asahi shinbun, evacuation, health

Disasters take heavy toll on nursing home residents, asahi shinbun, 7/20/11

At least 616 senior citizens who resided in long-term care facilities when the Great East Japan Earthquake struck died by the end of May, even though they all survived the actual quake and tsunami.

Most of the deaths are likely so-called disaster-related deaths brought about by a drastic change in their living environments.

In the month of March alone there were almost three times the number of deaths compared with the same period of 2010 at the care facilities in 42 municipalities in Iwate, Miyagi and Fukushima prefectures that were either hit by the tsunami or where residents were forced to evacuate due to the accident at the Fukushima No. 1 nuclear power plant.

The Asahi Shimbun sent questionnaires in June to 219 special nursing homes for the elderly or health services facilities for the aged in those 42 municipalities. Responses were received from 159 facilities.

Between mid-March and the end of May last year, about 300 people died in those 159 facilities. However, the number of deaths more than doubled in the same period this year.

Of the 616 people who died this year, 80 percent were either in their 80s or 90s. About half were certified with having a need for the most extensive level of long-term care.

About 30 percent of the deaths were due to respiratory diseases, such as pneumonia. There were also many cases of senior citizens falling ill due to the cold or from concerns about the aftermath of the disaster.

In cities where more than 1,000 people died due to the tsunami, there was an increase of about 3.5 times in the number of deaths at the long-term care facilities, excluding deaths directly caused by the disasters, over the same period last year.

In mid to late March, when the effects from the disasters were higher, there were 224 deaths due to old age or disease at the care facilities, an increase of 2.8 times over last year. The comparison was made with two-thirds of the number of deaths in the entire month of March 2010.

In Fukushima Prefecture, the number of dead gradually increased, with the number in May reaching 59, the highest figure. There were many facilities in Fukushima that had to evacuate residents to separate facilities in other prefectures due to the nuclear accident. Among facilities that evacuated residents, the number of deaths between mid-March and the end of May was 2.4 times the number from the same period in 2010.

The experiences at individual facilities point to the negative effects of placing the elderly in unfamiliar surroundings.

The Chojuso, a special nursing home in Minami-Soma, Fukushima Prefecture, that was about 25 kilometers north of the Fukushima No. 1 plant, had 56 residents when the disasters struck. The evacuation of the residents to 13 different facilities in Tochigi Prefecture began nine days after the quake.

About 80 percent of the residents were close to bed-ridden. Some elderly had to be hospitalized after their conditions worsened following a bus ride of about six hours.

Masakatsu Nakagawa, 66, the head of the facility, said, “There is a very high risk to moving the residents.”

While facility officials sought an evacuation location closer to the Chojuso, they were forced to move the residents to different facilities because there was a large overall demand for evacuation.

Soon after the evacuation, the 51-year-old counselor at the Chojuso began receiving phone calls from the facilities that had taken in the residents.

One resident would not eat, while another developed a fever.

On April 4, an 85-year-old man who used a wheelchair died of aspiration pneumonia. On April 27, a 91-year-old man died. By the end of May, 16 residents had died. Because only about one resident died every month at the Chojuso under normal circumstances, facility workers were shocked at the large increase.

“The facilities who took in our residents did their best to provide care,” the counselor said. “I believe the burden of the move and the loneliness of evacuation life had an influence.”

At the Keishinryo special nursing home in Kesennuma, Miyagi Prefecture, the 50 residents were evacuated to the second floor when the tsunami struck and they were all saved.

Problems only began to develop on the night of March 12 after residents were evacuated to a gymnasium. An 88-year-old woman died amid the frigid conditions at the evacuation center.

The residents moved to another facility two days later, but without electricity, the health of a number of residents also deteriorated.

In the month after the quake and tsunami, nine residents, ranging in age from 64 to 102, died, a figure that was triple the number for March 2010.

While the actual cause of death is not known, none of the residents were in a terminal stage of an illness. The head of the facility said, “This is unthinkable under normal circumstances. I believe the disasters had an effect.”

With vital lines of infrastructure cut off due to the disasters, workers at care facilities had to secure food and fuel for facility residents.

One facility in Miyagi Prefecture collected light oil in order to keep a generator going.

At another facility, workers formed a bicycle brigade for their shopping expeditions.

One major negative factor was the long period in which electricity was lost.

At one facility in Ishinomaki, Miyagi Prefecture, residents came down with hypothermia and pneumonia because there was insufficient heat. In March alone, five residents in their 80s and 90s died.

At other facilities, feeding tubes became in short supply, while workers at another facility said a liquid diet could not be provided based on the relief supplies distributed, such as rice balls.

Some facilities were able to minimize the negative effects through efforts made by the local government.

In Iwaki, Fukushima Prefecture, vehicles used at care facilities were given certificates recognizing the vehicles as for emergency use. That allowed those vehicles to receive preferential treatment at gasoline stations.

A city official said, “We felt it would be necessary to obtain water and food. Care facilities have the same risks that hospitals face so we did not discriminate between such facilities.”

(This article was written by Yusuke Ishimura, Kenjiro Takahashi and Chikako Numata.)

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About liz

from the u.s., recently moved from kobe to sendai, japan, researching community-based housing recovery after disaster.

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