Disaster, Older Adults and Philanthropy
Prepared by Jennifer W. Campbell, MA, MSW, PhD, Grantmakers In Aging and Graduate School of Social Work and Social Research, Bryn Mawr College.
Hurricane Matthew, Typhoon Haiyan, Hurricane Sandy, the Japanese tsunami, the Haiti earthquake, Hurricane Katrina, the Nepal earthquake – these disasters grabbed the headlines and riveted our attention. When the unthinkable happens and entire areas are devastated, we are stunned, helpless, and overcome by the human tragedy that is unfolding.
But the story beneath this story is of older adults who are rendered infinitely more vulnerable in a disaster. Older adults are more likely to die in a disaster than other groups:
- Typhoon Haiyan in Philippines (2013): More than a million older Filipinos have been affected or displaced, and one out of three who died was over the age of 60.
- Hurricane Sandy (2012): Half of the victims were older adults.
- Japanese tsunami (2011): Older adults comprised 65 percent of the victims.
- Hurricane Katrina (2005): 70 percent of the dead were older adults.
A disaster by definition is a situation where the needs of people are more than the response system can handle. How often do disasters occur? Governor Cuomo of New York quipped after Hurricane Sandy that New York “has a 100-year old flood every two years now.” FEMA has documented that every state or tribal government in the U.S. has had at least one major disaster declaration, and that most areas have had many more. The United States has experienced 589 major disaster declarations since 2005 when Hurricane Katrina hit. Every state has experienced a disaster. Everyone has a stake in disaster planning.
As much as philanthropies try to assist older adults when disaster strikes, they often find it very challenging to respond for two reasons: philanthropies need to understand the nuances of disaster philanthropy, and also need to understand the specific vulnerabilities of older adults in a disaster.
Impact of Disasters
Why are disaster-related death rates so much higher for older adults?
- Not moving out of harm’s way: Being unable to move quickly out of harm’s way can become a terminal diagnosis. Forty-two percent of Americans over 65 has some kind of functional limitation, which could be a hindrance in a disaster.
- Slow or reluctant to evacuate: For many older adults, home is where they feel safest. There is always a contingent that refuses or is unable to evacuate, putting both themselves and rescuers at risk. HelpAge’s Mark Gorman also points out that older people are often reluctant to seek assistance, feeling that others need it more than they do.
- Past performance is no guarantee of future returns: In the Gulf States, past hurricanes are well-remembered and often referred to like crazy maiden aunts with quirky personalities, as in, “I didn’t evacuate for [Hurricane] Bertha, and well, you know Bertha…” But decisions not to evacuate based on these past experiences often turned out to be deadly gambles.
- Chronic conditions can deteriorate quickly: Chronic health conditions, even if they are well-managed, depend on daily medication. About three quarters of all Americans over 65 have two or more chronic conditions, and many take between four and eight prescription drugs. Without access to medication (often the case in post-disaster chaos), conditions such as diabetes, high blood pressure, and heart disease quickly become acute problems. Add fear, stress, and grief to the mix, and the risk of death rises exponentially.
- Cut off from help: Homebound older adults can be nearly invisible to neighbors, rendering them extremely vulnerable in a disaster. A building with no elevator - or an elevator rendered useless by a disaster - may further isolate older adults. We experienced this problem in the U.S. during Hurricane Sandy, particularly in high-rise apartment buildings that lost power and stranded older people on high floors. A web of connections to family and friends keeps people safe during times of danger. When those connections are too few or too fragmented, that safety net breaks and older adults are left to fend for themselves.
(For an expanded discussion of these issues, see the article by Dr. Campbell and Dr. John Feather, CEO of Grantmakers In Aging, in the Huffington Post.)
The Role of Philanthropy
Philanthropy often finds disasters challenging to respond to for a variety of reasons:
- Unplanned event: Natural disasters are a poor fit with careful, strategic, multi-year strategic philanthropic plans.
- Zone of giving: Disasters are often outside of philanthropies’ regional zone of giving.
- Whom to partner with? Finding a local partner is critical post-disaster. But many local organizations are also affected by the disaster and may have offices destroyed and staff displaced. Yet the question remains as to who will be a reliable partner to ensure that the funds given will be handled responsibly? During the immediate aftermath of a disaster it is difficult to establish effective partnerships if none were in place prior to the disaster. Finding a vetted partner with adequate capacity and proven reliability is a challenge.
- Need for quick decisions: Many philanthropic organizations respond to requests only a few times a year. This slow turnaround is a poor match for the immediate needs in a disaster.
- Whose jurisdiction? In a disaster, it is often not clear if the government has responsibility to pay for certain services, or if those services are truly unmet needs that are appropriate for philanthropic intervention.
Once philanthropy decides to respond to a disaster, there are still decisions to be made about which type of disaster funding to award. The Center for Disaster Philanthropy notes four distinct phases of the disaster life cycle:
- Mitigation: Disaster mitigation work involves directly preventing future emergencies and/or minimizing their negative effects. It requires hazard risk analysis and the application of strategies to reduce the likelihood that hazards will become disasters, such as flood-proofing homes or buying insurance.
- Disaster preparedness: Disaster preparedness efforts include plans or preparations made in advance of an emergency that help individuals and communities get ready. Such preparations might include the stocking of food and water, or the gathering and screening of willing volunteers.
- Disaster response: Disaster response work includes any actions taken in the midst of or immediately following an emergency, including efforts to save lives and to prevent further property damage. Ideally, disaster response involves putting already established disaster preparedness plans into motion. Typically, this phase of the disaster life cycle draws the most attention.
- Disaster recovery:
-Disaster recovery happens after damages have been assessed. It involves actions to return the affected community to its pre-disaster state or better and ideally to make it less vulnerable to future risk. Risk identification includes understanding the nature of hazards as well as understanding the nature of vulnerabilities. Subsequent efforts may range from physical upgrades to education, training, and public awareness campaigns.
-Most people give immediately after a crisis, in response to clear emotional appeals. Yet donors who allocate funds across the disaster life cycle have an opportunity to help ensure that each dollar given reaches its full potential.
Tailoring Disaster Philanthropy to Older Adults
Funders interested in supporting older adults affected by disasters need to identify approaches which will ensure that assistance reaches their target population. These may include:
- Finding a trusted partner in the disaster zone who understands the needs of the local older adults.
- Caring for the caregivers - an important aspect of disaster philanthropy with older adults.
- Using the convening power of philanthropy to pull local and outside experts in aging to help conceptualize a response to disaster that will be effective.
- Supporting peer-to-peer programming can be very effective by using older adults to reach out to other older adults post-disaster.
- Helping older adults rebuild resilience as part of the recovery process.
Other lessons from disaster philanthropy include:
- Creative solutions emerge from disasters: new leaders, new organizations and new initiatives can follow a disaster. Philanthropy has an opportunity to be a catalyst to support innovation post-disaster.
- Consider small grants with a quick turnaround.
- Be prepared that disaster grants may not produce the same high level return-on-investment that “regular” grants do.
Examples of Funders Who Have Targeted Older Adults and Disasters
Funders have stepped up to respond to disasters and have combined their knowledge about philanthropy, disasters and older adults and to provide strategic assistance following disasters.
After Hurricane Katrina, the AARP Foundation created the AARP Foundation Disaster Relief and Recovery Fund with a commitment of $1 million in matching funds. Members and employees contributed to the fund. They ultimately funded $3.5 million in four rounds of funding. AARP Foundation then responded to the Haiti earthquake ($1.5 million), the Japanese tsunami ($142,340), Hurricane Sandy ($1.6 million), the Oklahoma tornado ($.6 million) and Typhoon Haiyan ($1.1 million). AARP was able to draw on a rich history of existing partnerships to ensure that the funds they granted were carefully targeted to meet the needs of vulnerable older adults.
The Altman Foundation and the New York Community Trust both funded the New York Academy of Medicine to develop recommendations to improve disaster response for older adults. The Altman Foundation grant of $100,000 was awarded right after the Hurricane Sandy, and the New York Community Trust grant of $185,000 was awarded the year following the storm.
Following Hurricane Katrina, the John A. Hartford Foundation funded a study on hurricane and disaster preparedness for long-term care facilities. Their objective was to support the development and testing of disaster training exercises, and to disseminate these tools across the country to nursing homes and assisted living facilities in order to reduce the deaths and suffering of frail elders during hurricanes and other disasters.
With generous support from The Atlantic Philanthropies and the Robert Wood Johnson Foundation, Grantmakers In Aging created the Hurricane Fund for the Elderly, designed to focus on the needs of older adults after Katrina. It brought $4.8 million in new funding to the rebuilding of services for older adults. Funders included the AARP Foundation, The Atlantic Philanthropies, John A. Hartford Foundation, Los Angeles – Jewish Federation, Louisiana Disaster Recovery Foundation, Lower Pearl River Valley Foundation, New York Community Trust, The Retirement Research Foundation, the Robert Wood Johnson Foundation, UJA-Federation of New York, United Jewish Communities – Federation Services, and “The Woods” Charitable Trust. Each of these foundations stepped out of its traditional philanthropic cycle of giving to respond to extraordinary events that had deeply affected the lives of older adults. Building on established relationships, they were able to move relatively quickly to respond to targeted needs for older adults.
Grantmakers interested in funding on issues of disaster preparedness might want to examine the following issues:
- Lack of Extensive Literature on Disasters, Older Adults and Philanthropy. Although there is a good deal of literature about philanthropy and disasters, there is much less that focuses directly on the needs of older adults in a disaster. Thus each philanthropic organization that wants to support older adults post-disaster needs to work closely with members of the aging services community to figure out how best respond to the needs of older adults in a specific disaster.
- Weather Patterns Changing: The Center for Disaster Philanthropy notes that climate change, with its frequent temperature extremes and weather whiplash, loads storms with more energy, increasing their intensity and often, their range. Communities (and funders) need to be prepared for more intense storms and the economic impact of the damage from such “super storms.” Funders can help by focusing on educating people about climate change, funding research on climate-related illnesses that affect older adults (such as asthma and hypothermia), and awarding grants that support building affordable housing and small business recovery after disasters.
- Changes in Services for Older Adults: Many changes in the service system for older adults are in process and have the potential to positively affect older adults impacted by a disaster. The Administration on Aging has transitioned to Administration for Community Living, linking older adult issues and disability issues together. While this merger has the potential to better serve older adults, it will be important to monitor the how the needs of older adults fare during this shift at the Federal level
Disasters provide both an opportunity and challenge for the philanthropic community. Because disasters do not fit neatly into the planning process that guides most philanthropic organizations, disasters require that funders step outside of the structures that usually guide them. Funders then have the opportunity to work with local partners, being alert to creative solutions and looking ahead to consider how to best leverage limited dollars. A capacity to work within a rapidly-changing environment is crucial. When faced with how to best to respond to the needs of older adults in a disaster, funders need to combine their knowledge of all three components of this work: knowledge about philanthropy, older adults and disasters.
Source: Grantmakers In Aging February 2014
Administration on Aging, “Keeping Older Adults and People with Disabilities Safe and Healthy During Emergencies,” 2014. ACL also published “Just in Case: Emergency Readiness for Older Adults and Caregivers,” in 2006. Kit includes a fact sheet and checklist, and a video.
Alzheimer’s Association, “Disaster Preparedness: Home and Community-Based Services for People with Dementia and their Caregivers,” (undated).
Campbell, Jennifer W., “What’s Brewing on the Disaster Preparedness Front?,” Aging Today, October 23, 2012.
Center for Disaster Philanthropy, “Issue Insight: Older Adults and Disasters,” May 5, 2014.
Centers for Disease Control, “Identifying Vulnerable Adults and Legal Options for Increasing Their Protection During All-Hazards Emergencies: A Cross-Sector Guide for States and Communities,” March 2012. This booklet covers topic areas such as developing plans, partnering and collaboration, using data for action, building registries, using law-based solutions, sheltering, and caregiver preparedness. In addition to being informative, it is a very good read, full of examples of exciting and innovative work that communities are doing to improve ways older adults fare in a disaster.
Feather, John and Campbell, Jennifer W., “Why Older Adults Face More Danger in Natural Disasters,” The Huffington Post, December 18, 2013.
New York Academy of Medicine, “Resilient Communities: Empowering Older Adults in Disasters and Daily Life,” July 2014.
Philanthropy New York, “Best Practices in Disaster Grantmaking,” 2008. Created with support from the Ford Foundation this report is designed to share knowledge about philanthropic responses to the hurricanes that were deemed, by both funders and grant recipients, to be “successful.”
Organizations Involved in Disaster Preparedness
AoA: The Administration on Aging: AoA has become a part of the Administration for Community Living. Staff from the Administration for Community Living work with ASPR making plans for disaster preparedness.
American Red Cross: The Red Cross is a national humanitarian organization that provides disaster response. Much of its work related to older adults is carried out by its local chapters.
ASPR: Office of the Assistant Secretary for Preparedness and Response: The Secretary of Health and Human Services (HHS) delegates to ASPR the leadership role for all health and medical services support functions in a health emergency or public health event. The creation of ASPR consolidated planning for disasters and also helped to build federal emergency medical operational capacity during an emergency or disaster.
Center for Disaster Philanthropy: The Center’s mission is to help funders make more thoughtful disaster-related giving decisions and maximize the impact of their gifts. It provides information and resources that promote more strategic grantmaking related to disaster preparedness and recovery.
CDC: The Centers for Disease Control and Prevention - Healthy Aging Program: This program produces some excellent material on disaster preparedness. The CDC Healthy Aging Program provides content expertise on the specific vulnerabilities of older adults and resources to better protect them.
FEMA: Federal Emergency Management Agency: FEMA helps citizens and first responders work together to build and improve capacity to prepare for and recover from all hazards. FEMA also tracks data about disasters.