Lost in the shuffle

Bumpy evacuations
Most facilities did evacuate, trying to follow prearranged plans, but it's a complicated undertaking, even in the best of situations.

"Many (residents) are at risk for pressure sores. If they’ve got respiratory problems, you’ve got to transport oxygen. Some medications have to be refrigerated, like insulin. You have hydration issues. That’s just the beginning of it. ... There can be a laundry list of problems for transporting people," says Donald Jambois, administrator of the Rayville Nursing and Rehabilitation Center. The facility has taken in about 60 evacuees, all of whom are in touch with relatives, over the past few months.

In the case of Katrina, with the scale of the evacuation covering such a large geographical area, some nursing home administrators found that the facilities they were evacuating to were full when their residents arrived.

Initially, many elderly clients had to be tracked down, says Christy Frederic, executive director of the Louisiana chapter of the Alzheimer’s Association. In the search for one client, she found he wasn't at the prearranged evacuation site in Alexandria, La.

“The evacuation site was already overwhelmed,” says Frederic, so the group traveled on.

At a second facility they ran into the same problem. Finally, they relocated to a facility near Lafayette, La.

“It took four days before we could locate George,” Frederic says. But finally she was able to report to family members in New York that he had been located, and was “feisty and gregarious.”  (Due to Hurricane Rita, George was evacuated yet again.)

The Louisiana Nursing Home Association posted an urgent bulletin in early September urging hospitals and nursing homes around the country to report any Katrina evacuees who ended up in their care. Now, the association has built a database of about 5,400 people and where they ended up following the hurricane.

That accounts for perhaps one-third of the people evacuated from nursing homes in the storm-stricken area. But it is far from accounting for all the nursing home residents who moved to other facilities, or are now living with family, or are missing.

Support networks torn apart
Elderly people living independently like Olympia have been more difficult to track down.

"One of the things we saw … was senior citizens who were living independently with a robust support network … and that social network was blown apart," says Frederic. "That kind of trauma to someone who’s already frail can set them back, and they may not recover."

Many of these people ended up on buses, in caravans and in shelters, she says. "In some cases they could not represent themselves adequately."

In the weeks after the storm, the Alzheimer's Association scoured shelters and towns where there were large numbers of evacuees, trying to find elderly people who needed to be moved or provided more care, or who had been separated from essential medications. They moved a handful seen as too frail to remain in shelters to nursing homes and sought out "neighbors" to keep an eye on others who remained in temporary housing. They also provided mass training to emergency workers, volunteers and nursing staff on how to recognize and handle evacuees who suffer dementia.

Preparing for the worst
The association has used this crisis to promote their Safe Return program, which registers Alzheimer's sufferers and their emergency contacts in a national database. Those registered in the program wear an ID bracelet or necklace to alert others to their condition.

The program allows people who get confused or disoriented to get home safely in normal times. But its proponents say the registration is just that much more critical in the case of a disaster. "People with dementia are more likely to wander if they are agitated," says Beth Kallmyer, who organized volunteers to help train "instant caregivers" in Mississippi.

The group is also pushing for families to get prepared to help ensure that elderly relatives and friends don't slip through the cracks in a disaster. They recommend keeping an emergency kit in a plastic container that includes extra medications and glasses, copies of identification and legal documents such as power of attorney, medical documents and physician contact information.

As for Olympia, she didn't even bring her ID. Her purse and all its contents remained in her house, which was almost untouched by the storm.

While Ambeau-Scott hasn't given up hope of finding her, the family has delivered DNA samples to authorities still trying to identify the dead. The waiting and wondering have taken a toll.

"We've all been so worried," she says. "We need closure now."

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