Preparedness Planning for Home Healthcare Providers
How to Prepare for the Emergency That Could Turn a Home Into a Makeshift Hospital
During a disaster, home healthcare professionals care for patients who do not require hospitalization or cannot be admitted into overwhelmed healthcare facilities. Depleted supplies, personnel shortages, and other challenges during times of crisis may strain the ability of these care providers to address their patients' needs. Good preparedness planning is essential for ensuring that the needs of both patients, their service animals, and their caregivers are met in the most effective and professional manner possible.
When planning for contingencies, home healthcare providers must consider a variety of hazards and events that could impact their patients. Hurricanes, floods, tornadoes, earthquakes, tsunamis, wildfires, radiation releases, chemical exposures, seasonal and pandemic influenza, and acts of terrorism are just a few examples.
Assess Needs, Prepare Supplies, Make a Plan.
These are simple measures that home healthcare providers can implement to increase the personal readiness of their patients and themselves. Additionally, becoming familiar with existing emergency response plans, processes, and procedures in both the workplace and community is a critical component of preparedness. Once you are armed with the necessary resources, help your patients, their family members, and other caregivers to get a kit, make a plan and be informed.
Home healthcare professionals play a vital role in disaster preparedness because their patients depend on them for continuity of care during a catastrophic event. Discuss resource requirements with your patients, their family members, and your organization's staff. The following questions will help guide your planning:
Assess Needs
* Does your organization have a plan for emergencies or disasters?
* If your organization is severely impacted by an emergency or disaster, how will your patients' healthcare needs be met?
* Will you be expected to stay with your patients during an emergency or disaster in either their residence or in an emergency shelter?
* Do your patients have an alternate support system (e.g., family, friends, volunteers) in the event that essential home healthcare services are compromised?
Prepare Supplies
* Gather enough food, water, medication, and other life-sustaining necessities for a minimum of 3 days and up to 2 weeks.
* If a back-up generator is available, ensure your patients are familiar with how to safely operate it and have sufficient fuel.
* Provide patients or their family members with the required knowledge, tools, and supplies to maintain, replace, or repair essential medical devices, such as wheelchairs, ventilators, oxygen tanks, etc.
* Confirm your patients have a disaster supply kit. More information on creating disaster supply kits can be obtained at http://www.ready.gov or through the American Red Cross chapter at http://www.redcross.org.
Make a Plan
* If your organization is unable to ensure continuity of care, your patients should have a backup roster of home healthcare providers or an identified alternate means of care to ensure support during and after an emergency or disaster.
* To facilitate efficient and effective response, work with local emergency services providers (e.g., emergency medical service, hospitals and other healthcare facilities, fire, law enforcement, volunteer groups, etc.) to inform them about the services your organization provides and educate them about the particular needs of your patients.
* Develop a plan for your patients and their families so you will know how you will communicate in a crisis.
* Discuss electrical needs for essential equipment (e.g., refrigeration for food and medication, air conditioning, heating, oxygen concentrators, suction machines, etc) with your patients, their family members, local emergency services providers, and local utilities companies.
Home healthcare providers may be required to stay with their patients in special needs shelters during their stay. When assisting patients and their family members plan to shelter, consider the following:
* Learn the health and safety resources the shelter provides.
* Determine which additional resources your patients will require if the shelter is not able to meet their needs.
* Review your organization's plans, processes, and procedures for providing care and support for yourself and your patients while in the shelter.
* If patients are oxygen dependent, make arrangements to obtain extra supplies of oxygen canisters, refills, and other equipment as needed.
* Determine how patients will be transported to a special needs shelter and assist in making proper arrangements.
* Assist patients and their family members to prepare emergency supply kits with essential medications, equipment, and supplies that will not be provided by the shelter. Refer to http://www.ready.gov for a complete listing of kit supplies.
* Inform shelter managers if your patients have service animals. Pets are usually not permitted in special needs shelters.
Household Pet and Service Animal Considerations
Service animals (e.g., seeing-eye-dogs, hearing and signal dogs, assistance dogs, etc.) must be allowed in shelters as extensions of the patient under the provisions of the Americans with Disabilities Act. Therapy animals, such as dogs who visit patients in hospitals and nursing homes, are not considered service animals. Many state and local jurisdictions will shelter household pets. Coordinate with the local animal control to understand the options and inform patients and their family members so they can plan for their shelter needs. Other pet and service animal considerations:
* Assist patients in making arrangements with family members, relatives, friends, or other providers to care for pets during an evacuation or other extended emergency.
* Plan for a minimum of 3 days and up to 2 weeks of food and water (and possible medications) for your patients' pets and service animals.
* Prior to relocating to a shelter, assist patients in gathering necessary food, medications, food and water bowls, cat litter, cages, collars (with tags and/or paperwork showing proof of immunizations, if possible), leashes, and muzzles.
* Contact animal control, the regional Humane Society or affiliate office, or a local veterinarian for more information. Additional information can be obtained from the Humane Society of the United States at http://www.hsus.org.
Emergency Plan Review
Review emergency plans and procedures with your patients, their family, and your organization each year. Be sure to review:
* all patient health and medical needs
* supplies to reflect evolving patient needs
* patient, family, and emergency contact information
* healthcare-related legal documents
* patient, family, and organization communication plans.
Online Resources
* U.S. Department of Health and Human Services, Home Health Care During an Influenza Pandemic http://www.pandemicflu.gov/plan/healthcare/homehealth.html
* National Association for Home Care and Hospice http://www.nahc.org
* U.S. Department of Homeland Security http://www.ready.gov
* The Joint Commission, Home Care Accreditation Program http://www.jointcommission.org/AccreditationPrograms/HomeCare
Note: An easy way to maintain an updated list of medications is to place a copy of the information that comes with each prescription in a plastic bag. Store the plastic bag in a location that is easy to access in an emergency. Replace copies each year or when there are prescription changes. Also include regularly taken over-the-counter medications such as acetaminophen, ibuprofen, antacids, etc.