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Extreme Weather Is Killing Mostly Older Adults — And Has Been for Decades. Why Aren’t We More Prepared?

Some local disaster planning shows promise but deaths from Hawai‘i wildfires continue this trend

spinner image etina hingano stands among the wreckage of lahaina on maui in late august twenty twenty three
Etina Hingano returns to Lahaina, Maui, weeks after the deadliest fire in modern U.S. history destroyed her home and killed her neighbor.
David Butow for AARP

As the deadliest wildfire in modern U.S. history barreled through Maui this month, two friends turned to the ocean for salvation. Etina Hingano, 54, and Freeman Tam Lung, 80, fled the 20-unit Lahaina Crossroads Apartment complex where they were neighbors, and headed to the coastal town’s seawall to try to escape the flames. 

Hingano helped lower the 6-foot-5-inch, 300-pound Tam Lung onto some rocks along the water, but she knew that with his gout, the tall “kupuna”— or Hawaiian elder — was in pain. 

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“I told him he has to make it,” Hingano said. 

Over the next few grueling hours, Hingano had to distance herself from Tam Lung for her own safety, moving further out into the ocean, trying to dodge the fire’s heat and smoke. Hingano periodically cried out to ask whether Tam Lung was OK, and he’d give her a “shaka,” a Hawaiian hand signal — middle fingers curled, thumb and baby finger extended — to signify all was good. 

Then a truck exploded on the road right next to the seawall. Tam Lung screamed, and Hingano, hit by fumes from exploding vehicles, tumbled into the water, losing consciousness. 

“I thought I was going to die, and I could hear him still calling for me,” she said.

When she came to it, she could no longer hear Tam Lung's voice.

After midnight, when a rescue crew finally came to get Hingano and a group of roughly 30 others who were with her in the ocean, Tam Lung was left behind, unresponsive. The father of three, who loved his hometown of Lahaina, was officially announced by the county as one of the dead exactly two weeks later. 

Of the 115 confirmed deaths from the Lahaina fire, only 45 victims have been publicly identified. But most of those victims, nearly three-quarters, were over the age of 60. Among those identified were four residents of Hale Mahaolu Eono, a 35-unit independent living complex for low-income seniors, which was decimated by the blaze. Another three residents are still unaccounted for. 

These early signs of the Maui disaster reflect a long-standing trend: Older adults die at higher rates in extreme U.S. weather disasters than those who are younger. 

Of the roughly 150 deaths attributed to Hurricane Ian, which walloped Florida’s west coast last September, roughly two thirds were 65 or older. For Puerto Rico’s Hurricane Fiona, which also hit last September, adults 65 and older accounted for 35 of the 42 deaths. During Texas’s 2021 “Big Freeze,” people 60 and older made up 60 percent of deaths. In Northern California’s 2018 Camp Fire, which ravaged the town of Paradise, a staggering 72 of the 84 identified fatalities were people 60 or older.  The trend holds true looking at weather events going back decades.  

“We really do see it time and time again,” said Sue Anne Bell, an assistant professor at the University of Michigan School of Nursing, who works on disaster preparedness and response. “We have 50 years of research, or more, showing how older adults are a vulnerable population, but we’re still wrestling with the same problems.”

Some promising local and national efforts are underway across the country to confront the problem, but critics argue that persistently high death counts among older adults reveal not enough is being done. They fault disaster preparation strategies, which too often fail to take into account the unique difficulties faced by many older adults: chronic health issues, social isolation and an unwillingness to leave pets and homes. In addition, many seniors don’t acknowledge that climate change is causing storms and other weather events to become more extreme.  

“There is no one solution, but rather a group of solutions that need to take place at the individual level, the community level, the policy level and then at a greater societal level in terms of how we value our older adults,” Bell said.  

Those solutions can’t come quickly enough. The frequency of powerful and unpredictable weather events is accelerating — something particularly evident this year, with Southern California's blizzards, Vermont's flooding and the Southeast's Tropical Storm Idalia bearing down. 

In the 1980s, the nation suffered an extreme weather disaster that caused at least $1 billion in economic damage about once every four months on average after adjusting for inflation, according to a report by the National Oceanic and Atmospheric Association’s National Centers for Environmental Information.

In 2022, there was one every three weeks, on average.

As this happens, America’s older population is expanding. Adults 65 and older made up 17 percent of the U.S. population in 2020, totaling almost 56 million. But by 2040, they’ll make up 22 percent, totaling roughly 81 million, according to the U.S. Department of Health and Human Services Administration on Aging. One analysis of all coastal counties in the U.S. predicted that the proportion of people over 65 who live in coastal communities — highly vulnerable to weather events — will steadily rise to be over a third of the population by 2100, compared with less than a fifth today.

spinner image a fire in hawaii
Wildfires raced through the Maui town of Lahaina Aug. 8, leaving buildings like the historic Waiola Church in ashes.
Matthew Thayer/The Maui News via AP

Preparedness lacking for extreme weather events

Near the coast in Maui, more than two weeks after the Lahaina fires tore through the Hale Mahaolu Eono apartment complex, both the building and its community are in ruins. 

“I just can’t talk about it anymore,” said resident Tina Bass, 72, who escaped the burning complex in her car after smoke filled her unit. As she fled, she tried to convince neighbors to do the same, but some didn’t make it out. Four have been pronounced dead, and three were still unaccounted for as of Aug. 24, “and the rest of us are getting nothing from management about where we’re going to live,” Bass added. “It’s all too much.”  

Blame for the devastation at Hale Mahaolu Eono is being passed around. Many residents and their family members say they believe Hale Mahaolu, a private nonprofit company with 16 other affordable housing sites in Maui County, had a responsibility to help residents — all 62 or older, some with limited mobility, many without cars — escape. 

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In a statement, Hale Mahaolu noted that Eono is a facility for “independent adults, who navigate their own lives,” adding that, “our staff is available to help them when they request help, but we respect their autonomy and privacy.” Four residents were encouraged by the complex’s resident manager to evacuate around midday but declined, according to the statement, which also noted that no evacuation notice for Eono’s neighborhood was issued by Maui County.

Many others are placing blame on the county for failing to issue sufficient warnings. Maui’s official warning system — 80 outdoor sirens — never sounded as the fires raced toward the town at a mile per minute. Cellphone alerts to evacuate were issued, according to Hawai‘i officials, but many locals report they never received them. 

The search for a scapegoat is often fierce in the wake of a weather disaster, said Erin McLeod, president and CEO of Senior Friendship Centers Inc., a nonprofit that services more than 10,000 older adults across southwest Florida, including helping them prepare for extreme weather. But that blame can’t lie with one entity, she said: “Sticking it to somebody, I don’t think you can do that. There’s so many factors and layers here.” 

The University of Michigan’s Bell agrees. 

“We talk a lot about a whole community approach when it comes to addressing the effects of disasters,” she said. “It can’t just be for our emergency responders to address, but for our health care providers, our emergency managers, our aging advocates, and our older adults themselves as the key stakeholders, too.”

Solutions that prioritize the vulnerable

Some communities have learned from past disasters, introducing tailored strategies that help prevent deaths among older people during extreme weather events. 

In the wake of Florida’s Hurricane Irma in 2017, power outages led to the death of eight nursing home residents at the Rehabilitation Center at Hollywood Hills in the city of Hollywood due to overheating. Four more residents died after being evacuated from the sweltering facility. The tragedy led to the passage of legislation, supported by AARP, which requires senior living facilities to have comprehensive county-approved emergency management plans in place, as well as an alternate power source, such as an on-site generator, in the event of a power outage. 

These efforts appear to have had a positive impact. During Hurricane Ian, which blew into southwest Florida five years after Hurricane Irma, more than 8,000 residents of senior care facilities were evacuated, and no storm-related deaths were reported by the state’s roughly 4,000 nursing home and assisted living facilities. 

In Lahaina, no such regulation required Hale Mahaolu Eono to have an approved evacuation plan. As an independent senior living facility, it was not subject to the same laws that govern the state’s nursing homes and assisted living facilities.  

Despite some progress in places like Florida, major challenges persist, said Jeff Johnson, state director of AARP Florida: “How do we bring that attention and planning to those who are aging in place, at home, so we can ensure they are safe, too?” 

spinner image overhead view of destruction left by hurricane ian in october twenty twenty two
Destruction in Fort Myers Beach, Florida, in the wake of Hurricane Ian in 2022.
Johnny Milano/The New York Times

During Hurricane Ian, that’s the segment of the older population that suffered most, he said. Arduous and expensive disaster preparation checklists can be a hurdle, Johnson said. These checklists often call for storm-proofing homes, confirming insurance, assembling nonperishable food, collecting medical supplies, researching shelters, creating an emergency contact list, plotting evacuation routes and organizing important documents.  

“They’re a lot for anyone, let alone an older person who may have some dementia, or who is in a wheelchair, or who isn’t tech-savvy,” he said. “It becomes too overwhelming.”  

Disaster officials in southern Oregon recognized the hardships homebound older adults faced in preparing for extreme weather after floods overwhelmed the region in 1997. Afterward, Rogue Valley emergency managers partnered with the county’s Senior and Disability Services department to create a registry of community members who needed extra assistance. Volunteers check the list every three months to ensure contact information is up to date, and during public emergencies, people in impacted areas get calls to ask what support is needed. 

The program has helped get vital medications to rural residents during blizzards and provided wheelchair-friendly evacuation vehicles to residents with mobility challenges, said Connie Saldana, a planner at Rogue Valley Council of Governments Senior & Disability Services.

Plans with this kind of “local texture” are critical for saving older lives, said Kevin Smiley, an assistant sociology professor at Louisiana State University who investigates disasters and environmental change. Often, though, plans are too generic, he said. 

“There’s a real role for local organizations who have the know-how and the social networks,” he added. 

When Hurricane Maria struck Puerto Rico in 2017, hundreds of residents with disabilities were killed, and many of them were older adults. Carol Salas Pagán, director of the Puerto Rico University Center for Excellence in Developmental Disabilities, called out the “totally inadequate” response for the special-needs community. The Federal Emergency Management Agency (FEMA) invited Salas Pagán to join its National Advisory Council in 2019 to represent those with disabilities in each stage of the emergency management process.  

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Since then, FEMA’s disaster preparedness guidance has become more inclusive of older adults and other vulnerable communities, Salas Pagán said. The results can be seen in places like Boulder, Colorado; Chicago; and Los Angeles, all of which have introduced initiatives that bring either aging advocates or older residents themselves into disaster planning forums.  

Salas Pagán said there’s still plenty of work to be done: “Different counties and states are in very different stages of progress,” she said but “that national focus is helping drive it.”

Older adults often reluctant to evacuate

In Hawai‘i, Tam Lung had lived at Lahaina Crossroad Apartments for 18 years. He was a homebody who rarely left the complex, and found purpose in checking on neighbors and collecting their packages to ensure they weren’t stolen, Hingano said.  

On the day of the fire, as tenants started fleeing Crossroads for safety, Tam Lung didn’t want to leave. He rejected neighbors’ offers to give him a ride. But when a strong gust of heat swept through the complex and flames came into sight, Hingano demanded he come with her: “I said, ‘Freeman, I’m not gonna leave without you’.” 

Across the country, studies show that relatively few older adults have engaged in serious disaster planning. The University of Michigan’s 2019 National Poll on Healthy Aging found that only 40 percent of adults ages 50 to 80 surveyed had spoken with family or friends about what to do if an evacuation was needed. Less than half had signed up to receive alerts through their community’s emergency warning system. One in 3 didn’t know whether their communities even had a system.  

Many factors associated with aging can hinder preparation and response to a crisis. The hurdles Tam Lung faced — mobility issues, an attachment to a longtime home — are common, experts said, but they’re also just the beginning.  

McLeod, of Florida’s Senior Friendship Centers Inc., said she can offer “a million” reasons as to why seniors aren’t prepared to evacuate during Florida’s hurricanes, including high rates of chronic conditions, disability and dementia, and low rates of social connectivity. Many are also reluctant to ask for assistance because they believe that contact could land them in a long-term care facility when they want to stay in their homes

Last September, Tracey Brown, 61, didn’t realize that Hurricane Ian was heading straight for her Port Charlotte, Florida, home. 

“I don’t really watch a lot of news,” she said. 

It wasn’t until a friend called her the night before Ian was due to make landfall that she turned on the television to find she was in the hurricane’s path. Her 85-year-old mother, who lives around the corner, was, too. 

Brown ended up sheltering with her mother, and both survived the storm, despite some close calls and historic damage to her area. Even so, Brown believes she’s seen the worst of the weather bound for Florida. 

“I think we’re going to have more storms, but they ain’t gonna be like that one,” she said. “If we made it through that, then we can make it through all the other ones, too.”  

That’s another factor that needs to be considered by disaster managers, experts warn: a belief among older adults that weather events won’t get worse. 

A study published by Statista this year and conducted between 2015 and 2018 found that while 76 percent of respondents 55 and older believe they understand the issue of global warming fairly well or very well, only 29 percent believe that global warming and climate change will cause serious problems in their lifetime.

spinner image etina hingano sits on rocks next to the ocean where she clung on to survive the deadly wildfire earlier this month august twenty twenty three
Etina Hingano visits a section of the Lahaina shore, not far from where she and Freeman Tam Lung fought for their lives during the Maui fire.
David Butow for AARP

Community ties can boost disaster preparedness

Those studying disaster preparedness and response emphasize the power of a tight-knit community when it comes to protecting older adults. It won’t singlehandedly stop them from dying at disproportionate rates in extreme weather disasters, but local ties do help.

“It’s going to take a lot of tiny one percent efforts,” said McLeod of Senior Friendship Centers Inc., like helping someone find their local evacuation shelter, or offering them a spot on the couch, or a ride, or just checking in to see they’re OK. “It’s the one percent rule,” she said. 

In Lahaina, where official emergency assistance may have come too late, those one-percenters were likely critical for older adults, said Craig Gima, AARP Hawai‘i’s communications director: “When the government isn’t there yet, your neighbors are your lifeline.” 

In the nine years that Hingano lived at Crossroads, she often spent her off afternoons at Tam Lung’s apartment “talking story,” while helping him with his cleaning and laundry. She’d take him to the grocery store when he needed supplies and argued with him when he tried to pay for her items. 

When the wildfire tore through Lahaina on Aug. 8, Hingano was Tam Lung’s lifeline. When flying embers ignited Tam Lung’s shirt as they moved toward the seawall, Hingano used her bare hands to pat out the flames. When others trying to flee told Hingano that she needed to leave Tam Lung to save herself, she refused: “I said, ‘This is my neighbor. I can’t leave him. He has nobody here right now.’”

She won’t forget watching Tam Lung climb higher on the rocks by the seawall as the fire intensified, before the truck exploded. 

“I said, ‘Freeman, are you sure you're OK?’,” she recalled. “And he goes, ‘Yeah. I want to watch the fire. I want to see Lahaina one last time.’”       

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