title: To evacuate or not to evacuate: lessons learned from Louisiana nursing home administrators following Hurricanes Katrina and Rita.
abstract: OBJECTIVE
  To evaluate the "lessons learned" by Louisiana Nursing Home (NH) administrative directors (ADs) forced to make decisions relating to resident evacuation before Hurricanes Katrina and Rita and determine how emergency planning has changed in those NHs.
  
  
  METHODS
  Twenty in-depth telephone interviews followed by a focus group conducted in New Orleans.
  
  
  METHODS
  Louisiana NHs in parishes affected by Hurricanes Katrina and Rita.
  
  
  METHODS
  Twenty ADs employed by affected NHs during August and September 2005.
  
  
  METHODS
  Qualitative data sources consisted of transcribed telephone and focus group interviews. Data were analyzed using narrative summary analysis and descriptive data were tabulated using an abstraction tool.
  
  
  RESULTS
  Nine of 20 NHs evacuated before the hurricanes and 11 sheltered in place. Six additional NHs evacuated following the storms. The most common perceived consequences related to the evacuation process were resident morbidity or mortality (6 of 15), transportation issues (5 of 15), and staffing deficiencies (3 of 15). Common findings among the NHs that sheltered in place included supply shortages (8 of 11), facility damage (5 of 11), and staffing issues (4 of 11).
  
  
  CONCLUSIONS
  Respondents noted 4 general themes during the interviews and focus group session: (1) ADs felt abandoned by the state and federal emergency response apparatus during and after the hurricanes, and continue to feel that they are not a priority; (2) there is substantial physical and technical difficulty in evacuating frail NH residents; (3) staff retention remains a critical problem regardless of the evacuation decision; (4) there are key "lessons learned" that can be incorporated into future disaster planning.
authors.affiliation: Department of Medicine and Community Health, Brown University, Providence, RI, USA. ddosa@lifespan.org
authors.forename: David M
authors.initials: DM
authors.lastname: Dosa
authors.forename: Nancy
authors.initials: N
authors.lastname: Grossman
authors.forename: Terrie
authors.initials: T
authors.lastname: Wetle
authors.forename: Vincent
authors.initials: V
authors.lastname: Mor
mesh_terms: D000369:Aged, 80 and over; D003142:Communication; D004189:Disaster Planning / Q000379:methods*; D004190:Disasters; D017144:Focus Groups; D016330:Frail Elderly; D006801:Humans; D007407:Interviews as Topic; D008145:Louisiana; D015337:Multicenter Studies as Topic; D009735:Nursing Homes / Q000458:organization & administration*; D010360:Patient Transfer / Q000458:organization & administration*; D014187:Transportation of Patients