Janelle Christensen, PhD, MPH (AAGE member since 2006). Janelle’s research interests lie at the intersection of disaster management and aging studies, exploring how community dwelling families respond to emergency preparedness and disaster planning while simultaneously providing care for family members with Alzheimer’s disease. She completed both PhD in Applied Biocultural Medical Anthropology and a Masters in Public Health (MPH) at the University of South Florida and has done Socio-legal research in intentional communities (Camphill Communities) based on the care of individuals with developmental disabilities in both Germany and the United States while completing her MA in Sociology of Law. Janelle is currently working as a Program Data Analyst for the Health Information program at Palm Beach State College.
Elders and caregivers living in the Lake Okeechobee, Florida area provide a microcosm of such vulnerability and provide both insight into the difference between federal and local county policies, and potential success stories. The areas surrounding Lake Okeechobee was the site of one of the most deadly hurricanes to strike the United States in 1928 resulting in at least 1,836 dead (though it is estimated that there were far more).19–21 This area remains second only to New Orleans in vulnerability to hurricanes.22 (Zora Neal Hurston’s novel, Their Eyes Were Watching God, was based on this hurricane in the Lake Okeechobee area). Even with repairs on the dike surrounding the Lake which began in 2011, the area remains at risk.23,24
I interviewed twenty people providing care to someone with Alzheimer’s disease in Palm Beach County, Florida. Five of these families lived on in on the banks of Lake Okeechobee. All of the caregivers interviewed in this area were over the age of 40 themselves and caring for an adult parent with Alzheimer’s disease (all over the age of 65) who currently lived with them. Three of the five caregivers I interviewed who lived on the banks of Lake Okeechobee occupied federally funded “HUD” housing.25 Though the HUD buildings in Florida are usually constructed out of cinderblock (structurally stronger than wood framed homes), these particular buildings are located in hurricane prone areas and do not have hurricane shutters. Caregivers were told that if they so desired, they could install hurricane shutters on their rented HUD apartments, however, due to the financial barriers of doing so, none of the caregivers interviewed had installed them (Note: low income is a requirement for living in HUD housing, which would also preclude home improvements to rented property).
The lack of shutters was a concern not only for protecting windows from the impact of flying objects during hurricanes, but for protecting the contents of a home after the storm. Caregivers reported that crime rates increased after the hurricanes in 2004-2005. Some families are reluctant to evacuate in the future because they fear the loss of their property to theft. Caregivers interviewed expressed concern over the escalation in crime after future hurricanes because the local economy had deteriorated since 2004-2005. Many may choose not to evacuate in the past (or at least not to evacuate a great distance) because they want to be able to return and protect their belongings from the anticipated looting that has followed hurricanes.
There were other reasons cited for staying closer to home when evacuating: Special Needs Shelters,26 which might have more specific accommodations for someone with Alzheimer’s disease, were further away (approximately an hour) and only allowed one caregiver to be present. If they evacuated to the local shelter (located in a Bell Glade high school), then they could remain with their extended families. It is important to note that most of the city of Belle Glade is also on the banks of Lake Okeechobee. If the eye of a hurricane were to pass directly over Lake Okeechobee as it presumably did in 1928, there would be catastrophic flooding to the area and likely render even this shelter unsafe.
One caregiver was firm in evacuating for any hurricane threat, in large part because in addition to caring for her mother with Alzheimer’s disease, the caregiver also had a medical condition that qualified her for the Special Needs Shelter. This dyad evacuated for both Hurricanes Irene (2011) and Sandy (2012), even though the storms remained approximately 100 miles off the coast of Florida. Their experiences demonstrate the services that are available in Palm Beach County, should residents need them: before each storm, the county sent transportation to pick up both the caregiver and her mother and transport them to the Special Needs Shelter, where they could continue to receive necessary medical services. In addition, Palm Beach County coordinates with local Alzheimer’s care providers (i.e. Alzheimer’s Community Care) who provides specially trained volunteers to better address the needs of people with an Alzheimer’s disease or a related dementia during stressful disaster events. (Note: During 2011 and 2012, these dementia specific services were not deployed because the storms were not predicted to directly impact Florida). During the 2004-2005 hurricanes, this family was unable to return home after a hurricane due to the flooding in the area. The county and American Red Cross provided temporary housing in a skilled nursing facility where both the caregiver and her mother could receive care and necessary medical treatments. After the threat passed, and it was safe to do so, the county assisted in transporting them home.
The above example demonstrates a success story in service provision, coordination, and utilization. Palm Beach County has both the resources and the political impetus to provide these safety measures for its citizens. The same cannot be said for all of the counties that surround the shores of Lake Okeechobee.27 There can be a large variation in the availability of local resources and emergency management priorities from county to county. Furthermore, Lake Okeechobee has not received a direct hit from a hurricane in approximately 90 years, meaning the full capacity of even Palm Beach County to respond to a potential catastrophe has not been fully tested, especially as the intensity of hurricanes are predicted to increase as a result of warmer oceans.
The paradox facing many families is in an aging society is this: Those with the means to protect themselves in the event of a climate related disaster have less incentive to take the science behind climate change seriously than those who live at the margins, such as those who live below sea level in the 9th ward in New Orleans, Louisiana or elders living in HUD housing on the banks of Lake Okeechobee, Florida. However, those who are the most vulnerable often have the most difficulty prioritizing threats such as climate change; the threat of a stronger hurricane as a result of warmer oceans is much further from their thoughts than what they are going to eat and if they have enough medicine. For applied anthropologists (and others), advocating for policy that reduces emissions at the grass roots level is just one way to also advocate for the protection of vulnerable populations most likely to suffer during climate change induced disasters.
This entry was a continuation of the Aging in an Age of Climate Change series. To see the previous post, click HERE.
19. Barnes J. Florida Hurricane History. UNC Publishers; 2007:1–407.
20. Mykle R. Killer ’Cane: The Dealy Hurricane of 1928. Cooper Square Press; 2002:232.
21. Kleinberg E. Black Cloud: The Deadly Hurricane of 1928. New York, New York, USA: Carroll & Graf Publishers; 2003:283.
22. Leatherman S. 10 Most Vulnerable Areas to Hurricanes. Hurric Cent. 2006. Available at: http://www.hurricanecenter.com/hurricane-information/top-10-most-vulnerable-areas-to-hurricanes/. Accessed May 1, 2012.
23. Leatherman S, Zhang K, Xiao C. Lake Okeechobee, Florida: The next hurricane disaster? Water Resour Impact. 2007;9:5–7.
24. Morgan C. A Vulnerable Lake Okeechobee. Maimi Her. 2013. Available at: http://www.miamiherald.com/2013/09/20/3639411/a-vulnerable-lake-okeechobee.html.
25. U.S. Department of Housing and Urban Development (H.U.D.). 2014. Available at: http://portal.hud.gov/hudportal/HUD?src=/states/florida/offices.
26. Guidance on Planning for Personal Assistance Services in General Population Shelters. Fed Emerg Manag Agency. 2010:24. Available at: http://www.fema.gov/pdf/emergency/disasterhousing/guidance_plan_ps_gpops.pdf. Accessed February 2, 2011.
27. Map of Florida. Map-of-Florida.net. Available at: http://www.map-of-florida.net/florida/.