Hurricanes Harvey, Irma, and Maria displaced millions of people this past August and September, leaving nearly incomprehensible wreckage in their wake. For those with neurologic disabilities, especially those unable to move around easily, the misfortunes were multiplied. As I write this, many are still in evacuation centers, worried about whether they will be able to return to their modified residences, and, if they can, whether their electric scooters, lifts, and other accommodations will be operational.
People with neurologic disorders face numerous additional challenges during and after a natural disaster. Many are at increased risk for exacerbations of their illnesses due to stress, dehydration, and lack of sleep. Others may not have access to medication or refrigeration. A disaster may interrupt medical treatment or disable lifesaving services.
A little more than 10 years ago, I interviewed several people with neurologic conditions who had been affected by Hurricanes Katrina and Rita. One woman, whose husband had amyotrophic lateral sclerosis, told me they were turned away from emergency shelters because he was dependent on a ventilator. Her husband finally got a bed at a medical center, but the experience was traumatic. Afterwards, she worked to create a step-by-step plan for the next evacuation.
Planning ahead for emergencies can be lifesaving, and you shouldn't wait until a disaster happens. Good resources are available to anyone who has a neurologic condition or is caring for someone with mobility, visual, auditory, speech, or cognitive impairments. The US Centers for Disease Control and Prevention, the American Red Cross, and patient organizations such as the National Multiple Sclerosis Society and the Alzheimer's Association offer advice for constructing a plan.
In this issue, we help you prepare for another type of catastrophe: the loss of a caregiver. Caregivers typically are not expected to die before those they care for. But because caregivers often neglect their own health, they are at risk for illness. If caregivers do die first, families are often thrown into a crisis as they struggle to pick up the pieces. Our "For the Caregiver" article provides practical advice on how to get organized in the event of such a worst-case scenario.
All of us at Brain & Life send our thoughts and best wishes to readers affected by Hurricanes Harvey, Irma, and Maria. As Dan Gasby says in our cover story, "Unforgettable," referring to how Alzheimer's disease has changed life for him and his wife, B. Smith: "The disease has made me realize how precious every little thing is." Watching the scenes from Texas, Florida, Puerto Rico, and the Caribbean has done that for so many of us.
Besides appreciating the little things, we also appreciate all our readers. Your letters in response to my last column, "Find Your Silver Lining," were an example of how you are often the ultimate experts. If you have a backup or emergency plan that you'd like to share, please write to us at BrainandLife@wolterskluwer.com.
Orly Avitzur, MD, MBA, FAAN
Editor-in-Chief
