Emergency and disaster planning

A storm, a long power outage or an order to leave home is hard for anyone. For a person living with dementia, it can be much harder. New places, noise, crowds and a broken routine can bring on fear, confusion and wandering.¹

The good news is that a little planning goes a long way. This page helps you pack a go-bag, gather medical papers, get through a power outage, and leave home safely if you must.

Why emergencies are harder with dementia

A person with dementia may not understand a weather warning. They may forget what you told them an hour ago. They may refuse to leave a familiar home, or become upset in a crowded shelter.

The Alzheimer's Association warns that travel, new surroundings and changes in routine raise the risk of agitation and wandering.¹ Late-day confusion, called sundowning, can make evenings in a shelter or hotel even harder.¹

Older adults also have other risks. Their bodies handle heat less well, and many take medicines that affect how they sweat or control body temperature.⁸ They are also more likely to get seriously ill from carbon monoxide (a poison gas with no smell).⁴

Step 1: Make a plan with your helpers

You cannot do this alone. Build a small team of family, friends and neighbors who can step in.² The care circle tool can help you list names and jobs.

1. Pick at least one backup person. Give them a key to the home. Show them where the emergency supplies are and how to give medicines or use any medical equipment.²
2. Plan a way out. Decide who will drive and where you will go, such as a relative's home outside the area. Plan for a walker or wheelchair too.^1,2
3. Learn other people's plans. If the person goes to an adult day center or lives in assisted living, ask about their disaster plan. Ask who is in charge of moving people out.¹
4. Ask about the dialysis center or clinic. If the person gets regular treatment, learn the clinic's emergency plan and find a backup place.²
5. Share medical papers. Give copies of the medical history, medicine list and doctor contacts to people other than the main caregiver.¹
6. Post emergency numbers. Keep a list for police, fire, the hospital and poison control near the phone.¹⁴

Watch the weather. If a big storm is coming, move routine appointments to another day.¹ Sign up for alerts from your city or county so you hear about evacuations early.¹¹

Step 2: Pack a go-bag

Store the bag in a waterproof container that is easy to grab. Put medicines and papers in waterproof bags too.¹ Swap out water, food, medicine and batteries before they expire.¹¹

Basic supplies for the household

• Water: about one gallon per person per day, for several days³
• Food that does not spoil, plus a hand can opener³
• A battery or hand-crank radio, a flashlight and extra batteries³
• A first aid kit and a whistle³
• A cell phone charger and a backup battery^1,3
• Some cash³

Extra items for the person with dementia

• Clothes that are easy to change and fit the season¹
• Slip-on or Velcro shoes¹
• Spare glasses, and hearing aid batteries if they use them
• Incontinence pads or briefs, if needed¹
• Liquid meals or soft foods they like¹
• A comfort item, such as a family photo, a favorite blanket, a purse or hand lotion¹
• A recent photo of the person, in case they get lost¹
• An ID bracelet and labels sewn into clothing¹

Medicines

• Extra supplies of prescription medicines¹
• A written list of every medicine and how it is taken¹
• Medical supplies, plus batteries and chargers for any devices²

Talk with your pharmacist before a disaster about keeping an emergency supply. Ask how emergency refills work in your state.⁵ See managing medicines at home for more help. Never stop or change a medicine on your own. Talk with the doctor or pharmacist first.

Step 3: Gather important papers

Make copies of these papers. Keep one set in the go-bag and one saved as a secure electronic file.¹

Mail can be slow for weeks after a disaster. Ready.gov suggests getting federal benefits by direct deposit or a prepaid debit card so payments keep arriving.²

ID and wandering programs

A person with dementia who is lost in a disaster may not be able to say who they are. An ID bracelet helps. MedicAlert runs a 24-hour service with the Alzheimer's Association. It gives first responders the person's medical facts and helps when someone with dementia goes missing.¹³ If you sign up for a service like this, put its phone number in the go-bag.¹ Learn more on our page about wandering and getting lost.

Power outages

Power outages are the most common emergency for many families. Plan for them before a storm.

Medical equipment

If the person uses oxygen, a CPAP machine, a power wheelchair or other electric equipment, plan for backup power. Keep spare batteries and chargers ready.² Keep portable oxygen tanks where you can reach them.¹ Ask your power company whether it keeps a list of customers who use medical equipment.

The federal emPOWER program helps local health agencies plan for people on Medicare who live at home and depend on electric medical equipment or certain home health services. It counts more than 4.6 million of them.¹⁰ Still, you should not count on someone coming to check. Have your own plan.

If medical equipment is lost or ruined in a disaster, call the supplier. Medicare may be able to replace it. If you have a Medicare Advantage plan, call your plan. You can also call 1-800-MEDICARE (1-800-633-4227).⁹

Generators and carbon monoxide

Put carbon monoxide and smoke detectors near sleeping areas. Change the batteries when you change the clocks in spring and fall.^4,14

Medicines that need the fridge

Some medicines lose strength if they get too warm. Check the label or ask a pharmacist whether a medicine is still safe to use.⁵ For insulin, the FDA says opened or unopened vials and cartridges can be kept out of the fridge between 59 and 86 degrees F for up to 28 days.⁶ Do not use insulin that has frozen.⁶

Throw away medicines that touched floodwater. The FDA allows one exception: a lifesaving medicine with no replacement may be used if it looks normal, until you can get a new supply.⁵

Food safety

A closed fridge keeps food cold for about 4 hours. A full freezer stays cold for about 48 hours, or about 24 hours if half full.⁷ Throw out meat, fish, eggs and leftovers after 4 hours without power. Never taste food to see if it is safe. When in doubt, throw it out.⁷

Heat and cold

Older adults are at higher risk of heat illness.⁸ A person with dementia may not notice they are too hot or thirsty, or may forget to drink.

• Keep them in air conditioning as much as you can. A fan alone is not enough on very hot days.⁸
• Offer water often, before they feel thirsty. If the doctor limits fluids, ask how much to give in hot weather.⁸
• If you have no air conditioning, call your local health department to find a cool place.⁸
• Watch for muscle cramps, headache, nausea or vomiting. Get medical care right away if you see these.⁸

In winter outages, dress the person in layers and keep them in one warm room. Do not use the oven or a gas stove to heat the home, because it can cause carbon monoxide.

If you have to leave home

1. Leave early. If an evacuation is likely, do not wait. Leaving early helps you avoid traffic and crowds.¹
2. Tell people where you are going. Let family, friends and doctors know you are moving. Update them as you go.¹
3. Stay together. Do not leave the person with dementia alone, even for a moment.¹
4. Tell staff about the diagnosis. When it fits, tell shelter, hotel or airline workers that the person has dementia so they can help.¹
5. Care for the body first. Make sure the person is warm or cool enough, has had water, and has used the bathroom. Then comfort them.¹
6. Stay calm. The person picks up on your mood. A calm voice helps them feel safe.¹

If there is no time to prepare, focus on safety. Grab the phone charger, water, medicine and weather-fit clothes if you can do it fast, and go.¹

Coastal Virginia: know your zone

Virginia's Know Your Zone program covers about 1.25 million people in 23 coastal localities. Hurricane evacuation zones are labeled A to D. You can look up your zone by address at KnowYourZoneVA.org.¹¹ The Virginia Department of Emergency Management (VDEM) explains that you only need to move to a higher zone that is not being evacuated.¹¹ For other help after a storm, you can dial 2-1-1 in Virginia.¹¹

Shelters

The American Red Cross keeps a map of open shelters. Bring bedding, clothes, medicines and your go-bag. Tell staff about any medical equipment, supplies or special diet when you arrive. Red Cross shelters are accessible to people with disabilities and can help replace lost prescriptions and glasses.¹² Service animals are welcome, and shelters try to make room for pets, sometimes in a separate area.¹²

A shelter can be loud and bright. Ask staff for a quieter corner. Bring the comfort item from the go-bag, and try to keep meals and bedtime close to the usual times.

If the person goes missing

People with dementia are more likely to wander during the chaos of an emergency.¹ Search the nearby area right away. Most people who wander are found within half a mile of where they started.¹

After the emergency

Expect the person to be more confused or upset for a while after a disaster. Return to the usual routine as soon as you can. Watch for signs of illness, such as fever, new confusion or not eating. A sudden change in thinking can be delirium (sudden confusion from illness), which needs a doctor.

Take care of yourself too. Disasters are stressful, and caregivers often put their own needs last. Lean on your helpers, and see caregiver stress and burnout. A short breathing practice like the cyclic sigh can help in tense moments. If you feel hopeless or overwhelmed, call or text 988 to reach the 988 Suicide and Crisis Lifeline.

When to get help

• Call 911 for a fire, trouble breathing, chest pain, signs of carbon monoxide, heat stroke, or a missing person.
• Call the doctor or pharmacist if you lose medicines or they get wet, too hot or frozen.⁵
• Call the Alzheimer's Association 24/7 Helpline at 800-272-3900 for dementia advice at any hour.¹
• Dial 2-1-1 in Virginia for local help with food, shelter and other needs.¹¹

For other risks at home, see making the home safer and the safety hub.

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.