Category Archives: Emergency Preparedness

Emergency Preparedness Post-Injury – Cognition and Emotion

This post is the fourth and final entry in a series on the unique challenges encountered when addressing emergency preparedness in the life of a brain injury survivor.  This final post will cover possible issues in this arena that can arise regarding the cognitive and emotional difficulties left in the wake of a traumatic brain injury.  Below is a list of some of those issues.
1.   Brain injury survivors generally become far more susceptible to stress and agitation in their lives post-injury.  It is therefore often helpful to have handy items that can be used to help the survivor maintain calm.  Music that the survivor finds to be particularly relaxing is an example of such a device.
2.   For survivors who have cognitive difficulties such as memory problems, the evacuation process can be very confusing.  They may forget why they are evacuating or where they are going to.  Calmly repeating the evacuation plan and/or having the evacuation plan in writing can help reduce this confusion.
3.  Most people, even without a brain injury, find extensive travel in a car to be stressful.  It is often helpful in reducing that stress to keep to a schedule of planned breaks when evacuating.
4.  If a survivor has issues with impulse control, he or she may be more likely to make hostile comments or rashly suggest an unwise course of action during the evacuation.  At these times, loved ones should calmly remind the survivor of the evacuation plan and that the loved one has the situation under control.  If the loved one reacts with anger at the survivor, this is likely to cause a further escalation of emotions.
5.  As many brain injury survivors have already experienced significant loss due to their injuries, an evacuation and concerns for potential losses resulting from a disaster may trigger memories of those losses previously suffered.  Some survivors may need extra emotional support at this time as memories of old  losses and new concerns for fresh ones coalesce into significant emotional struggles.
6.  All people, especially those with brain injuries that affect cognitive skills, do best when operating under a stable schedule.  Survivors and loved ones should attempt to create a daily schedule to reinsert such stability into the evacuation environment.
7.   The more an evacuation plan is practiced and reviewed, the less stress there will be when it is time for a real evacuation.  Regularly going through evacuation plans will make the process less stressful for a person with a brain injury.
Hopefully, this series of posts helped bring attention to the important issues that brain injury survivors and their loved ones need to consider regarding emergency preparedness post-injury.

Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org

Emergency Preparedness Post-Injury – Medical/Health Issues

This post is the third in a series on the unique challenges encountered by those living in the aftermath of a brain injury when they’re required to address issues related to emergency preparedness.  There are many possible such issues that can arise regarding medical/health concerns.  Below is a list of some of those issues.

1.  When people are forced to evacuate from areas effected by a natural disaster, there is an immediate substantial population increase in those cities evacuated to.  This puts a remarkable strain on any local  medical system, particularly pharmacies.  Let’s look for example at a city which has pharmacies normally prepared to have enough medication on hand for a population of 50,000.  Following an evacuation, the actual population may increase to 70,000.  Pharmacies are not equipped to deal with this increase and medication shortages inevitably occur.  Most government agencies recommend that people bring a one to two weeks’ supply of medication with them when they evacuate.  You may want to err on the side of caution and bring enough for two weeks to one month.  This same rule of thumb should also be used when preparing a stock of disposable medical items such as syringes, incontinence supplies and testing strips.
2.  In general, medications are sensitive to heat.  Keeping them in the trunk of a car or a similar location on a warm day can cause medications to degrade.  Further, many medications such as insulin require refrigeration.  For these medications, consider mobile storage in an icebox with cold packs or in a portable refrigeration device.
3.  Medications should be kept in their original boxes/bottles and be transported in a container capable of being sealed and re-sealed, such as a plastic bag with a zipper.  Do not take medications and dump them all into one container.  This is a nightmare to sort through later and can lead to crucial delays and even errors in medication administered.
4.  Medical devices and equipment should be protected from water or other potential environmental hazards.
5 .  If a medical device or equipment operates on electricity, make sure to bring an emergency power source such as extra batteries or a car adapter power cord.
6.  Keep a list of all important medical information.  This includes information such as health history, medications (with dosages), doctors, allergies and immunizations.  The Center for Disease Control has an excellent example of such a list available for download from their website: www.bt.cdc.gov/disasters/kiwy.asp
Another excellent example can be downloaded from the AARP website: assets.aarp.org/www.aarp.org_/articles/ctg/ARPCOR9008_Individual_Tool_Kit_021909.pdf
7.  Identify in the area that’s been evacuated to the medical and health facilities that would need to be relied upon were an emergency to occur, such as  hospitals and pharmacies.
8.  Following a brain injury many survivors require a special diet, such as a diabetic diet.  When purchasing food for an evacuation, it is important to keep this special diet in mind.  For instance it may be important to check boxed foods, such as crackers, for their sugar and sodium levels.
9.  If a survivor has an item that helps to communicate difficulties suffered, such as a medical bracelet or aphasia card, it is important not to forget such an item.  These items do not help the survivor if they are left at home.
10.  If a survivor has pain issues, it is a good idea to pre-plan breaks in the trip as long periods confined to a car tend to exacerbate existing pain issues.
Hopefully this post helped to raise awareness regarding medical/health issues that a brain injury survivor needs to consider in the context of emergency preparedness.  The next post will cover cognitive and stress issues as they relate to emergency preparedness in such a scenario.

Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org

Emergency Preparedness Post-Injury – Shelter/Housing Issues

This post is the second in a series on the unique challenges encountered when addressing emergency preparedness following a brain injury.  There are many possible issues following a brain injury that can arise regarding shelter/housing.  Below is a list of some of those issues.
1.  People commonly evacuate to the home of a family member or loved one during a hurricane.  After a brain injury, the survivor and his or her family need to discuss whether any home previously chosen as a destination is handicapped accessible.  For instance, if the survivor is in a wheelchair and the only way to enter a home is via a stairway, the home will now clearly be far less accessible to the survivor.  Further, if the survivor now has need for a large amount of equipment, the survivor and his or her family need to assess whether there is enough room in the home to accommodate all such equipment.
2.  Usually hotels offer better handicapped accessibility than private homes as they must follow federal accessibility law.  Many times hotels have a limited number of rooms available that are equipped to meet the specific needs of people with disabilities.  It is often helpful to inform hotels in advance that a person planning a stay has a disability.  This helps everyone involved with preparations in order to ensure the smoothest transition possible.  Keep in mind that it still applies in this scenario that it is illegal for a person to be denied housing based on a disability.
3.  When making plans for emergency housing, it is important to also take into consideration the outside of a home/hotel.  As an example, a house may be sufficiently accessible on the inside but may have an uneven, gravel driveway on which the survivor cannot walk without risking a fall.
4.  If the survivor with a brain injury becomes easily agitated by noise or suffers from similar problems, it may be best to get a hotel room as far away as possible from any restaurants, ice machines, lobbies or elevators.  Similarly, it may therefore be best to evacuate to a private home that has few if any children or pets.
5.  Keep in mind that it is illegal for facilities such as hotels to bar service animals.
Hopefully this post helped to raise awareness regarding shelter/housing issues that a brain injury survivor needs to consider in the context of emergency preparedness.  The next post will cover medical and health issues as they relate to emergency preparedness in such a scenario.

Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org

Emergency Preparedness Post-Injury – Transportation Issues

With each June 1st comes that year’s hurricane season and a fresh reminder of the need to plan for potential emergencies.  People often do not realize the full extent to which many important new challenges need to be taken into consideration following a brain injury, particularly new challenges that present themselves in relation to emergency evacuations.  This series of posts is intended to educate regarding some useful and effective ways to approach those new challenges encountered when planning for an emergency evacuation with a brain injury survivor.

There are many possible issues following a brain injury that can arise regarding transportation preparedness.  Below is a list of some of those issues.

1.  Is the brain injury survivor able to drive independently to safety?  If the survivor has not been cleared to drive, it is vital to identify a responsible party capable of transporting the survivor to safety.  Can a friend or relative drive the survivor or does the survivor need to be evacuated through a municipal program?  If a municipal program must be used, is the survivor registered for this program?

Many states provide emergency evacuation services for the disabled and elderly.  It is recommended that all persons with disabilities be registered with their local 211 system or other like emergency evacuation system, even if they already have an emergency plan in place.  Registering with an emergency evacuation system does not require that one use the services it offers, but it does provide a safety net in case an emergency plan does not work.   Also, the 211 services are free so there can be no issues encountered related to registration costs.

2.  It is important to come to a determination well in advance as to which vehicle will be best  utilized in an evacuation.  Ask yourself, “Do I have a vehicle that is able to transport all the people who would be evacuating while still possessing the room necessary to accommodate all necessary equipment (wheelchair, etc.)?”

3.    If the brain injury survivor has a physical difficulty which affects the ability to transfer in or out of a vehicle, it is important that other people in the vehicle are educated on the necessary transfer process and capable of assisting.

4.   Pre-plan and locate rest stops that are handicapped accessible.  If the brain injury survivor is incontinent, it is important to find rest stops that have enough room to allow for changing a diaper and cleaning up.  Often rest stops simply put a grab bar in a regular-sized stall in order to comply with accessibility laws, but unfortunately such restrooms remain from any practical or real perspective inaccessible.

5.   For those that take medication or make frequent use of assistive equipment, make sure that any such medication or equipment is stored in an easily accessible location in the vehicle and not packed underneath many other items.  It is important that medication not be stored in an area of the vehicle prone to excessive heat in order to avoid the medication potentially losing potency.

6.  The cardinal rule on evacuation is that the earlier one leaves, the less potential there is for problems with transportation to occur.

Hopefully this post helped to raise awareness regarding transportation issues that a brain injury survivor needs to consider in the context of emergency preparedness.  The next post will cover shelter/housing issues as they relate to emergency preparedness in such a scenario.

Learn about brain injury treatment services at the Transitional Learning Center: tlcrehab.org