Responding to Natural Disasters: Spinal Cord Injury and Disorders
Frances M. Weaver BA MA PhD
Edward Hines, Jr. VA Hospital
Hines, IL
Funding Period: June 2006 - September 2007

Individuals with spinal cord injuries and disorders (SCI&D) are particularly at risk during times of natural disasters due to their impaired mobility and other special needs such as power wheelchairs and ventilator-dependency. The purpose of this study is to use lessons learned from recent disasters to develop a toolkit or guide for facilities that care for veterans with SCI&D and for veterans with SCI&D and their families on how best to respond to a natural disaster.

Our objectives are: 1) To identify lessons learned from natural disasters that have affected veterans with spinal cord injuries and disorders (SCI&D), 2) To develop a toolkit focused on improving natural disaster preparedness for facilities caring for persons with SCI&D and individuals with SCI&D. Our long term objective is to develop a natural disaster preparedness plan for veterans with SCI&D that will be used nationwide, can be implemented quickly, and is applicable to other high-risk populations. This study will serve as the first step toward a larger study to implement best practices for disaster preparedness and evaluating readiness across the VA.

Thirty (N) telephone interviews were conducted. Providers (n=16) consisted of physicians, social workers, therapists, and care coordinators who worked in VHA for four to 25 years. The 14 veterans interviewed had been living with SCI for five to 43 years. Data were coded by two investigators using constant comparative analysis.

Most providers and patients had lived through at least one weather-related natural disaster. Veterans with SCI were typically evacuated to unaffected areas or were admitted to nearby SCI centers. Providers and veterans who had encountered prior disasters drew on those experiences to guide their actions. Other participants explained that many aspects of a response take shape “in the moment” and that pre-established plans serve as useful starting points. Social support from family and local agencies was critical for veterans to attain a sense of personal preparedness. Providers described the importance of understanding both the medical and living situations of SCI veterans so that those “at risk” could be identified. This information was used to develop tools like critical patient call lists, and to prioritize response efforts to ensure that high risk individuals were brought into a facility or relocated to safe areas.

Conclusions: Responding to natural disasters in high risk populations requires appropriate organizational and community resources, but also tailoring responses to address the unique needs of individuals with SCI. Integrating opportunities into the flow of routine clinical work where providers and patients can share information about disaster preparedness may facilitate optimal SCI care when such events occur.

A natural disaster preparedness plan for veterans with SCI&D could be developed, that could be used nationwide, implemented quickly, and be applicable to other high-risk populations.

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