To evacuate or shelter-in-place? Emergency management for LTC homes and nursing homes

It 5:30 a.m. on Monday, January 5, 1998. You run a long-term care home in Epiville, a town of 27,000, not far from the Quebec border. Most of your 60 residents are ambulatory, several have mobility issues, and two are considered frail. Freezing rain has fallen all night, rendering the roads all but impassable and a tree has fallen, blocking the entrance to your building. These conditions mean that staff for the next shift may not be able to make it into work and the staff members who are nearing the end of their shift may not be able to leave. The forecast calls for two more days of freezing rain.

So what do you do? What are your most immediate concerns and next steps? How do the answers to those questions change when, shortly after 7 a.m., the roof collapses? Or when the hydro shuts off shortly thereafter? What needs to be in place to help with those answers?  And with a vulnerable population in your care, do you evacuate the building or do you “shelter-in-place?” In other words, should you stay or should you go?

In an engaging Friday morning session entitled “Should We Stay or Should We Go? – Long-Term Care Homes and Nursing Homes Developing Plans for Sheltering-in-Place or Evacuation,” Richard Bochenek from OAHPP’s emergency management team walked participants through the emergency management cycle of mitigation, preparedness, response and recovery. After detailing the components of an emergency operations plan (EOP), and highlighting the level of thought and foresight such an undertaking requires, he put each working group in the midst of an escalating theoretical crisis, and asked its members to manage their way through the situation.

Bochenek distilled the decision to evacuate or shelter in place to a pair of simple formulas:  if the threat faced by staying is greater than the risk posed by leaving, you must evacuate; if the risk (to the patients) posed by leaving is greater than the threat faced by staying, you must shelter-in-place.

Bochenek reminded the group that EOPs are living documents that must be reviewed and tested annually, as well as after each emergency.