Nursing Homes' Hard Choice: Stay or Leave?

By Peter Whoriskey
Washington Post Staff Writer
Sunday, October 23, 2005

NAPLES, Fla. Oct. 22 -- A hurricane is forecast to hit this city, a mandatory evacuation order is in effect for coastal areas, and many residents are packing up and fleeing.

The 108 residents of the Lakeside Pavilion nursing home, however, are staying put.

After days of gazing at the Weather Channel and the Web site of the National Hurricane Center, the operators of the home have decided not to evacuate the patients, most of whom are in wheelchairs and some of whom would have to be transported with intravenous lines, feeding tubes or oxygen tanks.

It is the kind of decision that "hampers your sleep," said nursing home administrator Bill Maggard.

"I made a decision yesterday that I think it's safer to keep my residents here," he said Saturday.

The decision to stay or flee in the event of a hurricane can be difficult even for the able-bodied. But as the evacuations for hurricanes Katrina and Rita showed this year, the decisions made at nursing homes more likely could be a matter of life and death. Several nursing home patients died in Louisiana because they were not evacuated before Katrina hit, and in one case the owners of a home were charged with negligent homicide. On the other hand, several nursing home patients perished because they were evacuated; they died in transit.

There are 28 nursing homes in Collier County, where officials were preparing to bear the brunt of Hurricane Wilma. And of the seven that are in the coastal area where a mandatory evacuation order is in effect, three had been evacuated by Saturday, officials said. The others were either preparing to evacuate or were still waiting to make a decision based on the forecast of the storm's path and severity.

As nursing home operators pondered their decisions, forecasters issued a hurricane warning for all of southern Florida, including the Keys, as Wilma displayed her destructive power on Mexico's Yucatan Peninsula. Though the storm was downgraded to a Category 2, its sustained winds, clocked at 100 mph, raked the Mexican coastline for the second day, tearing off roofs, downing trees and power lines, and forcing tourists and residents trapped in hotels and shelters to seek refuge on higher floors. At least three people were killed.

"Never in the history of Quintana Roo have we had a storm like this," the Associated Press quoted Felix Gonzalez Cantu, the governor of the province that includes the resort sites of Cancun, Playa del Carmen and Cozumel, as saying.

On Saturday, modern storm history was made when a tropical storm formed in the Caribbean, 125 miles south-southeast of the Dominican Republic. It was the 22nd tropical storm of the current hurricane season, the highest number on record.

The World Meteorological Organization, the U.N. agency that names storms, has dubbed the latest one "Alpha," using the first letter of the Greek alphabet because, after Wilma, it had run out of letters from the Roman alphabet. (Names beginning with Q, U, X, Y and Z are never used.) It was the first time meteorologists have had to turn to the Greek alphabet to name a storm. The hurricane season does not end until Nov. 30.

In Florida, where Wilma is expected to make landfall sometime on Monday, Collier County's emergency management director, Dan Summers, estimated that about half of the county's residents have evacuated in the face of what is expected to remain a Category 2 storm.

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