Experiences of Veterans, Caregivers, and VA Home-Based Care Providers before, during, and Post-Hurricane Ian

On 28 September 2022, Hurricane Ian pummeled parts of south Florida. Disaster and climate change research has shown that disasters exacerbate inequalities, especially amongst older and physically vulnerable people. Florida has a large population of Veterans managing multiple chronic health conditions and receiving long-term care in-home from Veterans Health Administration (VA) programs, including Home Based Primary Care and Medical Foster Home. To describe how VA staff provided high quality care during and after the hurricane, and how Veterans and caregivers accessed needed healthcare and supports post-hurricane, we conducted a site visit to Lee County, Florida area in May 2023, conducting N = 25 interviews with VA staff, Veterans, and caregivers. Findings from qualitative thematic analysis showed that while some Veterans and caregivers experienced significant challenges during and after the hurricane, including displacement and difficulty accessing oxygen, they felt highly supported by VA care teams. Staff efforts post-hurricane focused on improving care coordination in anticipation of future disasters, especially around communicating with Veterans and their caregivers, and a VA workgroup formed to implement changes. As climate change causes more severe hazard events, lessons learned from this project can better support healthcare staff, older adults, and their caregivers before and after major disasters.

Critical healthcare for older adults post Hurricane Ian in Florida, United States

We highlight critical public healthcare inadequacies for older adult populations resulting in fatalities after Hurricane Ian. We summarize whether a fatality was a result of the storm directly, indirectly, or not at all. Massive destruction from Ian eliminated critical life-sustaining health care for the week following the hurricane. This disproportionately affected the older adult population, with most elder deaths attributed to a lack of some form of health care. To prevent further unnecessary deaths following a disaster event, we recommend that public health policy practitioners, medical practitioners, and state officials consider how to provide managed opt-in emergency care services, mobile elderly care until restoration of power and services, and revisions to community-based critical care provider building codes to include generators and fuel. We offer this viewpoint to generate discussion among public health and emergency planners.