Why hurricane preparation and recovery is especially difficult for many senior citizens

— -- Hurricanes Harvey and Irma have shown the tremendous risks at the hands of dangerous storms. For the elderly who live in hurricane zones, severe storms pose even more of a threat since many have disabilities and medical conditions for which they need special care.

During, and after, a hurricane strikes caring for seniors requires special attention and planning.

Even independent seniors can suffer disproportionately from natural disasters like hurricanes, especially when basic necessities like food and water are hard to find. For those who have trouble getting around, the risks are amplified and they can often find themselves more vulnerable.

“The frailest of the adults are unlikely to manage the money stressors and the aftereffects of a hurricane,” said Dr. Anne Fabiny, a UCSF School of Medicine professor working at the San Francisco VA center. “Be it using a cane, a walker or being consigned to a bed, the elderly cannot respond to adversities like this without help.”

Here are few of the major challenges the elderly have faced in Harvey, Irma and other major storms –- and ways to help them:

Access to the necessities: Food, water and medications

Access to safe food and water is a challenge during natural disasters. Seniors run an increased risk of dehydration because they may not feel thirsty, a lack of sensation that becomes more problematic as people grow older.

Those caring for elderly loved ones should make sure they have access to potable water and that they are actually drinking it. Also, because the elderly tend to take more medications, it is vitally important that they have access to all essential medications, whether at home or in a shelter.

Getting to a safe place, even when moving around is a challenge

Many elderly require a wheelchair, a walker or some other kind of assistive device to get around. They may also need hearing and visual aids. So provisions should be in place for transportation of the elderly along with their assistive devices during a storm. For the elderly living in assisted living and nursing homes, the facilities should have an emergency plan to transport the elderly, if necessary, to a safe shelter with all their medications and assistive devices.

Power outages can cause an even more dire situation for some seniors. Many pieces of specialized medical equipment used disproportionately by the elderly rely on electricity. One example: a 2005 study showed that about half of Americans needing dialysis were aged 65 years or older. A blackout is far more than just an inconvenience for these patients –- it could create a life-threatening situation.

Psychological effects: Dealing with the devastation

While many of the dangers posed to seniors by natural disasters are limited by the duration of the event, the psychological effects can often last long after the physical threat has passed for seniors.

“There is a high risk of delirium and confusion in the elderly,” Fabiny said. “This could be brought on by a number of factors, including missed medications and dehydration.”

The signs of delirium, which call for immediate medical attention, are easily confused with dementia. Caregivers, family members and medical professionals at the shelters should watch for abrupt changes in their mental status and seek medical care immediately if present.

The loss of a home can have a special impact on seniors, as well, as it come with a fear of institutionalization. Seniors may need reassurance that serious damage to their homes does not mean they will be sent to facilities.

“The best way to combat the fear is to be clear regarding the resources available and the next steps in place to help them cope better,” Fabiny said, adding that community support is also important in helping the elderly through the grieving process while recovering from the storm and getting back to normal life.

Local resources and agencies that can help

For seniors with special needs, some additional resources exist. Before a storm, there are evacuation assistance programs and special needs shelters for the elderly, some which provide transportation.

After a disaster, seniors can reach out to local aging service providers for assistance with food stamps, FEMA services and housing. In Florida, the Department of Elder Affairs works in conjunction with local area agencies on aging to ensure all their clients are safe and all their needs are met. Many retirement communities also have arrangements for special food and water distribution centers that help these people avoid long lines, as well as emergency workers who deliver supplies to homebound elders.

For family members attempting to get in touch with elderly relatives in Florida, the Area Agencies on Aging (AAA) can help track them down and confirm that they are safe.

Lastly, many older adults are reluctant to ask for help for the fear of exposing their disabilities and vulnerabilities. It never hurts to reach out and offer assistance to seniors, even if they don't indicate need.

Monisha Shah, M.D., is a pediatric medicine resident at The University of Texas Health Science Center at Houston.