation and evacuation decision-making.

Emergency planning for vulnerable populations constitutes a major element of community disaster preparedness and is an area in which guidance is particularly sparse. As evidenced by the well-publicized deaths of nursing home residents following Hurricanes Katrina and Rita, the need to improve nursing home emergency preparedness is self-evident. Nevertheless, as efforts to improve preparedness develop, a central controversy remains. Aside from mandatory complete evacuations, is it better to evacuate or not to evacuate frail elderly nursing home residents in the setting of hurricane emergencies? This paper reviews the historical evidence on both sides of the argument and suggests a policy and research agenda.

Objective: Professionals and paraprofessionals working in disaster settings need tools to identify persons with mental health needs. To validate the Sprint-E as a measure of postdisaster distress and treatment need, the authors tested (1) the concurrent validity of the measure compared with other measures of distress, (2) the sensitivity and specificity of a "3/7 rule" on the Sprint-E relative to probable PTSD diagnosis, and (3) the hypothesis that Sprint-E scores would be stable in the absence of treatment but would improve in its presence., Method: In Study 1, data were collected at the point of enrollment from 165 adults participating in a Florida treatment program implemented in response to the 2004 hurricanes. In Study 2, data were collected at points of referral, pretreatment, and intermediate treatment from 128 adults participating in a Baton Rouge Louisiana treatment program implemented in response to the 2005 hurricanes, Katrina and Rita., Results: The utility of a 3/7 rule for the Sprint-E, with 3 suggesting possible and 7 suggesting probable treatment needs, was supported in Study 1. Tested against the PTSD Checklist, the Sprint-E performed well in ROC analyses (area under the curve = 0.87); a score of 7 achieved sensitivity of 78 percent and specificity of 79 percent. In Study 2, Sprint-E scores evidenced little change between referral and pretreatment but substantial change between pretreatment and intermediate treatment., Conclusion: The Sprint-E is useful as an assessment and referral tool in situations where more in-depth assessment is not feasible and mental health services are available.