Survival of the Un-Fittest -- What to Do for the Ill, Disabled and Elderly, by Echo A.

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Part of preparing for any emergency, including TEOTWAWKI, is making plans for those who cannot take care of themselves. Yet, there is very information out there about what to do about Grandma and Grandpa in a crisis situation, or those who just may not be the “fittest.”   Having elders who have been struggling with dementia or who are in cancer treatment, having seen so many of our soldiers come home with PTSD, having loved ones who are chronically ill or permanently disabled, I think about prepping in perhaps a different way than others. After seeking out the information I needed myself from doctors, mental health professionals and fellow preppers, I am now sharing some of the practical advice I’ve found for helping those we love who do not appear to be the best candidates for survival. Why?

For some, caring and preparing for those with less than optimal survival chances may seem like a foolish, even dangerous, goal. Certainly, some soul-searching is required when thinking about who you are willing to “carry” (figuratively and perhaps literally), and just how far you are willing to put yourself and other members of your group in jeopardy to care for someone who may not make it in even a best-case scenario.  You will have to make your own decisions about who to help and who to abandon. But I could not leave my parents, in-laws and grandparents any more than I could leave my children to weather the chaos on their own. I also cannot justify leaving other relatives or friends where they could be victimized by those who prey on the weak. The Biblical commandment to “honor thy father and mother” means not just that I honor them, but that I must also care for them in a crisis. I cannot bear the consequences of writing them off, or leaving them to the unkindness of strangers or the bureaucracy of FEMA. The same goes for all of those I am responsible for, by virtue of my being able, even if they are not.

In the case of illness or dementia, even if it meant that moving them might hasten their deaths, I would choose to care for my own family and friends. Perhaps it is my own rationalization, but I would prefer that if they do indeed die, they do so in the company of people who love them and who will treat them with dignity, not at the hands of mobs or criminals.

If my loved ones were currently in a hospital, nursing home or assisted living situation, I would know the facility’s emergency plan and contingency plans. In case of an emergency, would my people be evacuated, by what means, by whom, and to where? (And I would make my own plans to take custody of them instead).  I would try to be as low-key as possible to avoid alarming the powers that be about any specific disaster or emergency, but I would get the information that could protect them, and make it possible for me to intercept them as quickly as possible in a crisis.

For those who require daily prescription medications, such as cardiac patients, diabetics, epileptics and other chronic illness patients (including those recovering from cancer treatment), some logistical planning now will save anxiety and life-threatening repercussions later.

You will need to know (and have written down) all medications, what they’re for, dosing schedules, and danger signs to watch for. At first, the problem will be in stockpiling enough medication when most insurance covers only minimal monthly quantities. Many times though, a sympathetic physician can prescribe a twice-daily med instead of a once-daily, for example. Explain you’d like to keep a back-up supply for the patient in case of loss, misplacing or forgetting when traveling.

As your supply grows, be especially diligent about rotating meds, using the oldest for current needs and storing the newest in a cool, non-humid environment, and including desiccant packets whenever possible.  (Ask your pharmacy, as they throw these out by the hundreds). 

One of my doctor friends tells me that more than 80% of his geriatric patients are on mood-altering drugs. A similarly large percentage of handicapped and cancer patients are routinely put on these drugs as well. For those who are on antidepressants, antipsychotics or anti-anxiety meds, benzodiazepines or steroids, special cautions apply. These drugs can cause terrible effects if stopped suddenly, and most require a very gradual weaning off the drug if one wishes or is forced to discontinue use. Check with your patient’s physician, and do your own research on ALL of the drugs your patient is taking ( is an excellent resource), and plan accordingly.

While health can vary widely among seniors, there are specific concerns that are common to most. Circulation issues such as edema, bruising and bleeding, dehydration, and constipation can all be more serious in the aged, no matter what the fitness level. Falls and resulting injuries should always be avoided and prevented, as the consequences for elders can be much more serious than normal.
Simple observation and precaution about everyday conditions is necessary. We lose the ability to adapt rapidly to temperature variations as we age—most elderly people feel “cold” faster than younger companions and are at special risk of hypothermia. Your preparations will have to include supplies that ensure more warmth, such as extra clothes, hats, socks & gloves, and you will have to be vigilant in caring for elders who get wet or chilled.

Response to heat or exercise can also be a problem. Fluid intake of seniors must be monitored closely at all times. Dehydration during exertion or other stress may occur rapidly and without warning, causing diarrhea, vomiting, delirium and ultimately, death.

Many seniors will have dietary deficits, due to waning appetite, poor digestion, or self-sacrifice for others’ needs. Without adequate fiber-rich foods (or supplements) and liquids, constipation can become a life-threatening situation for an elder, not merely a painful inconvenience. Stool softener and laxatives should have a starring place in your senior’s medical kit. Lack of vital nutrients may also affect sight, hearing and balance. Keep an eye on their diets and make sure they get the nutrition they need.

Seniors are subject to painful and dramatic bruising when injured, especially if they have been on blood-thinning medications, commonly prescribed to prevent arterial plaques and stroke. Excessive bleeding and inability to clot are also effects of these drugs. Avoid injury first, and if unsuccessful, treat bruises and bleeding quickly to forestall further complication. Every cut or abrasion is also a potential site for infection, which can overwhelm one who is already weak, so be particularly aware of your charges’ skin condition.
Swelling of the extremities due to poor vascular circulation can incapacitate your older loved one. Compression socks, or in a pinch, elastic bandages, are a good addition to the clothing or first aid kit.

Preparation for your loved ones begins with talking to them. You may be surprised to find out that oldsters are more prepared than you thought. After all, many have lived through tough economic depressions and wartime shortages, and they know a thing or two about living well with less convenience. Someone whose breathing depends on oxygen may have already prepared for a power failure or disruption of supply. If not, you can help that person get prepared.  Someone who is overweight or in poor physical condition can benefit from a daily walk or strength training, even without the threat of an emergency. You might be the motivator or the companion to help improve the quality of that person’s life, now and in case of future crises.
Approach with a sincere offer of help, but be sure to ask what general and specific help they would need from you in case of an emergency. You do not know what the unique needs are until you ask.
For those that still don’t accept the idea that all sorts of manmade disaster and mayhem can happen here, and can happen at any time, the conversation can take place in the context of preparing for a natural calamity, such as a tornado, earthquake or fire.

Be aware that some of the sick, disabled and elderly may need to be convinced that their survival is possible, even probable, if they prepare themselves mentally and physically. You may hear this type of defeatism in statements such as “Don’t worry about me, I wouldn’t want to live in that world anyway…” Your people need to know that that a can-do, positive attitude combined with practical planning and preparation can up their chances. They need to know you’ll be there to help them. Most importantly, they need to know that their survival is of paramount importance to you.

You should not assume that because your parent is sick, your grandparent is old, your friend is diabetic, your relative is obese, or your neighbor is blind, that these people are helpless or even less than capable of survival.  Emotional strength, mental tenacity, technical skill sets or ethical leadership can quickly trump any physical challenges, depending on the situation. Lack of emotional resiliency or deteriorating mental stability can quickly turn a strong athlete into a greater liability to the group than Granny who needs a cane.
For example, I have a physically-fit friend who stocks an “earthquake kit,” a 72-hour stopgap to see her through a brief disruption of water and food supplies “until help arrives.” She refuses to consider anything more than that, because it would mean that she would be on her own for longer than she is willing to be. She refuses to own a firearm, because that would mean that she might have to use it. This head-in-the-sand attitude is not preparedness, in spite of her pride in running 10Ks on the weekends, having a few gallons of water and a three-day supply of food in the garage.
On the other hand, my 85-year old mother bought a retreat back in the 1970s, stocked it with supplies and learned to shoot. She has a stay-put plan, several bug-out escape routes, keeps her stock rotated, tests her equipment regularly and maintains situational awareness, even when she’s just going to the bank or grocery store. She has a mental toughness that belies the physical weaknesses of a woman her age.

All of the people you care about have combinations of physical and mental challenges. What we all have in common is our need to be useful, no matter what our abilities or lack of abilities. A person without functioning legs can still wield a weapon or man a security cam. Someone who is blind can still direct audio comms. Everyone has skills and talents that the family and community need, and the survival of the whole group dictates finding appropriate jobs for everyone.
Those who are critically ill or in the advanced stages of dementia may need to have round-the-clock caregivers, which could put a strain on community labor resources. The whole group would ideally have the same reverence and respect for all the members’ quality of life, even the infirm and ill.

Much of the information about surviving natural disasters or man-made insanities assumes that we will prepare not only our environment, but ourselves as well. In order to deal with a crisis, realize that while we are teaching ourselves new skills, setting aside food stores, preparing security and energy options and planning for those who are weaker than ourselves, we must diligently prep our own minds and bodies to withstand the multiple demands that will be required.

Knowing that stresses of panic, physical exertion, mental exhaustion, and lack of sleep will pile up and collapse you if you are not ready, is not enough. Add in caring for others who are young, old, chronically ill, obese, disabled or just darn difficult, and your preparedness becomes even more critical.
Part of the process requires that we must be physically fit ourselves before we can take care of others. So put down that list and go exercise, at least some part of every day! Do not allow yourself to become out of shape, while you’re stockpiling supplies and securing your environment. There are people depending on you. Make sure you are the fittest you can be, physically and mentally. Then you can expend energy on building a community that includes everyone you care about, even the unfit.

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This page contains a single entry by Jim Rawles published on August 5, 2012 1:59 AM.

Letter Re: Halfway Preppers was the previous entry in this blog.

Notes from JWR: is the next entry in this blog.

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