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9/10/2015

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Welcome to

“Emergency Preparedness for

Homebound Seniors – Be Prepared, Be

Informed, Be Safe!”

Presenters: William Hallman, Angela Senger-Mersich and Tim Getty

Facilitator: Magda Hageman-Apol

The webinar will begin at 3:30 p.m. Eastern Daylight Time

Emergency Preparedness for Homebound Seniors

William K. Hallman, Professor, Rutgers University, NJ* Rita McWilliams, Research Associate, Rutgers University, NJ

Angela Senger-Mersich, Research Associate, Rutgers University, NJ*

Tim Getty, Nutrition Director, The Heritage Agency on Aging, IA*

Cara Cuite, Assoc. Research Professor, Rutgers University, NJ

Carol Byrd-Bredbenner, Professor, Rutgers University, NJ

Linda Netterville, Vice Pres., Grants Management, Meals on Wheels America, VA

September 10, 2015

*Presenters

Be Prepared, Be Informed, Be Safe!

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Today’s Presentation

• What is emergency preparedness?

• Overview of Rutgers study

• Case studies

• New Jersey Case Study – 2011 Hurricane Irene

• Iowa Case Study – 2008 Cedar Rapids flooding

• Interventions suggested by data

• Q & A

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When we think “Emergency,”

what images come to mind?

Weather

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Flooding

Fire and Wildfire

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Earthquake and Tsunami

Disease

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Terrorism

Emergency Preparedness Is:

The preparation and planning necessary

to effectively handle an emergency

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What Are Your (Agency) Goals in an Emergency?

• Ensure that:

• Staff and volunteers are safe

• Clients are safe, fed, and can sustain themselves until the emergency is over, or until outside help arrives

• Ensure that your agency can continue to serve your clients

These Goals Require…

• Organizational planning and responses • Disaster recovery/business continuity

• Infrastructure (e.g. storage and kitchen)

• Agency evacuation plan

• Pre-emergency planning • Provision of emergency supplies

• Information, instructions & reassurance

• e.g.: what will happen if deliveries are suspended for a time period?

• Post-emergency planning • Calls to clients

• Resumption of delivery

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Recommended Steps for Individuals

• Notify utilities if you use medical equipment for life support • Get/make a kit

• Food, water and supplies for at least 3 days • List of contacts: for alerts, transport, help • Keep kit in designated place • Keep items fresh by changing them every 6 months

• Make a plan • What to do in different situations

• Evacuate to safe place or shelter in place • How to communicate with others

• Stay informed • Learn what protective measures to take

• Before, during, and after an emergency

• Learn contact information needed for emergency alerts/plans • Keep a list of type and model numbers of medical devices

Emergency Plans For the General Population …

• Presuppose certain abilities and capabilities

• Transportation o To prepare

o To evacuate if necessary

o To obtain supplies from central distribution points

• Communication o To receive emergency instructions

o To receive emergency alerts/updates

o Location of emergency shelters

o To obtain supplies from central distribution points

• Presuppose individual has resources (car, cell phone, etc.)

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This Population is Different!

• Older

• Homebound

• Often reluctant to leave home

• High prevalence of illness e.g., arthritis, heart disease, cancer,

respiratory disease, diabetes

• Disabilities o Dexterity

o Vision & hearing

• Mobility issues

• Depend on nutritionally balanced HDMs

The challenge is to help them respond to emergencies.

This Population is Different!

• Very little research literature on home-bound seniors

Research study to: • Examine the food safety of HDM

recipients • Understand the nutritional quality of

the food available • Identify the critical needs of this

vulnerable population, particularly during times of emergency

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Key Question

• How can we best help home-bound seniors to – Be Prepared, Be Informed, Be Safe!

Rutgers/MOWA Study

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Data Collection

• Data collected in more than 700 homes in 5 states.

• Arkansas

• California

• Iowa

• New Jersey

• South Carolina

• From 2011-2013

Data Collection Methods

• Methods included:

• Face-to-face computer facilitated interview;

• Home food safety kitchen audit;

• Catalog of all of the food in the clients’ homes • Collected using a novel UPC scanning technology and computer database

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Participants • Eligibility

• 60 years of age or older

• Live alone

• Not cognitively impaired

• Receive home delivered meals (HDMs) for at least six months

• Consent to an in-home visit

• Characteristics of the 725 participants • 2/3 were female and non-Hispanic White. A little more than half were

older than 80 yrs. (54%), about 6 in 10 were high school educated (58%), and almost half (46%) had a monthly income between $900 to $1,999.

• All participants received a refrigerator thermometer and a $10 Visa card.

Sufficiency & Nutritional Quality of In-Home Food Supply

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Client nutritional needs

• 75% receive only 5 HDMs per week • 7% receive less than 5

• 18% receive more than 5

• Almost all (97%) keep food in their home that was not provided by an HDM agency

In-Home Food Supply

Total Calories

N %

18,999 or less 181 25

19,000-31,499 179 25

31,500-47,999 169 24

48,000 or more 188 26

Total calories in each household ranged from 120 to 168,689 An average of 36,686 ± 24,885 calories per home.

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In-Home Food Supply

About how many days do you think you could go without feeling hungry, eating only food you have in your home right now?

# Days % Cumulative %

0 to 1 9 9

2 to 4 35 44

5 to 7 40 84

8 to 14 12 96

15 to 30 4 100

30+

8 in 10 believe they have food that will last for a week or less

In-Home Food Supply


Actual Number of 2000 kcal

Days of Supply

# Days % Cumulative % % Cumulative %

0 to 1 9 9 2 2

2 to 4 35 44 6 8

5 to 7 40 84 9 17

8 to 14 12 96 29 46

15 to 30 4 100 40 86

30+ 14 100

Participants under-estimated the length of time their in-home food supplies would last.

8 in 10 have food that will last for more than a week

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What Types of Foods Were in the Homes?

Percent of total calories

Take Away

In an emergency where HDM deliveries are interrupted:

• Some HDM clients are at risk of hunger

• On average, the in-home food supply of this population is not nutritionally sound

• Calcium is approximately 25% too low.

• Sodium is 53% higher than recommended.

• Sugar is 103% higher than recommended.

• Depending on the food they have at home is potentially a problem for clients who are diabetic or have high blood pressure

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Emergency Preparedness

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Emergency Kits

References: http://www.redcross.org/images/MEDIA_CustomProductCatalog/m4640086_Disaster_Preparedness_for_Srs-English.revised_7-09.pdf

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Red Cross.org • Water

• Non-perishable food (for 3 days)

• NOAA weather radio

• Flashlight

• Extra batteries

• First aid kit

• Personal hygiene items

• Tape

• Multi-use tool

• Prescription medication

• Rain poncho

• Towels

• Survival blanket

Ready.gov • Water

• Non-perishable food (for 3 days)

• NOAA weather radio

• Flashlight

• Extra batteries

• First aid kit

• Personal sanitation items

• Plastic sheeting and duct tape

• Wrench or pliers

• Prescription medication

• Manual can opener for food

• Whistle to signal for help

• Dust mask

• Cell phone with chargers

• Battery-powered/hand crank radio

• Local maps

• Cash

What Should Go Into the Kit?

Emergency Supplies and Equipment

80 78 77

59

44 44

33

0

10

20

30

40

50

60

70

80

90

100

Flashlight First Aid Kit Manual CanOpener

EmergencyFood

Radio Cellphone EmergencyWater

%

Yes

N = 725

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Additional Factors to Consider in an Emergency

• Evacuation • Lack of transportation

• Evacuation centers may not be ADA* compliant

• Evacuation centers may not be equipped to handle health-related devices

• Shelter-In-Place • Emergency food distribution centers may not be accessible

• Lack of food, water, emergency supplies

• Lack of back-up power for medical devices

• Inability to communicate with support network

*Americans with Disabilities Act

Additional Factors to Consider in an Emergency

• Device Dependency • Wheelchair batteries, oxygen, nebulizer, catheters

• Keep list of type and model numbers of medical devices

• Extra batteries for hearing aids

• Medications • Have adequate supply to get through the emergency

• Provide for medications that require refrigeration

• May affect cognitive processes

• Personal Hygiene Items • Disposable absorbent undergarments

• Pets & Service Animals • Have enough food & water for them

• Many will not evacuate without them

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Barriers & Health Issues Influencing Emergency Preparedness

Barriers Influencing Preparedness

• Difficulty opening containers • Almost two-thirds (62%) have difficulty opening jars and bottles • Almost half (47%) have difficulty using a manual can opener • Almost half (45%) have difficulty opening cans with a pull-tab

• One-third (34%) reported having foods in their home that

they are unable to open without help

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Health Issues Influencing Preparedness

• Movement Restrictions • Three quarters (76%) reported use of an assistive device

(wheelchair, walker, and/or cane) • 17% reported that their assistive device prevents freely accessing the kitchen


• Half (51%) reported vision problems • Often have difficulty reading labels or expiration dates on food

packages • Vision problems that make it difficult to prepare meals

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• Almost a quarter (23%) reported tooth or mouth problems that make it hard to eat

• Dietary Restrictions • One-third (32%) self-reported following a prescribed diet (high-fiber,

low-fat, low-salt, no-sugar-added and/or low-calorie)

• Two thirds (67%) self-reported a high blood pressure diagnosis

• One-third (33%) self-reported a diabetes diagnosis

Mobility Issues are not Usually Considered in Emergency Planning

• Three quarters (76%) do not drive.

• Over half cannot • walk a block (63%),

• climb one flight of stairs (56%),

• lift and carry groceries (72%), or

• shop for groceries (63%)

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Our Data Suggest

• May have great difficulty evacuating

• May face problems staying at home (sheltering-in-place) – Are at risk because they have inadequate emergency food, water, and

supplies

In the event of an emergency, some HDM clients …

Our Data Suggest

• Underestimate the amount of food they have in their homes, but: – May still be at risk of hunger because they cannot open, cook, or eat

food items they have on hand

– Have an illness that can be made worse by eating inappropriate foods

In the event of an emergency, some HDM clients …

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Case Studies

• New Jersey Case Study – Hurricane IRENE

• Iowa Case Study – Cedar Rapids flooding

New Jersey Case Study

Hurricane IRENE

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Hurricane IRENE

Landfall in New Jersey on Sunday, August 28, 2011

Hurricane IRENE – Some Facts…

• Throughout its path, Irene caused widespread destruction

• At least 45 deaths and more than $7.3 billion in damages • Major flooding, downed trees and power lines • Forced road closures, evacuations, and major rescue efforts • Closure of major airports • Suspension of Amtrak train service • NYC mass transit system closed for the first time • 8 million people without power (some for a week or longer)

• Irene’s most damaging impact was from torrential rainfall.

Reference:

http://www.noaa.gov

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HDM Agency in New Jersey

Central New Jersey experienced pervasive flooding and power outages during Irene.

“Boxes of food were floating around; rice bags had expanded; all of the kitchen was under water: 3-4 feet of water! The stove was flooded – completely unusable. A big dumpster was floating in the street. I’ve never seen anything like this.”

Celeste C. (HDM Agency)

The flooding destroyed the agency’s kitchen and food storage area, and caused a shut-down of their operation. HDM agency was unable to deliver meals for 3 days.

Hurricane IRENE

= acute emergency situation

How did the homebound elderly served by the agency prepare for Irene and how did they fare in its aftermath?

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Opportunity for a longitudinal study

• Questionnaire

• level of emergency preparedness

• occurrence of power outages

• food consumption

• feelings

• food safety knowledge (FDA recommendations were provided at end of survey)

• Telephone interviews with seniors

• 5 to 9 weeks post Irene

Methods

Participants

• A subset of the main MOWA/RUTGERS study

• Main data collection completed a month or more prior to Irene.

• 36 New Jersey HDM recipients completed the phone interview

• Characteristics • Similar to those in the main study:

• Around 2/3 were female and non-Hispanic White.

• More than half were older than 80 yrs. (64%),

• 3/4 were high school educated (76%),

• More than half (58%) had a monthly income between $900 to $1,999.

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Key Findings

Client Emergency Preparation

• Almost all (92%) of the participants stayed in their homes (sheltered-in-place) during the hurricane.

• Many seniors did not prepare for Irene.

• Almost two thirds (64%) did not stock up on extra food beforehand.

• Six in 10 (61%) did not stock up on extra water beforehand.

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Agency Emergency Preparation

The New Jersey HDM Agency prepared their clients for Irene:

• Monitored the weather report • Assembled emergency meal kits (materials were on hand)

• Delivered the emergency meal kits on Friday 8/26/2011, two days before Irene hit on Sunday 8/28/2011

Contents of emergency meal (shelf-stable; all single servings): o Powdered cocoa o Powdered milk o Fruit cocktail (either can or plastic cup) o Tuna fish or beef stew or chicken stew o Crackers (1 Ritz crackers; 1 Graham crackers) o Can of carrots o Can of Campbell tomato soup o Melba toast (hard toast) o Bottle of water (12-15 oz)

The HDM Agency met the agency goals!

• Prepared and delivered emergency meals before Irene

• Adapted quickly to the loss of their kitchen: Had a caterer in place within 3 days to ensure their clients are fed

• Seven of the 33 (21%) of the participants who sheltered in place expressed thanks for the HDM agency deliveries

However: There is not always advance warning.

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KUDOS to the NJ HDM agency! They had a caterer going within 3 days.

“I’m very happy with [the HDM agency]. The people delivering are wonderful, and the management is fantastic. They never let you down. They gave out that emergency package with soups and fruits before the storm; and for the holidays they always do something special.”

Client Nutritional Needs

• Only partially met by HDMs

• 85% receive only 5 HDMs per week.

• Dietary Restrictions • 76% self-reported a high blood pressure diagnosis • 64% self-reported following a prescribed diet (e.g., low-salt, no-

sugar-added and/or low-calorie) • 33% self-reported a diabetes diagnosis

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In-Home Food Supply

Total Calories

N %

<18,999 9 28

19,000-31,499 10 31

31,500-47,999 7 22

48,000+ 6 19

Total calories in the households ranged from 5,323 to 99,752; with an average of 34,761 ± 23,458 calories per home.

Estimated In-Home Food Supply


# Days % Cumulative %

0 to 1 2 to 4 36 36

5 to 7 43 79

8 to 14 14 93

15 to 30 7 100

30+

8 in 10 believe they have food that will last for a week or less

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In-Home Food Supply


Actual # 2000 kcal Days of

Supply

# Days % Cumulative % % Cumulative %

0 to 1 2 to 4 36 36 3 3

5 to 7 43 79 9 12

8 to 14 14 93 38 50

15 to 30 7 100 34 84

30+ 16 100

Participants under-estimated the length of time their in-home food supplies would last.

Almost 9 in 10 have food that will last for more than a week

Did Participants Experience Hunger During Irene?

• Almost half of the seniors received food (mostly home-cooked meals) from • family members (34%)

• neighbors (13%)

• 41% said they had enough food and did not need/want food.

• Only two participants said they ran out of food, and one person stated they had to cut back on food so it would last.

“I’m diabetic. I ran out of food. I ate what I wasn’t supposed to eat. My sugar went up.”

“I’m in a wheelchair. I have one leg off and the other half is off. I didn’t have enough food I was supposed to eat.”

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Water

Did you have enough water to drink in your home until the HDM agency could deliver again?

• 31 participants replied YES • 11 of these specifically stated that they always have extra water

• 2 participants did not have enough water • 1 of these was diabetic

Even though 6 in 10 did not stock up on extra water, almost all of them had enough water to drink.

Emergency Supplies

56

46

88

55

34 39

22

0

10

20

30

40

50

60

70

80

90

100

Flashlight First Aid Kit Manual CanOpener

EmergencyFood

Radio Cellphone EmergencyWater

Item

%

Yes

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Emergency Preparedness:

Food Safety Issues

Food Eaten During Irene: Storage Type

During the time interval that HDMs were not delivered

• 92% of participants ate dry food

• 75% ate canned food

• 50% ate produce

• 91% ate refrigerated food

• 72% ate frozen food

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Power Outage

• Power went out for 41% (13) of the participants.

• Of those,

• 50% only lost power for 2 hours or less.

• 25% lost power for 4-12 hours.

• 25% lost power for 12-24 hours.

Of those who lost power, approximately the same percentage ate refrigerated and frozen food.

Food Safety Behavior Post Power Outage

• Very little food was discarded.

• 4 out of 13 seniors who lost power ate food from the refrigerator/freezer after the power outage.

“The milk wasn’t cold, but I drank it … I didn’t get sick. So I guess it was ok.”

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Refrigerator and Freezer Temperatures MAIN Study

IRENE Study

% N %

No Freezer thermometer 96 29 94

No Refrigerator thermometer 94 26 87

Freezer temperature > 0 °F 67 29 94

Refrigerator > 40 °F 20 10 31

1. Refrigerator and freezer are too warm to begin with 2. Add power outage

↓ time stored food is safe to consume

Recommendations in the event of a power outage

Refrigerator

• Keep refrigerator doors closed as much as possible.

• A refrigerator will keep food safely cold for about 4 hours if it remains unopened.

• If the refrigerator is kept at above the recommended temperature, the time it will remain cold will decrease.

References: http://www.fda.gov/forconsumers/consumerupdates/ucm093704.htm http://www.fsis.usda.gov/factsheets/keeping_food_safe_during_an_emergency/index.asp

http://www.fsis.usda.gov/factsheets/keeping_food_safe_during_an_emergency/index.asp





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Est. Refrigerator Temperatures During Power Outage

If you had to guess, how long do you think food can be safely kept in the refrigerator when the power is out and the refrigerator door remains closed?

Participants estimates ranged from 4 to 168 hours (1 week)

• Only 1 (3%) participant was correct

• 11 (33%) did not know

• 1 (3%) said a week

Recommendations in the event of a power outage

Freezer

• Keep freezer doors closed as much as possible.

• A full freezer will keep food safely cold for about 48 hours (28 hours if it is half-full) if it remains unopened.

• If the freezer is kept at above the recommended temperature the time it will remain cold will decrease.

• For every 5°F above 0°F, the recommended storage time is cut in half.

References: http://www.fda.gov/forconsumers/consumerupdates/ucm093704.htm http://www.fsis.usda.gov/factsheets/keeping_food_safe_during_an_emergency/index.asp






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Est. Freezer Temperatures During Power Outage

If you had to guess, how long do you think food can be safely kept in the freezer when the power is out and the refrigerator door remains closed?

Participants estimates ranged from 5 to 168 hours (1 week)

• 11 (36%) participants were correct

• 11 (36%) did not know

• 2 (7%) said a week

Common Misunderstandings About Food Safety

• “If it smells good and tastes good, it’s good.”

• Many do not recognize the symptoms of foodborne illness.

• 2 participants thought food could not be eaten while the power was out, but could be eaten after the power was restored.

Discard any perishable food (such as meat, poultry, fish, eggs or leftovers) that has been above 40° F for two hours or more.

Reference: http://www.fda.gov/Food/ResourcesForYou/Consumers/ucm077023.htm

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Self-Reports of Distress Experienced

• When asked about their feelings during the hurricane and the time period the HDM agency was unable to provide them with food,

• about half of the seniors (52%) reported they were not worried. • Of those, 24% were not worried, because they have enough food.

• 24% experienced worry, anxiety or concern. • Of those, 15% were worried due to immobility and other disability, and

not being able to get in touch with family.

“No, I was not worried. It didn’t bother me.”

“No, I was just concerned that I would miss the variety of the MOW meals.” “I was scared

because I’m alone.”

Conclusions

The HDM Agency did what it was supposed to do!

• Their intervention worked well.

• Feeding their clients was ensured (before and after).

• Almost half of the seniors experienced power outage of <2hrs

• By and large they had enough food.

• The majority had emergency supplies

• Only a quarter expressed anxiety because of the hurricane.

• This was a short-term emergency (three days).

Seniors managed relatively well during this short-term disruption.

• Three seniors did go hungry and two ran out of water.

• Self-reported diabetics reported not having enough appropriate food (i.e., low in sodium, sugar) to eat.

• The majority had out of range refrigeration and freezer temperatures.

• Self-reports revealed misperceptions regarding food safety information when faced with a power outage.

Homebound seniors may not be able to manage this well during a long-term disruption.

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The HDM Agency resumed service in its original location in January 2013 – 1.5 year after Irene!

Iowa Case Study

Applying the Findings: Emergency Preparedness

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Floods of 2008 Eastern Iowa

July 10-14 2008

31.12 foot water level

$64 billion in damage

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Witwer Senior Center

Destroyed

Rural site washed into Cedar River

Both main kitchens heavily damaged

No meals missed

5,000 homes affected

1,200 homes destroyed No water in Cedar

Rapids for 1 week

No power for 3 days

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All seven counties federal disaster areas

10 square miles

affected

0 deaths

Lessons Learned - 2008

• Have a Plan

• Have a Back-up Plan

• Back up the back-up Plan

• Do not assume anything

• Don’t wait, error on side of caution

• Be proactive

• Participate in disaster drills

• Have a physical inventory of equipment stored off site

• Have back up data and emergency information stored off-site

• Take nothing for granted

• Be familiar with insurance coverage

• Be prepared for donations

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Lessons Learned from Rutgers Data

• Refocus on packaging and type of foods offered in home delivered meals – Manufacturers

– Menu cycle development

• Refocus on questions to better serve participants – Ability to use/availability of appliances

– Ability/dexterity to open containers/packages

• The Heritage Agency and local Red Cross Collaboration – 350 kits prepared and distributed

– Funding for food items: Walmart state giving grants

– Funding for emergency supplies: manufacturer in area (sponsorship)

• Contents: – Canvas/drawstring bag

– First aid kit, flashlight, poncho, disaster registration card

– 4 bottles water, food for three meals (canned and dry)

• Planned mass distribution in greater Cedar Rapids area first – THEN……………………………..

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June 30, 2014 Major Flash Flooding

Emergency Preparedness

became Disaster Response

Main kitchen out of

service at least two

full days. Unable to

deliver meals. Kits

delivered by any

means to rural older

adults.

Applying the Findings in Iowa

• Discovery of needs of additional services – Adjustment of meals provided

– Case Management

– Pet Assistance

• Referrals

– DHS

– Information, referral and assistance

• Revision of home delivered meal qualifications

– Transportation/ability to “safely” drive

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Meals on Wheels to see more cuts in Iowa Program also sees 8 percent jump in participants Gazette-KCRG MARCH 29, 2014 | 12:04 AM

Without Meals on Wheels, Roxanne Prandy isn’t sure she how often she and her husband would eat.

Prandy, 57, said she has trouble holding a job lately due to an ankle injury that has required multiple surgeries. Her husband James Prandy, 74, has had three strokes.

“You make a choice. You either buy medication or food,” she said. “Without Meals on Wheels, we probably wouldn’t eat a lot of the time.”

The Prandys are far from alone. Last year, in partnership with local providers such as Meals on Wheels, the Cedar Rapids-based Heritage Area Agency on Aging provided over 388,000 home meals to low income, frail seniors in Linn, Johnson, Benton, Cedar, Jones, Johnson, Iowa

and Washington counties.

The agency has seen rising need recently, with an eight percent increase in the number of new participants in fiscal year 2013.

But funding to keep those meals coming is not meeting demand. The Heritage Agency received $44,000 in cuts due to the sequestration, and is preparing to receive larger cuts in 2014.

The agency fell short of its funding goal by 54,000 meals in fiscal year 2013. That meant in some cases cutting down how many days per week they serve meals at locations such as senior centers, and in other cases reducing the number of meals they deliver per week to each client.

“The need is great. People would be surprised how great,” said Tim Getty, Heritage Agency nutrition coordinator. “It’s kind o f a silent issue, but the need is out there.”

The agency will hold a Fill the Plate telethon 5:30 to 9:30 p.m., Dec. 8, on KCRG TV9.3 to raise awareness and funds for the meal program. KCRG and The Gazette are owned by the same parent company.

Getty said many patrons were able to support themselves their entire lives, but cascading health problems as they leave the work force make it harder to get by.

The Prandys are an example of that. Roxanne Prandy said she and her husband, who have been married 31 years, were always financially stable until, suddenly, they couldn’t provide for themselves anymore.

“You never think you’re going to be here,” she said. “And then you end up asking, ‘What am I going to do?’”

According to a recent study conducted in collaboration with the Meals on Wheels Association of America, Rutgers University and the Heritage Agency, 21 percent of participants the agency serves could not prepare meals

without assistance, and 60 percent could not drive.

The study also found more than 14 percent of home-delivered meal participants have eaten less than the felt they should in the last 30 days because they did not enough money to buy food.

Seventeen percent eat only one meal per day. “If you need help, don’t be afraid to ask,” Roxanne Prandy said. “For years I didn’t. Horizons can help you in so many ways.”+

IOWA Newspaper- 2014

Summing Up

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What Are Your (Agency) Goals in an Emergency?

• Ensure that: • Staff and volunteers are safe

• Clients are safe, fed, and can sustain themselves until the emergency is over, or until outside help arrives

• Ensure that your agency can continue to serve your clients

How Do We Achieve This?

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Possible Agency-Level Interventions

• Have a plan in place • Work with local office of emergency management

• Plans need to: • Include planning for a range of emergencies (foreseeable and unforeseeable;

likely and unlikely).

• Be well thought-out, and practical

• Be flexible

• What happens if you lose:

• Electricity

• Water

• Internet

• Facilities

• Be in place for both short-term and long-term emergencies

• What happens if a disaster lasts for more than a few days?


• Ensure that clients have emergency meals on-hand at all times

• Don’t wait until you think there is going to be an emergency

• Financial considerations

• Reimbursement issues

• Do clients keep them on hand, or do they eat them?

• Emergency meals need to be:

• Easy to open

• Easy to eat

• Nutritionally appropriate (diabetic and low-sodium foods)

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• Back-up information in advance

• Have emergency plan and client information backed up in multiple places

• Be sure to have hard copy off-site

• Identify your most vulnerable clients in advance

• Work with local office of emergency management when possible

• Send them list of most vulnerable clients

• Update it regularly


Communication with Clients: • Far in advance of emergency

• Inform clients about emergency supplies to have available.

• Educate clients about appropriate food storage lengths and safe refrigerator and freezer temperatures in the event of a power failure.

• Immediately prior to emergency

• Verify that they actually have emergency meal kit available.

• Inform them ahead of time if you know deliveries will not be possible.

• During an emergency when possible

• Call when deliveries would normally be made.

• After emergency if deliveries will not resume

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• Educate clients about: • Food safety after a power failure

• Safe refrigerator and freezer temperatures

• When/what foods should be discarded after a power failure

• Food may stay cold for 4 hours in a closed refrigerator with a starting temperature of 40° F

• A full freezer will keep its temperature for about 48 hours (if unopened)

• A half-full freezer will keep its temperature for about 24 hours (if unopened)

• A good resource: http://www.foodsafety.gov/blog/poweroutage.html#

Thank you

Study Collaborators:

Carol Byrd-Bredbenner, PhD, RD, FAND1

Cara L. Cuite, PhD William K. Hallman, PhD1 Rita M. McWilliams, PhD, MPH1 Angela Senger-Mersich, MS1

Tim Getty, Nutrition Director2 Linda Netterville, RD, LD3

1 Rutgers, the State University of New Jersey 2 The Heritage Agency on Aging, IA 3 Meals on Wheels America

We would like to thank the local MOWA-affiliated agencies, their data collectors, and the participants in this study who made this research possible.

http://www.foodsafety.gov/blog/poweroutage.html

http://www.foodsafety.gov/blog/poweroutage.html

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Useful Websites

fema.gov

ready.gov

redcross.org aoa.gov

cdc.gov

For More Information: William K Hallman, PhD. Professor/Chair Department of Human Ecology Rutgers University 55 Dudley Road New Brunswick, NJ 08901-8520 (848) 932-9227 [email protected]

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Upcoming NRCNA Webinars in September!

Findings from the Nutrition Services Program

Process Study and Meal Cost Analysis

Presenters: Susan Jenkins, Ph.D., James Mabli, Ph.D. and Jessica Ziegler, M.P.P

When: September 24, 2015

Time: 3:30 PM to 4:30 PM EDT

Fee: FREE

Register at: https://attendee.gotowebinar.com/register/4343396753817796353

https://attendee.gotowebinar.com/register/4343396753817796353

https://attendee.gotowebinar.com/register/4343396753817796353

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