THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Sunday, September 10, 1995 TAG: 9509110211
SECTION: LOCAL PAGE: B3 EDITION: FINAL
SOURCE: BY MARIE JOYCE, STAFF WRITER
LENGTH: Long : 101 lines
Three weeks ago, as Hurricane Felix loomed, the Virginia Beach Health Department decided to try something new - a shelter equipped to help people with special medical needs.
After Felix fizzled, health officials stepped back to review lessons learned. They learned this:
People with major health problems need to get out of town before a hurricane, or stay at home and get someone to stay with them and take care of them. There's no facility here that can help.
And they need to be making those arrangements now, says the Virginia Beach health director, before the next hurricane threatens.
The issue is more crucial now than it was five years ago: More sick people are recuperating at home. Hospitals usually no longer keep patients who have chronic medical needs. To cut costs, they are sending people home much earlier than before, replacing round-the-clock assistance with visits from a home health nurse.
The special-needs shelter was an experiment. Officials chose Larkspur Middle School, and staffed it with two public health nurses - other shelters had one - plus social services workers, volunteers, police, an ambulance team to take emergency cases to the hospital.
They envisioned it as a place offering basic help. For instance, someone with asthma might stay there, since stress can trigger an attack and the person might need to be taken to the hospital.
``We would just be there in case something happened,'' said Patricia Holbert, one of the public health nurses who staffed the shelter.
About 50 of the people who came to the shelter fit that description, she said, including a young woman with a seeing-eye dog who needed help caring for her dog in a strange place. Several pregnant women who were approaching their due dates showed up.
Another visitor came all the way from North Carolina. She could breathe only with help from an oxygen machine, and she was concerned about power outages. Her husband was there to help her.
But the shelter also got calls from people they couldn't help. One man had just been released from the hospital and was encased in a full body cast. He was living in a trailer. The public health workers didn't have enough people to go pick him up, and if he had arrived at the shelter, said Holbert, they wouldn't have had the staff to move him, a hospital bed to put him on or equipment to care for him. And the nurses, who usually work with health maintenance and disease prevention, aren't experienced in caring for very ill people.
Other residents who asked but couldn't be helped included a person who was paralyzed, a another with a feeding tube in his stomach and a one on a respirator.
``It's just too complicated,'' Holbert said. ``You're not surrounded with the equipment you need to take care of that person.''
The shelter got three calls from hospitals wanting to direct people there.
``There's a whole group of people who are cared for at home. . . If (these) people can stay in their homes, they're probably better off there,'' said Dr. Suzanne Dandoy, Virginia Beach health director.
``The hospitals are not going to take them. The hospitals need to be available for people who are acutely traumatized.''
Hospitals, she said, are not geared any more for maintenance. ``The system has changed.''
So what should chronically ill people do? Start planning now, Dandoy said.
``People need to take personal responsibility,'' said Dandoy. ``If they have family somewhere else in the state, they might be talking to them.'' Or they should make arrangements to have someone stay with them.
``This is not one of the things the government can take care of,'' she said. ILLUSTRATION: Graphic
WHO CAN USE THE SHELTER
It's not certain that Virginia Beach will sponsor another
special-needs shelter. If it does, it will be able to offer only
very basic aid. Here's a general list of who can and cannot use the
shelter.
The shelter cannot serve people who:
Need hospital beds.
Need isolation, either because they are carrying a dangerous
infectious disease or because their health puts them at particular
risk.
Are on a respirator.
Need constant supervision, unless they bring an assistant with
them.
Need a tracheostomy (an opening in the windpipe) and need
frequent suctioning.
The shelter can serve people who can handle their own special
needs or can bring a family member or assistant to help them. This
includes people who:
Have a catheter they can take care of themselves, or that someone
with them can take care of.
Use a wheelchair.
Use a walker or crutches.
Have a tracheostomy but do'nt need suctioning.
Are incontinent, but can bring supplies and have an assistant to
provide care.
Need oxygen, but can bring their own tank and equipment.
by CNB