title: Trial of a survey instrument to establish the hurricane preparedness of and medical impact on a vulnerable, older population.
abstract: BACKGROUND
  Millions of vulnerable, elderly individuals live in coastal areas susceptible to hurricanes and are at risk for adverse health outcomes. The purpose of this study was to determine the status of preparedness for and possible health consequences of a hurricane on a vulnerable, but experienced, elderly population.
  
  
  OBJECTIVE
  Preparedness guidelines have been published, but it is unclear how well-prepared elderly individuals are for hurricanes, and what impact hurricanes may have on their health.
  
  
  METHODS
  Five hundred forty-seven ambulatory patients who attended an urban teaching hospital's geriatrics clinic in Florida were surveyed. A 25-question survey that asked whether subjects followed the American Red Cross guidelines for hurricane preparation was developed. The participants were asked what hurricane supplies they had, and whether they would need to evacuate or utilize storm-proof window shutters. They also were queried about definitions and their understanding of hurricane warnings. Three possible health impacts during the two weeks following Hurricane Wilma in 2005 were asked: (1) falls; (2) missed medication; and (3) missed doctor's appointments. An additional 105 patients in the same clinic were asked about the same three health outcomes one and one-half years after the hurricane struck.
  
  
  RESULTS
  Two-thirds of respondents were missing at least one supply item. A multivariate analysis indicated that there was no relationship between the subjects' demographic characteristics and the possession of the suggested disaster supplies. Although 36% would need to evacuate, only 56% of these 36% had a plan. Only 63% had storm-proof windows or shutters, and of these, only 46% could install them. Gasoline-powered electrical generators can be useful, but also a source of morbidity or mortality following a hurricane. For example, this study found that 28% of respondents had generators, but only 46% knew how to use them. Subjects immediately after the hurricane missed fewer doses of medication than at other times (3.4% vs. 6.7%; p < 0.0001) and fell slightly less often (8.8% vs. 12.9%; p < 0.0001). However, there were significantly more missed doctors appointments after the hurricane (11.6% vs. 0.1%, p < 0.0001).
  
  
  CONCLUSIONS
  The survey indicated that even a well-experienced population lacks adequate hurricane preparation. Most still are vulnerable in at least one aspect of preparation. The elderly may be more likely to miss medical appointments immediately following a hurricane. Interventions to improve hurricane preparedness should be piloted.
authors.affiliation: Division of Geriatrics and Gerontology, University of Miami Miller School of Medicine, Miami, FL, USA. evan.cherniack@va.gov
authors.forename: E Paul
authors.initials: EP
authors.lastname: Cherniack
authors.forename: Lauran
authors.initials: L
authors.lastname: Sandals
authors.forename: Linda
authors.initials: L
authors.lastname: Brooks
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mintzer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004189:Disaster Planning; D004190:Disasters; D005260:Female; D005431:Florida; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D011795:Surveys and Questionnaires; D035862:Vulnerable Populations