In hurricanes’ wake, new concerns about elderly and tainted waters

Although Hurricanes Harvey and Irma have stormed off into the record books, their harms, particularly to health, persist for Texans, Floridians, and residents of the Caribbean. Recovery and return to normalcy will take the ravaged areas longer than many Americans realize, experts say. And they already are uncovering systemic woes, some fatal, with which planners and lawmakers will need to reckon with to better prepare for the next storm.

In Florida, for example, while hospitals, generally speaking, had adapted and rode out Irma maybe better than might be expected, nursing homes did not. They’re under new scrutiny, notably after eight residents died in an already troubled and roasting Hollywood, Fla., nursing home.

That incident refocused official attention on a sizable and particularly storm-afflicted population in the Sunshine State: its senior citizens. Whether in others’ care or ostensibly on their own, millions of older Floridians were left even more vulnerable after Irma, which cut off critical life services, including power, cooling, transportation, and access to medical services and food and other supplies.

State and federal officials have insisted that they had tried to safeguard seniors, especially in nursing homes, with regulations and other measures. But the Hollywood deaths shredded that argument, particularly when information emerged that the nursing home had a long record of violations and problems pre-storm, much less that its operators may have made a half-hearted stab at complying with half-measures on storm readiness: the facility, to comply with loosely written federal measures, had installed a generator. It was under-powered, delivering electricity to the kitchen, and it could not operate the home’s air conditioning systems, so temperatures, naturally, soared above 100 degrees.

Officials were prodded by the Hollywood deaths to check dozens of other senior care facilities across Florida, even as operators of the now-infamous home defended themselves and raised questions about their attempts to get help through multiple calls to no less than Gov. Rick Scott. The governor, over the weekend, imposed new rules on nursing homes, requiring them to swiftly ensure they can maintain safe temperatures for residents, though operators questioned the feasibility of complying with the new regulations in the midst of the state’s current chaos.

Meantime, as storm victims try to find their ways back to their homes and to rebuild their lives, they’re struggling not only with challenges from the likes of molds, bugs, vermin, and restoring power and transport, new worries are emerging about health-endangering taints spread by the hurricanes’ flooding.

In Florida, damaged infrastructure apparently has spread sewage and fecal contamination widely, contributing to what some are calling the Sunshine State’s “poop nightmare.” In Texas, the New York Times—at some cost and to its credit—has cooperated with local officials to test still-standing flood waters, finding them carrying risky levels of bacteria and toxins. The newspaper said it decided to work with others to conduct water tests because of a dearth of available and public information about its safety. That’s been an issue in pro-business, anti-regulatory, laissez-faire Houston, a metropolis built on the oil and gas industry and awash with chemical and manufacturing plants.

In my practice, I see not only the huge harms that patients suffer while seeking medical services, I also am both saddened and angered by the damage inflicted on the elderly by nursing homes’ neglect and abuse. When facilities already are shoddily run, poorly staffed, and offer substandard care, dire circumstance only can worsen awful nursing homes. Officials at all levels across the country need to step up their oversight of senior care, which already affects tens of millions of Americans and will need to assist even more as the nation grays.

Even as we offer our best thoughts and all the support we can to those afflicted by Harvey and Irma, we all need to think ahead and to plan and prepare for the next natural disasters and emergencies, including paying attention to what may happen to seniors—our older parents, grandparents, aunts, uncles, other relatives, friends, and loved ones. The New York Times has offered some timely, good ideas for consumers on scrutinizing nursing homes, and the Centers for Medicare and Medicaid Services (cms.gov) deserves credit for pushing ahead with a still-developing rating system for nursing homes, akin to what Uncle Sam offers for hospitals.