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Disasters spotlight safety needs of elderly

Better planning, new regulations among proposals

NEW YORK -- In a season of national calamities, the elderly have taken perhaps the hardest hit -- dying by the dozens in flooded Louisiana nursing homes, aboard a bus on fire near Dallas, and in the chilly waters of a New York lake after a tour boat capsized.

Different factors lay behind each event, yet together they are provoking debate on what more should be done to maximize the safety of older people. Though many are healthy and independent, others need special attention and care to get through an emergency.

Nursing homes are one obvious target for scrutiny and tighter regulation. Failure to carry out evacuation plans contributed to 56 deaths at two Louisiana nursing homes in the aftermath of Hurricane Katrina, and the industry nationwide faces pressure to curb the number of fatal fires and other safety problems.

Katrina also took a heavy, though yet uncounted, toll on seniors who lived on their own; some drowned and others were stranded for days. Dr. Robert Butler, a specialist on aging, said the hurricane should prompt authorities to be more aware of where frail and elderly people live, and proactively develop plans to help them in the event of a natural disaster or terrorist attack.

''In some sense, these tragedies reflect the invisibility of older people," said Butler, president of the International Longevity Center. ''No one is thinking about them ahead of time."

In addition to better disaster planning and closer oversight of nursing homes, other possible safety measures might be problematic in an era when older people increasingly want unfettered access to leisure, travel, and adventure. Former President George H. W. Bush celebrated his 80th birthday with a parachute jump; climbers vie to become the oldest to conquer famous peaks.

Though some of the 20 elderly tourists who died in Lake George were frail and a few used walkers, none wore life vests. Yet there is unlikely to be any clamor to impose a life vest requirement specifically on senior citizens -- a distance runner in his 70s might balk at being forced into precautions not required for an overweight, unfit 40-year-old.

''A lot of times, people who are frail or elderly don't wanted to be treated differently," said John Rother, director of policy and strategy for AARP. ''I'm not quick to jump on the bandwagon of requiring extra precautions. Accidents happen."

Many states impose special license renewal procedures for older motorists, such as more frequent vision tests. But no other transportation safety laws distinguish between senior citizens and other adults, said Melissa Savage of the National Council of State Legislatures.

''That age group is a very powerful lobby," she said. ''It doesn't happen too often that a state will get something passed that singles people out based on age."

To Butler, 78, the systematic safety flaws at many nursing homes -- inept evacuation plans, ill-trained staff, lack of fire sprinklers -- reflect a broader problem.

''We put little value on old people," he said. ''We need a better understanding of their particular vulnerabilities."

Rother said AARP, which represents millions of Americans older than 50, is conferring with nursing home executives about lessons to be learned from Katrina. He said one step could be for a region's nursing homes to collaborate more closely, for example ensuring that their contracts with bus companies to handle an evacuation don't overlap in a way that would produce a bus shortage.

The bus that burned in Texas was pressed into service to evacuate residents of a Houston-area nursing home from Hurricane Rita's path; 23 evacuees died. The bus went out of service in July after its registration expired, but was allowed back on the road through a waiver signed by Governor Rick Perry to aid relief efforts.

In Louisiana, by contrast, the death toll was heavy at two nursing homes that were not evacuated and then were flooded by Katrina. Owners of one home have been charged with negligent homicide while the other home is under investigation.

''There is clearly a need for special-needs shelters, places appropriate for a very vulnerable population," Rother said. ''These were not available in the Gulf."

Florida, in response to recent hurricanes, has begun establishing such centers, he said.

Likewise, Chicago authorities responded to the 1995 heat wave that killed more than 700 people, most of them elderly. Now, air-conditioned city buildings can be converted into cooling centers, and city workers start calling and visiting the frail and elderly.

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