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Early June brings hurricane season to Texas, and with that comes a fresh reminder of the need to plan for emergencies. People often don’t realize the full extent of consideration that new challenges require following a brain injury. They particularly may not understand new challenges regarding emergency situations, such as sheltering and evacuation.
In this blog, we’ll tell you some useful and effective ways to approach those new challenges when planning for an emergency with a brain injury survivor. We’ll cover how to address transportation issues, medical and health concerns, and cognitive and emotional difficulties in the wake of a traumatic brain injury.
After a brain injury, many possible issues may arise concerning transportation preparedness during an emergency. We’ve listed some of those issues below.
Is the brain injury survivor able to drive independently to safety?
If the survivor hasn’t been cleared to drive, it’s vital to identify a responsible person capable of transporting them to safety.
Can a friend or relative drive the survivor, or does the survivor need to be evacuated through a municipal program?
If they must use a municipal program, are they registered for the program?
Many states provide emergency evacuation services for the disabled and elderly. We recommend that all persons with disabilities register with their local 211 system or another similar emergency evacuation system, even if they already have an emergency plan in place.
Registering with an emergency evacuation system doesn’t mean the survivor has to use the services it offers. However, it provides a safety net in case an emergency plan doesn’t work. Additionally, 211 services are free, so there should be no issues regarding registration costs.
Deciding which vehicle will be best to use during an evacuation is an important step when preparing for an emergency. Consider whether you have a vehicle that can accommodate everyone who would evacuate, as well as the necessary equipment (wheelchairs, walkers, etc.).
If the brain injury survivor has a physical difficulty that may affect their ability to enter or exit a vehicle, it’s important that other people in the vehicle know the appropriate transfer process and can assist them.
Preplan and locate rest stops that people with disabilities can access. If the brain injury survivor is incontinent, it’s important to find rest stops that have enough room for clothing changes and cleanup. Rest stops often simply put a grab bar in a regular-sized stall to comply with accessibility laws, but unfortunately such restrooms remain inaccessible from any practical perspective.
For those who take medication or frequently use assistive equipment, make sure you store that medication or equipment in an easily accessible location in the vehicle. You should definitely not store medication in an area of the vehicle prone to excessive heat because the medication may lose its potency.
The cardinal rule of evacuation is that the earlier you leave, the less potential you have for transportation problems.
In addition to transportation, it’s important to consider medical and health concerns for post-brain injury patients when preparing for an emergency. We’ve listed some of these concerns below.
When people must evacuate from areas affected by a natural disaster, evacuated cities immediately experience a population surge. This puts a remarkable strain on any local medical system, particularly pharmacies.
For example, let’s say a city has pharmacies normally prepared to have enough on-hand medication for a population of 50,000. Following an evacuation, the population may increase to 70,000 or more. Most pharmacies aren’t equipped to deal with this increase, and medication shortages inevitably occur.
Most government agencies recommend that people bring one to two weeks’ worth of medication with them when they evacuate. You may want to err on the side of caution and bring enough for two weeks to one month. You should use this same general rule when preparing a stock of disposable medical items, such as syringes, incontinence supplies and testing strips.
Most medications are sensitive to heat. Keeping medications in the trunk of a car or a similar location on a warm day can cause them to degrade. Furthermore, many medications (such as insulin) require refrigeration. When in a vehicle, consider storing such medications in an icebox with cold packs or a portable refrigeration device.
You should also keep medications in their original boxes or bottles and transport them in a container you can seal and reseal. Plastic bags with a zipper work great for this situation.
Don’t take medications and place them all into one container. This can be a nightmare to sort through later and can lead to crucial delays. It can even lead to dangerous errors in administering medication.
Additionally, you should protect medical devices and equipment from water and other environmental hazards.
If a medical device or piece of equipment operates on electricity, make sure to bring an emergency power source, such as extra batteries or a car adapter power cord.
Keep a list of all important medical information. This includes health history, medications (with dosages), doctors, allergies and immunizations. The Centers for Disease Control and Prevention has an excellent example of such a list available for download on its website. You can download another excellent example of this kind of checklist from the AARP website.
When you reach your new location, make sure you know where the nearest medical and health facilities are. Knowing where the closest pharmacies and hospitals are will help if a medical emergency occurs after evacuation.
Following a brain injury, many survivors require a special diet, such as a diabetic diet. When purchasing food for evacuation, make sure to keep this diet in mind. For example, you may need to check boxed foods (crackers, cookies, etc.) for their sugar and sodium levels.
If a survivor has an item that helps communicate the difficulties they suffer, such as a medical bracelet or aphasia card, remember to bring that item. Left at home, it’s of no use.
Read on to learn about issues that can arise regarding the cognitive and emotional difficulties left after a traumatic brain injury.
Post-injury, brain injury survivors generally become far more susceptible to stress and agitation in their lives. Therefore, it’s often handy to have items that you can use to help them remain calm. Music played on a portable radio, phone or pair of headphones that the survivor finds relaxing is an example of such an item.
For survivors who have cognitive difficulties such as memory problems, the evacuation process can be very confusing. They may forget why they’re evacuating or where they’re going. Calmly repeating the evacuation plan and/or having the evacuation plan in writing can help reduce confusion.
If a survivor has issues with impulse control, they may be more likely to make hostile comments or rashly suggest an unwise action during the evacuation. At these times, loved ones should calmly remind them of the evacuation plan and that the loved one has the situation under control. If the loved one reacts with anger, emotions are likely to escalate.
Most people, even without a brain injury, find extensive car travel stressful. Keeping to a regular schedule of planned breaks during an evacuation often helps reduce that stress.
Because many brain injury survivors have already experienced significant loss due to their injury, an evacuation and worries about potential losses resulting from a disaster may trigger difficult memories. Some survivors may need extra emotional support at this time as memories of old losses and new concerns for fresh ones result in significant emotional struggles.
All people, especially those with brain injuries that affect cognitive skills, do best when operating under a stable schedule. Survivors and loved ones should try to create a daily schedule to reinforce stability in the evacuation environment.
The more you plan and review an evacuation plan, the less stress you’ll have when it’s time for a real evacuation. Regularly going through evacuation plans will make the process less stressful for a person with a brain injury, too.
Hopefully, this guide can help bring attention to the important issues that brain injury survivors and their loved ones need to consider regarding emergency preparedness post-injury.
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