In Case of Emergency

In early January of 2019, I received a letter from my mother’s care facility, stating…

“Dear Resident and/or Resident Representative,

…an unidentified man entered our resident community which resulted in an incident with the potential for harm...The immediate action taken by our staff to mitigate this incident was appropriate and in accordance to their emergency training…If you have additional questions, please contact administration…”

I immediately called the facility’s CEO, requesting more details.

Apparently, this man walked into the facility, without asking for any particular person. He then approached a resident, placing his hands around her throat. At that point, 911 was called and the staff did what they could to diffuse the situation. He then fled the facility, only to be confronted by law enforcement who subdued him.

The CEO revealed the local paper covered the incident; I searched for the piece.

Published one day after this event, additional disturbing details emerged. This thirty-five- year- old man entered the facility through the main doors and zeroed in on a 97-year-old-resident in a wheelchair. He grabbed her by the neck, lifted her out of the chair and shook her. The resident was later evaluated at the hospital and did not suffer any injuries. But, still, this was traumatic nonetheless; this was violent.

I was horrified.

I enquired further about the incident and was emailed a two- page Emergency Preparedness pamphlet which discussed the care facility’s general protocol, including such topics as internal fire and communications failure. But there was no detailed action plan.

Call me “high maintenance,” but I had more questions. And so, I further approached care facility staff and the Ombudsman’s office. I “carbon copied” all of the entities, via email, asking questions about the policies during such circumstances.

Days later, I received their answers.

I was emailed five installments of their Emergency Operations Plan (EOP), via attachments.

The Emergency Operations Plan:

I don’t know what your experience with care facilities may be. If you’ve placed your loved one in such a place, more than likely, you were presented with a copy of the resident’s handbook. If you weren’t, request one immediately.

But any version of an emergency plan will probably not be detailed within the handbook. You’ll have to specifically ask for that EOP. It took this horrifying incident with a disturbed man to do so where I was concerned.

Still, better late than never.

Ask about such a plan’s existence. Any good facility should have one available and should have no problem in giving a copy to you. If they do, that’s a red flag.

Documents may vary from state to state, facility to facility, but there should be some basic information provided in any emergency plan. It should include the following…

Resource Management:

Emergency supplies and equipment need to be always present. My mother’s care facility has a 72-hour emergency resource of food and medicine. There should also be a system in place that includes agreements with vendors for re-supply of necessary stock beyond that time period.

The Relocation Sites:

Alternate sites to temporarily house and care for residents also need to be clearly outlined. Arrangements, in the case of an emergency should include at least two sites for the residents’ safe, temporary dwelling. My mother’s care facility has listed both a Lutheran church and a public middle school as those relocation sites. This is called “Shelter in Place” and should also work with other skilled nursing facilities to take admissions in an emergency situation.

Likewise, here again, there should also be similar agreements with vendors, transportation, generator fuel, medical supplies, food, etcetera to continue providing these supplies for the duration of a crisis.

The Communication Plan:

Any care facility should have the necessary internal communication equipment. A landline telephone, overhead paging system and the internet are staples in that first line of defense; handheld radios and cell phones with texting capability should represent the second line of communication during a crisis.

Training Policy and Procedure:

Any facility should have, in place, a clear and updated training protocol involving its staff: administrators, social services and nurses; mock drills need to be a central feature of that policy.

Participation in these drills, which are not announced beforehand, should be a regular occurrence, involving both employees and residents.  Staff members identify the hazard and take immediate action according to that hazard’s policy, all while a manager assesses the drill in action. Once completed, this manager provides feedback and re-education.  No two drills are exactly the same, as the hazard/crisis of that day’s drill changes.  Drills include everything from severe weather to missing residents to structural damage.

It should be required of staff, upon hire and on at least an annual basis, to be thoroughly tested and trained in emergency preparedness. Administering First Aid and CPR need to be a part of that, as well as knowing how to contact law enforcement and 911 services.

Trauma Aftercare:

If a resident does experience a traumatic incident, a care plan needs to be established regarding the impact on each person involved.  After care interventions should include a medical evaluation with a physician, professional counseling, monitoring for mood/behavior changes, facility Chaplaincy visits and involvement from the person’s family, as needed, for support.

Emergency Contact Information:

In the event of an emergency, you, as family, should be contacted as soon as possible. Texting, emails and phone calls are needed to keep you updated. At a minimum, you should be able to reach the nurses’ station on your loved one’s floor, the lead nurse, the facility’s social worker (s) and administrator (s). Obtain and keep that contact information at the ready.

What is also helpful? The RN Supervisor (present during evenings and weekends), the Ombudsman’s office and even the CEO of the care facility should be contacted if you have any issue reaching any of the staff members listed above.  Don’t be shy about holding the care facility’s feet to the fire, if need be. When it comes to the welfare of your loved one, you need to know what’s going on. Bring this up at future quarterly care conferences, especially if there continue to be any glitches. Ask any and all questions that concern you.

Unfortunately, disasters, emergencies and a wide range of serious incidents can happen anywhere, to anyone. And yes, that can involve our most vulnerable.

Therefore, ask the questions of your loved one’s care facility. You are entitled to the answers. You’re entitled to know all of your family members are safe.

Copyright © 2019 by Sheryle Cruse