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Reclaim Your Calm

The Silent Storm

Margaret clutched Tom's hand, her weathered fingers intertwining with his. The room was eerily quiet, save for the labored wheeze of Tom's breathing. Outside, the world was a watery chaos—the storm had passed, but its aftermath remained.

Just yesterday, their modest home had been a haven of peace in Tom's final days. Now, it stood as an island in a sea of muddy water, roads washed away, leaving them stranded. The power had flickered out hours ago, silencing the steady hum of Tom's oxygen concentrator.

Margaret glanced at the backup oxygen tank, its gauge hovering dangerously close to empty. She'd always thought they were prepared—extra medications, a generator, emergency contacts. But nature had outsmarted them all.

Tom stirred, his eyes flickering open. "It's okay, Maggie," he whispered, his voice barely audible. But Margaret knew it wasn't. Without power, without oxygen, without help, Tom's time was running out faster than they'd ever anticipated.

She reached for her cell phone out of habit, but the "No Service" message mocked her efforts. Their lifeline to the hospice team, their beacon of comfort and guidance, was severed.

As the room grew darker, Margaret lit a candle, its flame casting dancing shadows on the walls. She looked at Tom, his face peaceful despite the dire circumstances. At that moment, she realized that while they couldn't control the storm outside, they could face this final challenge together, with dignity and love.

The night stretched on, each breath a victory, each moment a gift, as they waited for a rescue they weren't sure would come.

The Critical Importance of Disaster Preparedness in Hospice Care

In the realm of hospice care, where every moment is precious and comfort is paramount, the threat of a natural disaster looms as a stark reminder of our vulnerability.

As hospice providers, we bear a unique responsibility—not just to our patients, but to their families and our dedicated staff.

The unpredictable nature of disasters, from hurricanes to earthquakes, demands that we do more than hope for the best; we must prepare for the worst.

A comprehensive, well-tested disaster plan isn't just good business practice—it's a lifeline. In the face of nature's fury, our preparedness can mean the difference between continued care and catastrophic disruption, between comfort and distress, and in some cases, between life and death.

As we delve into the crucial topic of disaster readiness, remember: proactive planning today ensures we can fulfill our sacred duty of care, no matter what tomorrow brings.

CMS.gov: Emergency Preparedness

Hospices are required to have emergency preparedness plans in place.

The question remains during our busy days of caring for people, do we even think about, plan for, are we prepared for Mother Nature’s unpredictability?

The people in W. Carolina and Tennessee could never have predicted what happened to their towns, roads, businesses, and their communities. Our communities in Florida and the Gulf Coast have become accustomed to facing disasters that fast approach. The difference is time - they know when, where, and how hard it may hit.

California - what are we doing? We can plan for the El Nino rains - we all suck at driving in the rain. We know when the next snowstorm is coming and can plan for our people in mountain communities. Wildfires - that’s a crap shoot and we all know it.

Let’s talk about the next “Big One.” Ya, that earthquake is coming in our lifetime. It may be up North. It could be down South. But it’s coming and you know it.

We can bury our heads in the sand (or the beach), however have we walked through our disaster recovery plans for an unprecedented event like this?

When the 10 freeway (Interstate 10 that runs from Santa Monica to Florida) pancakes in the center of Los Angeles - how are you servicing your families?

When half of San Francisco falls into the bay - how are you servicing your families?

Even for the outliers near Highway 1 - we know that mud and rain have taken out portions of this gateway to our coastal folks.

What are you going to do?

Hospice Disaster Preparedness Plan:

Given the serious nature of any of these scenarios, a comprehensive contingency plan for a hospice dealing with natural disasters like hurricanes, earthquakes, tornadoes, or severe storms would be crucial. Here's an outline of what such a plan might include:

1. Supply Management:

   • Maintain an up-to-date inventory of critical supplies and medications

   • Establish relationships with multiple suppliers in geographic areas and asks them about their disaster preparedness plan.

   • Create a stockpile of essential items (medications, oxygen tanks, generators, etc.)

   • Rotate stock to prevent expiration

2. Power Backup:

   • Portable generators - do you have access or have them available for your in-home patients?

   • Regularly test and maintain these systems.

   • Train staff on proper use of generators.

   • Do you ask families if they have backup power options at their home?

3. Patient Prioritization:

   • Develop a system to categorize patients based on their needs and criticality.

   • Create individualized emergency plans for each patient.

4. Communication Plan:

   • Implement a robust communication system (satellite phones, two-way radios).

   • Establish a clear chain of command and communication protocol.

   • Create an emergency contact list for all patients, staff, and key stakeholders.

5. Transportation:

   • Ask your transport partners about their emergency preparedness plans.

   • Vehicles - company, associate vehicles - are they equipped with supplies and tools in case of an emergency?

6. Staff Preparedness:

   • Conduct regular emergency drills and training sessions.

   • Create a staff phone tree for quick communication and keep it up to date.

   • Develop a system for staff to report their status during emergencies.

7. Remote Care Protocols:

   • Establish ways to communicate and monitor patients remotely.

   • Develop guidelines for providing care instructions over the phone or other means if phones are not working.

8. Patient and Family Education:

   • Provide emergency preparedness training to patients and their families.

   • Distribute emergency kits and instructions to home-based patients.

9. Documentation and Records:

   • Ensure all patient records are digitized and accessible remotely.

   • Ask your EMR vendors what their emergency preparedness plans and discuss how and who you contact in case of an outage.

10. Evacuation Plans:

    • Develop clear evacuation procedures with your team.

    • Identify safe locations for patient relocation and discuss plans with your healthcare partners.

    • Establish protocols for deciding when and how to evacuate.

When hospice personnel cannot reach patients due to their own emergency circumstances:

1. Activate the backup staff roster, calling on employees from less affected areas

2. Utilize telemedicine to conduct virtual check-ins and provide care instructions

3. Coordinate with local emergency services to conduct welfare checks on patients

4. Engage community partners and volunteers to assist with basic patient needs

5. Provide detailed care instructions to patients' family members or caregivers

6. If necessary, coordinate patient transfer to hospitals or other care facilities

This plan would need to be regularly reviewed, updated, and practiced to ensure its effectiveness in various emergency scenarios. The key is flexibility and redundancy in systems to handle unpredictable situations.

Resources for Emergency Preparedness

National Hospice and Palliative Care Organization:

Check out the NHPCO resource specifically for Emergency Preparedness for Hospice Providers - A Regulatory Focused Resource.

CMS.gov - Health & Safety Standards - Emergency Preparedness

Guides, links, downloads are available here.

HHS.gov: Topic Collection: Homecare and Hospice

Redcross.org: Disaster Preparedness for Seniors by Seniors

Here’s an idea that may work for your hospice.

Create your “Emergency Preparedness Plan.”

Turn it into a PDF that your families and patients can download.

Include it in your personalized hospice newsletter created with @beehiiv.

Your families, associates, and referral partners can download it to their phones in case there is a real emergency.

Did you know? Something good to pass along to your families.