Katrina's lesson.

By now the grotesque imagery of wheelchair- and bed-bound elderly drowning in rising flood waters is "old news" but, of course, that imagery, for most of us, will never really go away. This column has neither the time nor the space to go into the situations that produced those images in post-Hurricane Katrina flooded New Orleans. I only want to underscore the on-target comments offered last month by the American Health Care Association's acting president and CEO, Bruce Yarwood, before the U.S. Senate Special Committee on Aging.

Yarwood very correctly pointed to the many less widely reported acts of heroism by many long-term care staff and management, setting aside their personal interests to move residents to safety, trying desperately to round up elusive transportation and other services, and heart-breakingly watching some of their frail charges die under the extraordinary stresses imposed upon them. More than that, Yarwood described what he considered to be a rational response to this disaster.

It wasn't only that individual facilities, as some critics would have it, simply "have to do better" or "hire better people." Yarwood situated long-term care within society at large and noted that "doing better" will involve extraordinary outreach and discussion with all levels of government agencies and private sources of help. The basic challenge, he said, "is that our nation must completely reevaluate and overhaul how we prepare and deal with crises on the scale of 9/11, Hurricane Katrina, and other scenarios involving weapons of mass destruction. As unpleasant as this is to contemplate, the central lesson learned is that the level of civil preparedness did not come close to matching the level of destruction."

Attention has to be paid, he said, to the communication and public service infrastructure, community-wide disaster planning, mutual support among providers, development of electronic medical records, and coordination of government agencies at all levels. And this doesn't mean waiting for someone else to do it--long-term care leaders have to be intimately involved in all these discussions, starting now.

Speaking for myself, I have to wonder about all the billions of dollars that have so far been spent on homeland security, supposedly preparing us for this sort of thing ever since 9/11. Where did the money go? What did it accomplish? The image comes to mind of former Homeland Security Secretary Tom Ridge visiting TV talk shows, smiling reassuringly, his "personal emergency kit" sitting primly on his lap--but perhaps I am being unfair.

It's time for America to get serious and stay serious. As for long-term care, coming off the agonies of Katrina, it should be placing well-aimed kicks at all levels of society to get things moving in Yarwood's far-seeing direction.

BY RICHARD L. PECK, EDITOR-IN-CHIEF

To send your comments on this editorial to the author and editors, e-mail [e-mail].