Should I Stay or Should I Go?

Home is not just a physical place made of brick and mortar; for older adults, home is the culmination of their life’s meaning. Home is the place where families are raised, where holidays and birthdays are celebrated, where loved ones are buried, and where long-standing relationships with neighbors, relatives and faith-based communities provide purpose. Due to the advancing impacts of climate change, homes and communities are increasingly placed at risk, particularly for older adults.

Currently, 40% of the U.S. population lives in an area at risk of sea-level rise, 16% of Americans live in an area at risk for wildfire, and in 2017, 60.2 million people lived in coastal areas on the Gulf of Mexico and the Atlantic seaboard (regions most at risk for hurricanes), a 16% increase from 2000. Many older adults are members of communities of color, which have been generationally redlined into areas more susceptible to the impacts of weather and climate-related disasters.

As more and more communities are placed at risk of experiencing a human-induced climate change disaster, many older adults are asking, not if, but when a disaster event damages their home, should they stay and rebuild? Or should they leave? Or, more ominously, can they leave if they want to?

Understanding Sense of Place

Emerging research tells us about the important role of sense of place—the emotions and feelings that bind a person to a certain geographic location—to both disaster preparedness and recovery for older adults. Understanding the relevance of sense of place to disaster recovery can allow for better systems of support for older adults to navigate these complex decisions (see also, Wallis et al., and FEMA).

Placemaking can inspire opportunity and revitalization, such as by facilitating the formation of new social networks.

After a disaster, when older adults face a disrupted community, a damaged home and the loss of prized possessions, which have been won, made, bought, or been gifted over the years, the decision to stay and rebuild in their community may not be a choice. Relocating is especially burdensome for older adults, who are more likely to be income-restricted and have chronic health conditions, mobility challenges, and other changes common with aging. For those who do remain in their community, the challenge of restoring damaged property entails a process that is tedious and inequitable (see also Bell et al., 2021).

Tellingly, in 2021 the National Advisory Council for the Federal Emergency Management Agency (FEMA) described disaster aid programs as “providing an additional boost to wealthy homeowners and others with less need, while lower-income individuals and others sink further into poverty after disasters.”

Remaining in a disaster-affected community creates a potentially dangerous gap in the continuity of care for older adults. Previously relied upon resources—primary care providers, urgent care facilities, home healthcare agencies, outpatient centers, grocery stores, pharmacies, public transportation—may be slow to return to normal operations following a disaster.

Our team’s research has shown that in hurricane-affected communities, the availability of healthcare providers decreases in the long term. Interruptions to such critical infrastructure add to older adults’ mental and physical health burden, which may already be challenged by the disaster’s physical impacts as well as its psychological fallout.

Placemaking—the building or rebuilding of healthy, cooperative, meaningful communities—is an infrequently chosen approach in recovery zones, but it can inspire opportunity and revitalization, such as by facilitating the formation of new social networks. The decision to stay also can assist in efforts to develop sustainable communities in the post-disaster phase, like the Babcock Ranch properties—which were left virtually untouched by the devastation of Hurricane Ian, due to a combination of being 30 miles inland, having undergrounded power lines, retaining ponds to protect houses from flooding and streets that absorb floodwaters. Similarly new fire-proof housing that sprang up in the wake of the 2018 Camp Fire is gaining traction with homeowners looking to reduce wildfire risks to their existing homes.

Our Approach to Climate Resiliency Isn’t Cheap

However, these developments are often too expensive for most Americans—the cheapest Babcock Ranch condo sits at a lofty $263,000, while retrofitting a home with fire-proof and other modifications can cost tens of thousands of dollars. Although there is increasing public support for building climate-resilient infrastructure and housing, including $369 billion in funding allocated for climate change in the Inflation Reduction Act, more must be done to ensure that sustainable housing is affordable and accessible to those most vulnerable to climate change, including older adults.

Despite the well-established challenges older adults face after climate-related disasters, in areas where rebuilding is possible, an attachment to place may aid in recovery from disaster. Older adults with the means to pick up their lives and move (or who are among the few to navigate the complicated disaster relief system successfully) have the opportunity to build a new life for themselves outside of disaster recovery zones.

‘The decision to stay in an affected community versus leaving will never be straightforward for most older adults.’

However, relocation can take a toll on mental health, creating increased stress, confusion, hopelessness and loneliness as older adults attempt to find new meaning and rebuild social and emotional wellness while simultaneously reckoning with trauma related to their displacement into an unfamiliar physical environment. Protecting against relocation stress is an area for potential intervention to preserve function for older adults and can be implemented by assisting older adults to relocate with family, or with close friends and neighbors, as a unit. Such unit-based relocations can help facilitate the placemaking process for older adults settling into a new community.

One goal for aging advocates is to support aging in place so that a person lives and ages in the home of their choice for as long as they are able, yet disasters tend to disrupt critical aging-in-place resources. Decades of research have shown the importance of social support and social networks in promoting healthy aging, which becomes especially important after a disaster (see also Browning et al., 2006; and Klinenberg, 2003. Research has described how the availability of social support from family members, friends, neighbors and others in the community is vital for older adults after disasters. Social support interventions that are most useful in disaster recovery are those that are timely, suitable and from the right source—in the form of informal and formal networks (see also Bell et al., 2021).

The decision to stay in an affected community versus leaving will never be straightforward for most older adults. Regardless, either scenario results in an unplanned and unwanted journey, jumping through administrative hoops, maneuvering a new or recovering healthcare system, or navigating rebuilding, whether in a new or a familiar community. In many cases, socioeconomic inequities, which inhibit access to critical disaster recovery resources, or physical damage, can limit older adults’ decision-making options.

Advocates for older adults can and must involve communities at risk of experiencing disasters in developing mitigation and preparedness strategies early. For now, aging advocates can serve as a resource in the community by being ready and prepared themselves. This includes learning about FEMA’s individual and public assistance policies, participating in local preparedness planning, and participating in the community to build vital social networks before a disaster occurs.

Maxim Molnar, BSN, is a student, Jennifer B. Inloes, BSN, RN, is an Adult/Gerontology Acute Care Doctor of Nursing Practice student and Sue Anne Bell, PhD, FNP-BC, FAAN, is an assistant professor in the Department of Systems, Populations and Leadership, all at the University of Michigan School of Nursing in Ann Arbor.

Photo caption: Fallen tree caused by Hurricane Sandy, 2012, Garden City, NY.

Photo credit: littlenySTOCK