June 2009 Issue

Be Prepared for Emergencies
By Becky Dorner, RD, LD
Today’s Dietitian
Vol. 11 No. 6 P. 12

In 2005, the hurricane season proved disastrous for Louisiana, Mississippi, Texas, and Florida. When Hurricanes Katrina and Rita hit the Gulf Coast, they wreaked havoc, death, and destruction. These storms may be the most costly natural disasters in U.S. history when measured in terms of loss of human life and damaged and destroyed property.

Approximately 1 million people were ordered to evacuate the Houston/Galveston, Tex., area due to Hurricane Rita. Freeways were jammed for hours, stranding evacuees without needed food, water, gasoline, and other supplies. Frail older adults evacuated from nursing homes sat on buses for up to 14 hours during the evacuation process.

The enormity of these disasters took many by surprise. No matter how well prepared people were, there were many situations they could not have predicted. The good news is that we can learn from these experiences and be ready when disaster strikes.

Risk Analysis
The first step when preparing for a natural or man-made disaster is to assess the likelihood of one occurring in your geographic area. Disasters can cause damage to electric and gas lines and water supplies. Repairs can take days due to closed roads, difficult travel and maneuverability, and hazardous conditions, and it may even be impossible for help to get through. With forewarning, there may be a need to evacuate. Those who choose to stay in a suspected danger area must make preparations to survive for days or weeks at a time.

Employee Training
To ensure that your employees are prepared for unexpected events, it is essential to train staff on the following:

• the contents of the overall emergency plan and the disaster feeding plan;

• the location of emergency equipment, food, water, and supplies;

• water purification techniques;

• sanitation/food safety;

• responsibilities in relationship to other departments;

• emergency contact numbers; and

• evacuation routes and routines.

Training should be part of initial orientation and should occur regularly thereafter. Mock disaster drills can determine the training’s impact and should be conducted at least twice per year. After each disaster drill, evaluate the staff’s response and the need for additional training and adjustments to the disaster plan.

Water Requirements
In the event of a loss of utilities, water may be unavailable or contaminated. Local authorities will notify area residents if water is unsafe. Purification methods include boiling and the use of chlorine bleach or water purification tablets.

The dietary department must have an adequate supply of water on hand for cooking, cleaning, drinking, and food preparation. A minimum three-day supply—and preferably seven-day—should be available. Additionally, the daily quantity of water that each resident will need can be determined by using the calculation in the accompanying table.

Food and Supplies
Always keep at least three full days’ worth (again, preferably seven) of food and supplies on hand. Prepare menus to use the perishable and potentially hazardous foods first. (Visit www.beckydorner.com for a sample three-day menu for emergencies.) Ensure that you also have the following supplies:

• emergency generators (train staff on which outlets are linked to the emergency power in your kitchen);

• cleaning supplies such as clean cloth towels or rags, household bleach, and hand sanitizers;

• a portable radio, a weather radio, nonelectric clocks, cellular telephones, flashlights, lanterns, and batteries;

• kitchen equipment such as manual can openers and egg beaters, potato mashers, and battery-operated, handheld blenders;

• fire extinguishers;

• first aid kits with alcohol swabs;

• gravity or bolus feeding supplies;

• water purification tablets;

• waterproof matches;

• a crowbar; and

• a tool kit.

Communications and Computer Systems
Plan a “phone tree” for emergency communications. Cell phones are the first backup for regular phone systems, and text messaging helps save batteries for extended cell phone use. Car chargers are useful, as long as gasoline is available to keep cars running. However, if cell towers are down or cell phone batteries run out, another backup plan must be in place.

Plan for a backup for computer systems and test it on a regular basis to ensure that it is working. Backup systems may include the use of generators to create the electricity needed to run the computer system and/or paper backup systems. Keep backup tape drives and other systems in a safe, accessible location.

If you have advance notice of a pending or potential disaster, print key information beforehand. Information such as patient/resident diet orders, food preferences, and allergies/intolerances will be essential to help professionals provide adequate care during evacuation or following a disaster.

Preparation Is Key
When disasters strike, the outcomes can be devastating. But you can survive and thrive if you are prepared, knowledgeable, adaptable, and calm during the experience.

— Becky Dorner, RD, LD, is a speaker and an author who provides publications, presentations, and consulting services to enhance the quality of care for the nation’s older adults. Visit www.beckydorner.com for free articles, newsletters, and information.

©2009 Becky Dorner & Associates. Excerpted from Dietary Disaster Plan, Becky Dorner & Associates, Inc, 2006.


Type of Water

Amount Needed


Example (7-day supply)

All-purpose water

1 gallon per person per day

# of people* X 1 gallon X 3 days (or 7 days)
= gallons of all-purpose water needed

100 people X 1 gallon X 7 days
= 700 gallons of all-purpose water

Drinking water

2 quarts (0.5 gallon) per person per day**

# of people* X 0.5 gallons** X 3 days (or 7 days)
= gallons of drinking water needed

100 people X 0.5 gallon X 7 days
= 350 gallons of drinking water

*Include residents/patients, staff, visitors, evacuees, and/or rescue workers, as appropriate.
**Hot climates can double the amount of fluid needed. If you are located in a hot climate area, increase the amount of drinking water to 1 gallon per person per day. You may also want to adjust the amount of all-purpose water accordingly.
Note: Please check your state regulations for specific quantities of water required.