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When Hurricane Ian struck southwestern Florida in 2022, it led to the deaths of more than 150 people – the majority of whom were older adults who had heart-related problems, power outage-related accidents, medical equipment failures or a lack of timely access to care.

The deaths drove home the importance of evacuating when natural hazards threaten homes and highlighted the complicated nature of doing so for the growing population of adults aging in place.

"A lot of people don't evacuate," said Dr. Lindsay Peterson, a research assistant professor in the School of Aging Studies at the University of South Florida in Tampa. "But this is especially true for older adults, especially if they don't have a lot of warning. It takes time to put a package together with medications and all the things they need on a daily basis.

"Imagine packing for a trip with multiple chronic conditions and you don't know how long you're going to be gone, and you might have just six to 12 hours to do it," she said. "A lot of people say, 'I can't do this. I'm just going to hope for the best.'"

With the National Weather Service predicting an above-normal Atlantic hurricane season this summer and fall – estimating up to 25 named storms and as many as seven major hurricanes – experts say planning and preparation are key to survival. And not just for hurricanes, but for the increasingly intense storms, heat waves, wildfires and other climate-related natural hazards that threaten people's lives and homes.

Know your risks

Recognizing the hazards is fundamental to preparedness, say experts, who admit this is no easy task.

"This has become a very complicated proposition in the U.S. as the climate has warmed," said Dr. Lori Peek, director of the Natural Hazards Center and a professor in the sociology department at the University of Colorado in Boulder. "It's no longer just coastal populations that are at risk."

The path of a hurricane can cover hundreds of miles, and people far inland can face flooding from storm surges, she said. But forecasters often know well in advance when a hurricane is coming. Peek suggested signing up for emergency alerts with local weather services and disaster agencies.

Rising temperatures also have given rise to above-normal potential for wildfires in several states this summer and fall, including parts of New Mexico, Arizona and California.

"Pay attention to the news and the weather service reports," Peterson said. "Do you live in an area where there are wildfires or that floods regularly? Know what your risks really are."

Plan ahead

"The first step is getting a plan in place before disaster strikes," Peek said. "I cannot emphasize enough how important this is."

The plan should include what to do if evacuation is necessary and what to do when riding out a hazard at home.

Evacuating

Whether staying or going, homes should be bolstered against approaching storms and other natural hazards, experts say.

"Start early in preparing your house to leave it," said Dr. Ron Acierno, executive director of the Trauma and Resilience Center at UTHealth Houston. "This means knowing how to turn off water and covering windows if possible."

Among other steps, the installing hurricane shutters or otherwise protecting windows by covering them with laminate, glazing or plywood. Outdoor furniture and other items should be stored indoors, mailboxes secured and tree branches trimmed to keep them from falling onto the house.

Then, make plans about where to go and how to get there, said Acierno, who is also a professor of psychiatry and behavioral sciences at UTHealth's McGovern Medical School.

Transportation can be especially challenging for older adults who may rely on buses, trains or ride-sharing services that could be in short supply during natural disasters, he said. But it's critical. "You need transportation to get to a shelter, to get food, batteries and water, to evacuate," Acierno said.

For people with vehicles, being prepared means keeping them in good working condition and maintaining a full tank of gas, Peterson said. For those without one, it's important to have a neighbor, friend or family member who can provide emergency transportation.

The plan should also include where to go in case evacuation becomes necessary. That might be the home of a family member or friend, but it might not be necessary to travel very far to get out of harm's way, she said. "You might only need to go 10 or 20 miles away. Just get outside the risk zone."

Older adults or people with high-risk medical conditions who don't have someone to stay with can reach out to local emergency and disaster agencies to see what resources might be available, Peek said. Some communities provide special-needs shelters with generators to power medical equipment, such as oxygen tanks or dialysis machines, though they may require registration.

"A lot more goes into evacuating someone with a heart condition, who might have a device like a wheelchair or scooter or oxygen that requires electricity," Peterson said.

Pet-friendly shelters can also make it easier for older adults to relocate, Acierno said, because "older adults will not abandon their 'babies.'"

Before leaving, be sure to make copies of important documents that may be needed during or after the disaster to get services or file insurance claims, Peterson said. This includes personal identification, medical records and insurance documents.

Having those copies is also important in case everything in the home gets destroyed, she said.

Peek, who had to during a wildfire in 2020, suggested setting aside cash and extra medications in case it's necessary to stay out of the home for a long period of time.

Staying in place

Evacuation isn't always necessary, or possible.

"Sometimes, people are truly unable to leave their homes," Peek said. "They may not have transportation, may not have money, may not have people to stay with or may not feel safe leaving their homes unattended."

And the shelters in their area might not be set up for older adults, Acierno said.

"Senior-friendly shelters are few and far between," he said. Shelters often lack quiet areas where seniors can rest, or they require people to sleep on cots that are especially uncomfortable for older adults with achy hips and joints.

But people who choose to shelter in place should understand the risk they are taking on, Peek said.

"If you are not going to leave, then it's absolutely critical to remember there may not be help that can come to you. Let that set in. Understand the risk that is being assumed," she said.

"And remember that the past is not prologue," Peek said. "Just because your home has not flooded in past hurricanes, that does not mean it won't flood this time."

If you're staying in place, identify any potential risks and try to address them, Peterson said.

"Think about the resilience of your home and what you need to do to make yourself safe, possibly without electricity and services for a two- to three-day period," she said. "Stock up on food, water, medicines, everything you need to live. Make a list of the things you need to survive on a daily basis. That is more complicated for someone who is older."

Peek said planning on how to handle power outages is key, especially if the person relies on a medical device for survival. Generators – and enough fuel to keep them going – can help.

Identify gaps and who can fill them

"Know your vulnerabilities," Peek said. "Have extra medications on hand if you have a heart condition. If you know there are other gaps in your planning, then it's really important to reach out to look for resources where you live."

Friends and family members of people who live in areas threatened by natural disasters can help by reaching out to help with the planning, Peek said.

"If you see your loved one lives in an area under threat, call them," she said. "Call them immediately. Ask how you can assist and support. Some people do not evacuate because they do not want to be a burden. So offer a place to stay or be supportive in some other way before that hurricane makes landfall."

And never underestimate a storm's potential, Peek said.

"People often say, 'I didn't think it was going to be this bad.' Those are such tragic words to hear after a disaster," she said. "Be realistic about how serious this storm season could be. We don't ever think it could happen to us."

More information on how to prepare for natural disasters or locate resources for older adults can be found through the , funded by the U.S. Administration on Aging.