New York ? In a season of national calamities, the elderly have taken perhaps the hardest hit – dying by the dozens in flooded Louisiana nursing homes, aboard a blazing bus near Dallas, in the chilly waters of a New York lake after a tour boat capsized.

Different factors lay behind each incident, yet together they are provoking debate on what more should be done to maximize the safety of older people. Though many are spry and resilient, others need special attention and care to get through an emergency.

Nursing homes are one obvious target for scrutiny and tighter regulation. Failure to carry out evacuation plans contributed to 56 deaths at two Louisiana nursing homes during Hurricane Katrina, and the industry nationwide faces pressure to curb the number of fatal fires and other safety problems.

Nursing home and hospital patients are placed in baggage carriers before they are boarded onto a C-141 plane Sept. 23 at South Texas Regional Airport in Port Arthur, Texas. The U.S. Army was evacuating patients before Hurricane Rita made landfall in Jefferson County.

‘Invisibility of older people’

Katrina also took a heavy, though yet uncounted, toll on seniors who lived on their own; some drowned and others were stranded helplessly for days. Dr. Robert Butler, an expert on aging, says the hurricane should prompt authorities to be more aware of where frail and elderly people live, and proactively develop plans to help them in the event of a natural disaster or terrorist attack.

“In some sense, these tragedies reflect the invisibility of older people,” said Butler, president of the International Longevity Center. “No one is thinking about them ahead of time.”

Beyond better disaster planning and closer oversight of nursing homes, other possible safety measures might be problematic in an era when older people increasingly want unfettered access to leisure, travel and adventure. Former President Bush celebrated his 80th birthday with a parachute jump; climbers vie to become the oldest to conquer famous peaks.

Though some of the 20 elderly tourists who died in Lake George were frail and a few used walkers, none wore life vests. Yet there is unlikely to be any clamor to impose a life vest requirement specifically on senior citizens.

“A lot of times people who are frail or elderly don’t wanted to be treated differently,” said John Rother, director of policy and strategy for AARP.

Firefighters work to cover the wreckage of a bus carrying senior citizens fleeing Hurricane Rita who died Sept. 23 when the bus caught fire in Wilmer, Texas. In a season of national calamities, the elderly have taken perhaps the hardest hit.

Many states impose special license renewal procedures for older motorists, such as more frequent vision tests. But no other transportation safety laws distinguish between senior citizens and other adults, said Melissa Savage of the National Council of State Legislatures.

“That age group is a very powerful lobby,” she said.

Rother said AARP, which represents millions of Americans over 50, is conferring with nursing home executives about lessons to be learned from Katrina. He said one step could be for a region’s nursing homes to collaborate more closely, for example ensuring that their contracts with bus companies to handle an evacuation don’t overlap in a way that would produce a bus shortage.

The bus that burned in Texas was pressed into service to carry residents of a Houston-area nursing home out of Hurricane Rita’s path; 23 evacuees died. The bus went out of service in July after its registration expired, but was allowed back on the road through a waiver signed by Gov. Rick Perry to aid relief efforts.

In Louisiana, by contrast, the death toll was heavy at two nursing homes that were not evacuated and then were flooded by Katrina. Owners of one home have been charged with negligent homicide; the other home is under investigation.

Even some New Orleans-area nursing home residents who were evacuated faced indignities, Rother said. Some were taken to the Superdome, where living conditions rapidly deteriorated; others were transferred without paperwork to health care facilities where the staff didn’t know who was arriving.

“There is clearly a need for special-needs shelters, places appropriate for a very vulnerable population,” Rother said. “These were not available in the Gulf.”

Changing systems

Florida, in response to recent hurricanes, has begun establishing such centers, Rother said.

Likewise, Chicago authorities responded to the 1995 heat wave that killed more than 700 people, most of them elderly. Now, during heat waves, air-conditioned city buildings can be converted into cooling centers, and city workers start calling and visiting the frail and elderly.

“One of the problems in the Gulf,” said Rother, “was that apparently the authorities had no idea where people were who needed help.”