Special News Analysis: Offering relief amid chaos, destruction

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Nursing homes rise to challenges of Hurricane Katrina with long hours, generosity and a dose of determination

It is said that disasters bring out the best in people, and Hurricane Katrina did just that for most workers in the long-term care field.
When the storm bore down on the Gulf Coast in late August, providers lent a helping hand to residents and colleagues in need.
Providers took in evacuees from other states; they worked around the clock to care for their residents; and they offered tons of food, supplies and assistance. 
Some efforts can only be described as heroic: At least one executive director stayed up all night working on the evacuation of his residents -- and then went to the airport to care for dying residents. One administrator stayed behind with seven residents who could not evacuate -- and fended off looters. An untold number of nurses and assistants worked tirelessly during the storm knowing they might return to homes that no longer existed.
Conversely, few can recall the nation's worst natural disaster and not be reminded of St. Rita's, the now-
infamous St. Bernard Parish nursing home, where 34 residents perished because they were not evacuated.
While details of the situation are still forthcoming, in many ways, it has come to symbolize what went wrong with hurricane emergency procedures in general. Providers and officials are among those pondering: What happened to the communications system? Why didn't more homes evacuate? And why weren't there better emergency procedures in place?
As questions get raised at the local and federal levels, nursing homes continue to rise to the occasion. Even in places as far from the eye of the storm as Boise, ID, which took in more than 20 residents after Katrina hit.
Vulnerable victims
The elderly were among Katrina's most defenseless victims. Between 85 and 100 residents died in Louisiana nursing homes during the hurricane and its aftermath, according to Joe Donchess, executive director of the Louisiana Nursing Home Association. Hundreds of others -- many elderly -- died in hospitals, residences or out in the open.
The scope of the disaster is unprecedented. In New Orleans, the landfall of the hurricane was only the start of the devastation. The collapse of the levees that followed led to surging water in facilities, homes and businesses.
Nursing homes were required to have their own evacuation plans, including contracts with transportation companies. Some nursing homes that chose not to evacuate faced perils of catastrophic proportions:  rising waters, lack of food and supplies, even violence.
In one of the darkest moments, Covenant Home in New Orleans evacuated after its bus driver was forced to surrender the vehicle to gun-wielding carjackers. As a result, 80 residents were transported to other nursing homes in the state.
The home was prepared for many contingencies but not looters.
"We had excellent plans. We had enough food for 10 days," said Peggy Hoffman, the facility's executive director.
"Now we'll have to equip our department heads with guns and teach them how to shoot," she said.
Out of the darkness
But even during the chaos, there were shining moments.
"Nursing homes made Herculean efforts," Donchess said, adding that if staff had not worked 14 hours a day, four days straight, then "there would have been many more lives lost."
The association executive coordinated rescue efforts from the emergency operations center in Baton Rouge, manning one of about 60 desks there.
Stories of heroism gush from him. Like the one about Irvin Boudreaux, a family member of an employee at Lavon Nursing Home, who drove his pick-up truck through high water to get to the facility. The man then rented two buses and rescued 50 residents, stopping only when random gunshots forced military personnel to turn him away during a second trip.
Another administrator evacuated 120 people and stayed behind with seven residents because they were too sick to leave. Looters tried to break in and get drugs, but he and a nurse locked the doors and fended them off.
Many homes rallied to each other's aid. Associatio