Local Risks · Household Guide
Most 72-hour guides assume every household member can carry a bag, read a map, and move quickly. This guide is for households where that assumption doesn't hold, and where the right plan is worth more than any piece of gear.
Build your household planThe starting point
A household that includes an older adult, particularly one with chronic conditions, mobility limitations, or cognitive changes, has a different set of vulnerabilities than the standard preparedness template assumes. It also has a different set of strengths.
This guide works through five areas where the standard plan falls short: medications, mobility and evacuation, power-dependent medical equipment, comfort and orientation during disruption, and the caregiver backup plan. Each section is specific. Nothing here requires buying expensive gear first.
Start with the medication plan. Everything else follows from there.
First priority
In almost every disruption, medication management is the highest-stakes logistics problem in a household with an older adult. The list below gets it in order before any emergency happens.
One document. One place. Update it every time anything changes.
Print three copies: one in the ready bag, one on the refrigerator, one with the backup caregiver. Photograph the list and store it in your phone's camera roll.
Most pharmacies will refill a prescription when 25% of the supply remains. Use that window.
Ask the prescribing physician directly: "What happens if this medication is missed for 24 hours?" The answer changes your evacuation priorities.
Insulin, some biologics, and eye drops require temperature control. A power outage changes the math immediately.
One waterproof folder. Ready in the ready bag.
A $6 waterproof document pouch from a hardware store handles everything. Store it in the same place every time.
Evacuation
Evacuation planning for a household that includes an older adult with limited mobility requires specific answers, not general intentions. "We'll figure it out" is not a plan.
Most evacuations are not sudden. A storm gives 12 to 24 hours of notice. An extended power outage becomes a problem over hours, not seconds. The timeline is usually longer than it feels, which means a good plan executed calmly beats a fast plan executed in confusion.
One practice run, when nothing is wrong, is worth more than any checklist. Do it once a year.
Confirm now that the household vehicle can fit a wheelchair or walker, and confirm who loads it. A wheelchair van or accessible vehicle takes advance arrangement. If the household relies on public transit or ride-share in an emergency, identify an accessible ride option before it's needed. Uber and Lyft wheelchair-accessible vehicles require advance booking and are not available everywhere.
Walk the exit route with the older adult now. How many steps to the car? Is there a ramp? If the household is in a multi-story building, identify the evacuation chair location. Some counties provide evacuation assistance registries for residents who need help leaving their home, contact your local emergency management office.
Not all emergency shelters are accessible. Most areas operate at least one designated accessible shelter. Contact your county emergency management office before an emergency to confirm which shelter accepts people with mobility limitations and medical equipment, and to register in advance if a registry exists. The Red Cross shelter finder is a useful starting point.
In any evacuation, households with older adults or mobility limitations should leave earlier than the standard recommendation. Traffic builds quickly. Gas stations run short. What takes most households 20 minutes takes longer when loading equipment, medications, and a person who moves carefully. Build the extra time in before you need it.
Power dependency
Power-dependent medical equipment turns an extended outage from an inconvenience into a medical situation. Three steps address it.
01
Most electric utilities maintain a medical baseline or life support registry. Registered households are typically prioritized for restoration and receive advance notice of planned outages. Call the utility's customer service line and ask specifically about a medical baseline program or life support designation.
Registration does not guarantee power continuity. It reduces outage duration in many cases and ensures the utility knows your situation.
02
Every piece of medical equipment has a watt rating on the label or in the manual. Common draws: CPAP machines run 30 to 60 watts, home oxygen concentrators run 300 to 600 watts, and nebulizers run 80 to 200 watts. That watt number determines what backup power option is realistic.
A 500Wh portable power station can run a CPAP for 8 to 12 hours. It cannot run an oxygen concentrator for more than a few hours. The math matters.
03
For CPAP and low-draw equipment: a 500Wh to 1,000Wh portable power station ($400 to $700) provides 1 to 2 nights. For oxygen concentrators or higher-draw equipment: a 2,000Wh station or a generator is the minimum. For anything life-critical, contact the equipment manufacturer directly about emergency protocols and battery backup options specific to the device.
Oxygen concentrators often have manufacturer-specific battery packs. Check before buying a generic solution.
For life-sustaining equipment like oxygen concentrators or home dialysis, the equipment supplier is required to have an emergency protocol. Ask them directly: "What is your protocol if my power goes out for 48 hours?" They should have an answer. If they don't, find a supplier who does. The prescribing physician should also know what your household's backup plan is.
During disruption
For many older adults, the disruption to routine is as disorienting as the physical disruption. This is especially true for individuals with dementia, cognitive changes, or anxiety. The physical environment can't always be maintained, but some of the anchors within it can be.
Meals, medications, and sleep at their normal times provide structure when physical surroundings change. If you're sheltering in place, keep the TV or radio on a familiar channel. If you're evacuating, bring a familiar blanket, a preferred cup, or another small anchor object.
Disruption to sleep is one of the most significant medical risks for older adults in an emergency. Prioritize a dark, quiet, and temperature-stable sleeping environment even in a shelter setting.
For individuals with dementia or significant cognitive changes, a disruption to the home environment can trigger acute confusion, distress, or changed behavior. Sheltering in place, if the home remains safe, is often the better option than evacuation to an unfamiliar location.
If evacuation is necessary, brief the caregiving team at the destination shelter or location about the individual's baseline, calming techniques, and any behavioral patterns that the care team should be aware of. Write this down in advance.
Keep the older adult informed at a level that is helpful, not alarming. "The power is out. We have a plan. You're safe here" is more useful than a full weather briefing. Calm, specific, repeated as needed.
If the older adult uses a hearing aid, confirm that spare batteries are in the ready bag. Communication becomes significantly harder if hearing aids fail during a disruption.
Older adults are more vulnerable to both heat and cold. The physiological mechanisms that regulate temperature become less reliable with age, and certain medications (diuretics, beta blockers, antipsychotics) compound the risk further.
In a heat event without power: identify the coolest room in the house and stay there. A battery-powered fan moves air but doesn't cool air, use wet towels for more effective cooling. In a cold event: concentrate the household in one room, use layered clothing, and monitor the indoor temperature. Below 60°F is a risk threshold for hypothermia in frail older adults.
Caregiver coordination
The primary caregiver, whether a family member or a hired professional, may not be reachable during a disruption. Roads close. Caregivers have their own households. A shift that was supposed to start at 8 a.m. may not start at all.
The backup plan is not "we'll call around." It is a named person, with a key, who has been briefed and has agreed to help.
One conversation, well in advance, handles this. Most neighbors and friends will say yes when asked directly.
One named person, confirmed in advance. They need a key, the medication list, and a 15-minute orientation to the older adult's routine and any equipment. Ideally a neighbor, friend, or family member within 10 minutes. Document their phone number in the household plan and in the portable document folder.
Medication schedule and where medications are stored. Which equipment is used and how to operate it. Dietary restrictions or preferences. The name and number of the primary physician. Any behavioral patterns or triggers, particularly for individuals with dementia. The location of the portable document folder.
If a home health agency provides care, contact them before an emergency to understand their emergency staffing policy. Do they guarantee coverage during declared disasters? Who is the backup contact if the regular caregiver can't come? Get those answers in writing. Most agencies have a protocol, but families rarely ask about it until they need it.
Establish a check-in schedule for any disruption: a call or text every 4 hours. If a check-in is missed, the backup caregiver goes by. Simple, agreed-to in advance, no ambiguity about whose job it is. Designate one family member as the primary point of contact so information isn't fragmented across group texts.
Step by step
A disruption creates noise and urgency. This sequence cuts through both.
Before anything else. Physical check first, then a brief, calm verbal orientation: "The power is out because of the storm. We have water, food, and your medications. You don't need to do anything right now." Keep your tone steady regardless of what is happening outside.
Write down the time the power went out. Check refrigerated medications and note how much time has elapsed. Confirm the charge status on any portable backup power. If the older adult uses a medical device, confirm it is operating or connected to backup power.
Disruptions make it easy to lose track of time and miss doses. Set an alarm if your phone has battery. Use the pill organizer in the ready bag. Do not skip doses of blood pressure, heart, diabetes, or seizure medications without consulting a physician.
A brief message: what's happening, what you need, when you expect to check in next. This is not asking for help, it's activating the plan you already made. The backup caregiver should know a disruption is in progress even if you don't immediately need them.
Heat stroke, hypothermia, dehydration, and medication-related events can all develop during extended disruptions. Warning signs to watch: confusion that is new or worse than baseline, pale or very flushed skin, unusual fatigue, difficulty breathing, or complaints about chest tightness. If any of these appear, call 911.
At 12 hours without power, evaluate: Is the home remaining within a safe temperature range? Are refrigerated medications still viable? Is medical equipment still running? If the answer to any of these is no, and if evacuation is physically possible, leaving becomes the right call. The decision gets harder the longer it's delayed.
Recovery
The disruption ending is not the same as the household returning to normal. Recovery for households that include an older adult typically takes longer, and the medical and emotional dimensions are often underestimated.
Reconcile medications
Check every medication against the printed list. Anything that was stored improperly, left out of refrigeration beyond its safe window, or used from the emergency supply should be assessed by the pharmacist before resuming normal use.
Schedule a follow-up with the primary physician
Any extended disruption, especially one involving heat, cold, dehydration, or medication interruption, warrants a check-in with the physician. Don't assume that because the older adult seems fine now, the disruption left no trace.
Assess the home before returning
After a flood, storm, or extended outage, check for structural damage, mold, carbon monoxide risks from generators that were run indoors, and any trip hazards created by storm damage. An older adult returning to an unsafe home is a second emergency.
Watch for delayed psychological effects
Disruption-related anxiety, sleep disturbance, and confusion can peak in the days after the event, not during it. Check in daily for a week. An older adult who seems fine on the day of recovery may be more affected three days later.
Restock what you used
Replace any emergency medication supply used, restock the pill organizer in the ready bag, refill the 7-day medication buffer to its full level, and recharge any backup power devices. Do this within 48 hours, while the list is fresh.
Update the household plan
Note what worked, what didn't, and what the household will do differently. This is best done while memory is clear. The backup caregiver's feedback is particularly valuable. Update the written plan and brief anyone who needs to know.
Resources
These are the organizations and programs specifically designed for older adults in emergency situations.
FEMA's dedicated preparedness guidance for older adults, including checklists and planning tools tailored to this population.
ready.gov/older-adults →
Locate open shelters in your area. Call your local Red Cross chapter in advance to ask about accessible shelter options and special needs registration.
redcross.org shelter finder →
The federal agency focused on aging and disability. Their emergency preparedness resources include links to Area Agencies on Aging, which provide local services and can connect households to emergency assistance programs.
acl.gov emergency preparedness →
A national directory connecting older adults and caregivers to local services, including emergency assistance programs. Available by phone (1-800-677-1116) or online.
eldercare.acl.gov →
NIH's MedlinePlus provides clinically reviewed guidance on emergency preparedness specific to older adults, including medication management and chronic disease considerations.
medlineplus.gov →
Most counties operate a special needs or access and functional needs (AFN) registry. Registering provides notification of evacuations and sometimes priority assistance. Search your county name plus "emergency management" or "special needs registry" to find yours.
Search "[your county] emergency management"
Starting point
The foundation every household needs, including households with older adults. Water, food, documents, the family plan, and a 30-minute starter checklist.
First 72 HoursGoing deeper
Documents, advance directives, financial resilience, community networks, and the annual drill. The practices that make a household durable, not just prepared.
Long-Term ResilienceExplore other household situation guides