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Evacuation - Supervision

Many people need help with activities of daily living. Family members or paid caregivers are likely to provide this support. People who need help may have Alzheimer's disease, psychiatric conditions like schizophrenia or depression, or other mental disabilities. Children and the elderly also may need supervision. In an emergency or disaster, they may lose the support of their caregiver. Planners need to include caregivers at all stages of planning. This way, a proper response to people needing supervision help is more likely.


There may be people in a community who rely on supervision or support. In order to maintain these supports, planners should reach out to people and service groups well before an event occurs.

Create partnerships with community groups. There may be community groups that provide supervision to those who need it. Planners should connect with these groups before an event. Planners should also consider how a group's services could help the planning process.

Educate the community. Being prepared is very important. Planners should ask citizens to:

Case Study: In 1997, the New York City Office of Emergency Management held an urban terrorism drill called the Interagency Chemical Exercise (I.C.E.). The drill included disability issues to give first responders a realistic situation. The goal was to teach response agencies how to improve plans. The drill showed that there was no way to identify victims. If people who need supervision are not identified, it will be hard to notify next of kin or care providers. This could delay important decisions like medical care and transport.

Lesson Learned:Planners should develop a system to identify and track victims who need supervision.

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When planning for evacuation, planners need to remember that many people with supervision needs may not be comfortable with emergencies. For example, people with dementia may have more stress and confusion due to a change of location. Strange noises and activities may also cause stress and confusion. Plans should try to limit stress and confusion.

Include caregivers in plans. Caregivers should evacuate with individuals they assist to ease any stress caused by change in location(s). When planning, make sure there is room for caregivers in specialized vehicles and destinations. Planners should also:

Case Study: In shelters set up after Hurricane Katrina, people with psychiatric needs often faced poor conditions and prejudicial treatment. Shelters were crowded, noisy, chaotic, confusing, and in some cases violent. Shelter conditions were unsafe for people with psychosis, anxiety, or depression. Many people with psychiatric disabilities were turned away from shelters. Others were put behind physical barriers to segregate them from the general population. Most special needs shelters were set up to help those with medical and physical disabilities, but not those with psychiatric needs. Many who were turned away from shelters ended up living on the streets with no services. Others were dumped into jails, emergency rooms, nursing homes, or mental institutions.

Lesson Learned:Include mental health professionals and other volunteers in shelter planning. This will ensure that people needing supervision have adequate support. Work with the American Red Cross when planning for shelters.

Plan for shelter resources. Many general shelters may not be able to handle the needs of people who rely on supervision. Caregivers or family members may be able to provide direct support for these persons at a shelter. Planners need to include caregivers or the support of other volunteers in shelter plans.

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Ideally, caregivers can help those in need of supervision return home after an event. However, caregivers may not always be available to help. Planning should include ways to request and help shelter workers in contacting someone's next of kin. In addition, planners may help provide support until temporary arrangements can be made.

Help with victim tracking. Like the many people, those with supervision needs may become disoriented and get lost. Planners should work with community groups to set up a system to track victims who may have become disoriented. Planners can help create call-in centers or computerized tracking systems. These systems will help reconnect people with their support networks and speed recovery.

Provide mental health support. Provide access to mental health support after an event. The extra stress of an event and a change in routine may worsen an individual's condition. Look for ways to provide long-term crisis counseling, particularly to people with chronic mental health needs and others who have suffered mental health issues resulting from the emergency or disaster.

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After an event, planners should draft after action reports (AAR). The AAR includes information on what support people required and if their needs were met during the disaster. The report may also include lessons learned to revise and improve plans. If the plan did not provide adequate supervision for people, consider ways to improve the plan. The report should include feedback from caregivers and people with supervision needs.

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Additional Resources

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