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Lost in the shuffle

There are still some 6,600 people reported missing from Hurricane Katrina.  Among them are people with Alzheimer's disease, unable to identify themselves or make their way home. By Kari Huus.
Olympia Reeves, in a photo taken by her family earlier this year.
Olympia Reeves, in a photo taken by her family earlier this
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Where is Olympia Reeves? In the rush to evacuate New Orleans amid rising flood waters, the 87-year-old was moved from her Uptown home to the city's convention center, family members say, and then she disappeared without a trace. There is good reason to believe she is alive, but unable to make her way back to family, and possibly unable to tell anyone her name. Reeves suffers from Alzheimer’s disease.

One relative who has been on the case since right after the storm is Dinah “Penny” Ambeau-Scott, who is married to Olympia's great-nephew. She was able to confirm with the 45th Infantry National Guard from Oklahoma that they evacuated Olympia to the New Orleans convention center.

The National Guard captain "said they took her from the house to the convention center, and that’s all they had," says Ambeau-Scott. At one point, Ambeau-Scott began calling every hospital in the region, alphabetically. An elderly woman with a similar profile turned up, and Ambeau-Scott thought she had located Olympia. But after exchanging pictures, she learned otherwise. "I just keep hitting a brick wall," she says.

Olympia is one of more than 6,000 people still reported missing after Hurricane Katrina hit. She is also a reminder of how great a toll the disaster took among elderly people, who were evacuated by the thousands from long-term care facilities, died in larger numbers than other groups and arguably suffered most in sweltering shelters and unfamiliar settings.

The non-profit Cajun Area Agency for the Aging has networked with state agencies, cross-checking lost-and-found persons lists and called scores of nursing homes in the effort to find Olympia. Still, 12 weeks after the storm the search has come up empty-handed.

“It’s like trying to find a needle in a haystack,” says Shannon Broussard, director of the agency, which has posted pictures on its Web site of people who, like Olympia, are lost and disabled. “We’ve exhausted all avenues in the search for these people.”

Trauma could worsen dementia
In a picture taken in better times, Olympia looks confident and lucid — her gray hair swept away from her face as she smiles at the camera. She was in the relatively early stages of Alzheimer's disease, so she still lived in her own home, with nurse aides to help her.

But getting lost in a disaster is terrifying for someone suffering dementia, experts say, and could exacerbate the difficulty of remembering and coping.

"When you are evacuated to a place you don’t recognize and don't know anybody, it makes it worse," says Broussard. "It might push you to the next stages of Alzheimer's sooner."

Also pictured on the CAAA site are 82-year old Ethel Herbert, who has Alzheimer's and was separated from her daughter when she was airlifted from the New Orleans Superdome, according to e-mail sent by the Louisiana Nursing Home Association to care facilities. Two others are elderly women who were found after the storm and placed in homes, but whose identity remains uncertain and whose families cannot be located.

"Most of the elderly who are out of state and might be a Jane or John Doe are individuals who were in their homes or in personal care situations," says John Donchess, executive director of the state nursing home association.

But many nursing home patients also went missing in the early days after the storm. "In some situations, patients were literally separated from the rest of nursing home staff and ended up at the airport to be treated. And they would just kind of be flown out helter-skelter by FEMA," says Donchess.

Elderly hit hard by hurricane chaos
No one can say how many people suffering dementia or other mental disabilities were displaced, or misplaced, in the hurricane. The National Center for Missing Adults says there are 6,644 people still missing from Katrina. A portion of those people, perhaps 20 percent, are dead, according to the center.

Of 539 Katrina victims so far identified in Louisiana, 64 percent were older than 60, according to the state Department of Health and Hospitals. Sixty-six of the fatalities were nursing home residents who were abandoned by staff or evacuated too late. Those cases have prompted criminal investigations.

Bumpy evacuations
Most facilities did evacuate, trying to follow prearranged plans, but it's a complicated undertaking, even in the best of situations.

"Many (residents) are at risk for pressure sores. If they’ve got respiratory problems, you’ve got to transport oxygen. Some medications have to be refrigerated, like insulin. You have hydration issues. That’s just the beginning of it. ... There can be a laundry list of problems for transporting people," says Donald Jambois, administrator of the Rayville Nursing and Rehabilitation Center. The facility has taken in about 60 evacuees, all of whom are in touch with relatives, over the past few months.

In the case of Katrina, with the scale of the evacuation covering such a large geographical area, some nursing home administrators found that the facilities they were evacuating to were full when their residents arrived.

Initially, many elderly clients had to be tracked down, says Christy Frederic, executive director of the Louisiana chapter of the Alzheimer’s Association. In the search for one client, she found he wasn't at the prearranged evacuation site in Alexandria, La.

“The evacuation site was already overwhelmed,” says Frederic, so the group traveled on.

At a second facility they ran into the same problem. Finally, they relocated to a facility near Lafayette, La.

“It took four days before we could locate George,” Frederic says. But finally she was able to report to family members in New York that he had been located, and was “feisty and gregarious.”  (Due to Hurricane Rita, George was evacuated yet again.)

The Louisiana Nursing Home Association posted an urgent bulletin in early September urging hospitals and nursing homes around the country to report any Katrina evacuees who ended up in their care. Now, the association has built a database of about 5,400 people and where they ended up following the hurricane.

That accounts for perhaps one-third of the people evacuated from nursing homes in the storm-stricken area. But it is far from accounting for all the nursing home residents who moved to other facilities, or are now living with family, or are missing.

Support networks torn apart
Elderly people living independently like Olympia have been more difficult to track down.

"One of the things we saw … was senior citizens who were living independently with a robust support network … and that social network was blown apart," says Frederic. "That kind of trauma to someone who’s already frail can set them back, and they may not recover."

Many of these people ended up on buses, in caravans and in shelters, she says. "In some cases they could not represent themselves adequately."

In the weeks after the storm, the Alzheimer's Association scoured shelters and towns where there were large numbers of evacuees, trying to find elderly people who needed to be moved or provided more care, or who had been separated from essential medications. They moved a handful seen as too frail to remain in shelters to nursing homes and sought out "neighbors" to keep an eye on others who remained in temporary housing. They also provided mass training to emergency workers, volunteers and nursing staff on how to recognize and handle evacuees who suffer dementia.

Preparing for the worst
The association has used this crisis to promote their Safe Return program, which registers Alzheimer's sufferers and their emergency contacts in a national database. Those registered in the program wear an ID bracelet or necklace to alert others to their condition.

The program allows people who get confused or disoriented to get home safely in normal times. But its proponents say the registration is just that much more critical in the case of a disaster. "People with dementia are more likely to wander if they are agitated," says Beth Kallmyer, who organized volunteers to help train "instant caregivers" in Mississippi.

The group is also pushing for families to get prepared to help ensure that elderly relatives and friends don't slip through the cracks in a disaster. They recommend keeping an emergency kit in a plastic container that includes extra medications and glasses, copies of identification and legal documents such as power of attorney, medical documents and physician contact information.

As for Olympia, she didn't even bring her ID. Her purse and all its contents remained in her house, which was almost untouched by the storm.

While Ambeau-Scott hasn't given up hope of finding her, the family has delivered DNA samples to authorities still trying to identify the dead. The waiting and wondering have taken a toll.

"We've all been so worried," she says. "We need closure now."