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Sister Cornelia from the Congregation of the Franciscan Sisters of Salzkotten (North Rhine-Westphalia) is responsible for crisis management in her community – and also contributes experience from nationwide project groups on crisis preparedness. As a founding member of the BIVG, the German Federal Initiative for Networked Emergency Response, it is very familiar with the interfaces between care, authorities and emergency organizations. The congregation operates two inpatient care facilities and also provides premises for an adjacent kindergarten.
In this interview, we talk about the key lessons learned from this work and Sr. Cornelia explains which simple, everyday steps can really help older people and family caregivers: From arrangements with pharmacies and GPs to medication plans and how neighborhoods can become a crucial safety line in an emergency. A conversation about the practical ability to act – and about responsibility, which begins where we don’t just think about ourselves.
SBC: Crisis plans often focus particularly on vulnerable groups. You are responsible for crisis management in your organization and therefore have a very practical approach. How do you define ‘vulnerable’ in your work – and how did you specifically approach the needs of these people when planning?
Sr. Cornelia: In addition to older people, this typically includes the chronically ill, people in need of care, people with disabilities – physical, cognitive or mental – and people in special circumstances. These include single people, people on low incomes, homeless people and refugees. People who are dependent on life-sustaining or power-dependent devices, such as ventilation, oxygen supply or similar medical technology, also clearly belong in this category for me.
Vulnerability’ is not just a question of age, but also of the health situation, social integration and the practical ability to act in everyday life. And this is precisely where I see the link to your focus on care at home: in inpatient facilities, crisis plans, routines and responsibilities are usually in place – in the home environment, this is much more difficult. There, care is often thought of in very general terms, but the really tricky part starts with care in the narrower sense: medication, complex restrictions, dementia, mobility, loss of communication, dependence on support.
>> In inpatient facilities, crisis plans, routines and responsibilities are usually in place – in the home environment, this is much more difficult. There, care is often thought of in very general terms, but the really tricky part starts with care in the narrower sense: medication, complex restrictions, dementia, mobility, loss of communication, dependence on support. <<
That’s why I think your expanded view of vulnerable groups also makes strategic sense: there may be concepts from other areas, such as dealing with mental impairments or social risk situations, that can be used as benchmarks or building blocks for home care. This transfer is worthwhile precisely because much of this has not yet been sufficiently concretized.
And another point that is important to me: the blackout is a very present scenario at the moment – but it is not the only one. Climate change-related events such as floods, storms or heatwaves are at least as relevant as local situations such as severe winter events or infrastructure disruptions. This is precisely why it makes sense to view crisis preparedness not as ‘one’ event, but as the ability to remain capable of acting in different scenarios.
I don’t know how present this is in Austria at the moment – but in Germany there were recently quite a few households that were suddenly left without electricity due to huge amounts of snow. Such situations are always an opportunity for me to pause for a moment and reflect: The ‘blackout’ is often not the beginning, but rather the end product of a chain of events. Many different scenarios can end up tipping in the same direction – and that’s precisely why it’s important to me not to narrow our precautions down to just one major event, but to think in context.
SBC: If I want to prepare myself for crises as an older, vulnerable person – or as a family caregiver who shares responsibility: What sources of information and contact points do you recommend?
Sr. Cornelia: What I can specifically recommend: In Germany, the brochure ‘Preparedness for crises and disasters’ from the German Federal Office of Civil Protection and Disaster Assistance is really very good. It has recently been updated and is extremely practical for use at home. It contains everything – from stockpiling to simple steps to take. Care is still not given enough thought, but the document is still excellent as a basic guide. Clearly described, without technical jargon, and presented in such a way that it is immediately understandable in everyday life. It is also available as a printed brochure that you can keep to hand at home. There are also regular information days, for example I attended a disaster prevention day in Paderborn. At these information days, you can get specific tips from the local aid organizations.
Put this advice and information in your own emergency folder – it’s quite simple, but enormously helpful. A folder in which all important documents are collected: Documents, contacts, medical information, insurance, possibly also a small checklist. I have also recommended this in our facilities. We have an internal crisis team, and something like this is part of their standard equipment.
And then there is something else that I think is underestimated: Regional contact points – some call them that, others call them ‘lighthouses’. In terms of content, it’s often the same thing: places you can turn to in the event of an incident and where information, support or basic supplies are organized. Familiarize yourself with your community: Where is my nearest point of contact – and how do I get there? You can often get this information from the town hall, the community center or local brochures. This is certainly the most concrete way for people who are dealing with pension provision for the first time to get started. These local guides are ideal for initial orientation in your own environment. However, many older people need support here or do not want to organize this on their own.
And another point that is important to me – especially with regard to home care: Outpatient care services also play a central role here. They are close by in everyday life, are familiar with many situations and, if there are appropriate arrangements, can provide support with preparation and routine checks. This is not the only solution in the event of a crisis, but it is a building block that should definitely be considered in the home.
My personal advice: make use of such contacts. Documents, concepts, guides – there is already a lot out there. But it often only becomes viable if you know people and organizations in the background who can be contacted in an emergency and don’t have to be set up first.
<< But it often only becomes sustainable if you know people and organizations in the background who can be contacted in an emergency.>>
Sister Cornelia from the Congregation of the Franciscan Sisters of Salzkotten (North Rhine-Westphalia) is responsible for crisis management in her community – and also contributes experience from nationwide project groups on crisis prevention.
As a founding member of the BIVG, the German Federal Initiative for Networked Emergency Response, it knows the interfaces between care, authorities and emergency organizations at close quarters. The congregation operates two inpatient care facilities and also provides premises for an adjacent kindergarten. (Photo credit: Private)
SBC: You have been commissioned to develop crisis plans in several projects. In your opinion, what specific preparations are really useful for older people – and for family caregivers – in the event of a crisis, without overburdening them?
Sr. Cornelia: I wouldn’t overload the preparation, but prioritize it clearly. From my point of view, three points are central:
Firstly: communication and orientation. If your cell phone and internet go down, you need a clear plan on how to get reliable information when the digital channels break down: A battery-operated or crankable radio is the simplest option. In addition, warning and emergency call apps can be useful – as a building block, not as the sole solution. In Germany, these include warning apps such as NINA or KATWARNand for emergency calls the official app Nora. This does not replace other channels, but can help as soon as the network is available again (even if only temporarily).
The initial orientation is followed by practical questions: What do I do when the lift stops? – and someone can hardly or no longer manage stairs? Such scenarios should be thought through soberly before they happen. And here’s another tip: if there is an elevator in the building, please check to see if anyone has gotten stuck in it.
Secondly: care on a small scale – without perfection. Have cash at home because ATMs and card payments can fail. A small amount of cash at home can make all the difference for small purchases or if transportation is necessary. Realism also helps more than ideal plans when it comes to food: if cooking is not possible, you need food that can be used without cooking. A small stockpile that fits in with everyday life is better than perfect lists that nobody implements.
It becomes particularly critical when it gets dark: Older people lose their bearings more quickly and the risk of falling increases. Take measures to reduce the risk of falling, because a lack of light can quickly become dangerous for older people. Keep basic, non-powered aids such as flashlights and batteries to hand. If pumps fail, water is not only relevant for drinking, but also for hygiene – keyword toilet. Pragmatic solutions can also help here – including service water strategies and suitable treatment agents.
Thirdly – and this has the highest priority for me: medication. Because so much is organized digitally and follow-up care cannot be reliably planned in an emergency, I clearly advise making arrangements in advance with the supply pharmacy and – if possible – also with the GP practice. Not in the sense of stockpiling, but in the sense of ‘knowing what is realistic’: Which medicines are essential? What can a small reserve look like? How can I get hold of what is urgently needed in an emergency?
One issue that is often seen too late is the cold chain of medicines. Insulin is the best-known example, but not the only one. This raises the very pragmatic question: what cooling options do I have if the electricity is cut off? Is there an emergency power solution for the household – if necessary, can it be purchased jointly or shared with the neighbors? You don’t have to solve everything perfectly, but you should be aware of the dependencies.
And finally: The most important buffer is often not technology, but relationships. In an emergency, everyday things determine whether someone remains able to act. If relatives are there, it is crucial to discuss things in advance: How do we get in touch? Who has a key to the apartment and will check how the grandparents are doing?
This is all the more true for people with dementia or very limited mobility: uncertainty can quickly turn into restlessness or confusion. A crisis can quickly become overwhelming if no one is prepared. This is where neighborhood becomes a safety factor. Relatives can be relieved enormously if they make arrangements with neighbors in advance: Who will drop by when in doubt? Who will respond if no one answers the phone? And what simple sign is considered a ‘please check’?
Power outages happen time and again in certain regions – and I say that deliberately without alarmism. And then it quickly becomes unpleasant for people in need of care and their relatives. That’s why, for me, prevention also involves an attitude: we have a responsibility for each other. Not only for our own family, but also in our immediate environment. In an emergency, you are happy if someone thinks for you – and you can also make the difference for others.
My conclusion is therefore: crisis preparedness does not have to be complicated – but it must be concrete and connectable to everyday life. And this is exactly where honest simulations and clear priorities help more than any perfect checklist.
<< Crisis prevention does not have to be complicated – but it must be concrete and connectable to everyday life.>>
SBC: As a member of a project group of the Federal Working Group of Independent Welfare Care, you have created a supporting handbook that helps inpatient care facilities and day care facilities to better prepare for crises and how to deal with them. Can you tell us a little about this project?
Sr. Cornelia: I was approached by Caritas at the time. We were around 60 people in a working group, later divided into subgroups. The result was published in February 2023 and is available online – including checklists, prioritization aids, emergency plans and recommendations for stockpiling. This procedure was later transferred to outpatient care services, as they now also have to have crisis concepts. I was no longer involved in this second handout, but it is also highly recommended because it provides specific materials.
What emerges very clearly from all these projects is the importance of networking. A concept is only resilient if it has been clarified in advance who will cooperate with whom in an emergency. For example, we have deliberately prepared cooperation arrangements in case we have to evacuate and need places in another facility or even a hospital at short notice. And internal networking with suppliers, technology companies and service providersis just as important – all of which can be crucial in a crisis to ensure that care is not completely disrupted. Because one thing is clear by law: care facilities must be able to maintain basic care for residents even in a crisis. This is not optional. And this applies not only to nursing homes, but also to hospitals and pharmacies.
Pharmacies in particular are a good example of how vulnerable our systems are. We didn’t have a blackout, but we did experience a situation in which a problematic software update suddenly caused a lot of things to stop working: Ordering systems, dispensing systems, the entire digital logistics. A nearby pharmacy was affected, it simply stopped working. As you can see, you don’t always need a major disaster scenario. A digital outage can have similar consequences – and immediately.
For relatives at home, I recommend: Talk to the delivery pharmacy as long as everything is running normally. Clarify: What happens if there is a power, IT or logistics failure? What is realistic – and what is not? Of course there are contracts and promises, but there is no such thing as one hundred percent certainty. This makes it all the more important to know these interfaces, establish communication and not just try to reach someone in an emergency.
In short: good crisis preparedness does not consist of paper. It consists of practical plans, clear priorities – and reliable relationships with the people who are really needed.
<< In short: good crisis preparedness does not consist of paper. It consists of practical plans, clear priorities – and reliable relationships with the people who are really needed. >>
This is also one of the most important findings: Plans only really work if you test them. Not theoretically, but honestly – with realistic assumptions. And yes, that takes effort: communication with the city and emergency organizations, internal coordination, preparation. But that’s exactly how you can see where you need to upgrade. It’s like a fire drill: you only realize what’s missing when you do it.
SBC: Are there any points in crisis management or prevention where you still see potential for development?
Sr. Cornelia: Within Germany, crisis preparation and management is sometimes structured differently depending on the federal state. Hesse ticks differently to North Rhine-Westphalia – and it is precisely this lack of uniformity that sometimes makes it really difficult in practice. We have already experienced this very clearly during the pandemic.
And then we come to an issue that has frankly annoyed me for years: the question of critical infrastructure. Hospitals, fire departments and traditional emergency organizations are considered critical infrastructure and therefore often have better access to resources. Inpatient care facilities, on the other hand, are not automatically included in this category in many places. And in my view, this is difficult to understand because people live there who cannot simply react quickly on their own in the event of a crisis.
I also regularly raise this issue, including with authorities involved in civil protection in Germany. I have been fighting for months for inpatient care facilities to finally be seriously considered in the logic of critical infrastructure. As long as this doesn’t happen, funding and investments often depend on coincidences: Who pays for it? Who feels responsible? And in the end, it is often said that the facility itself is responsible.
We used a grant from North Rhine-Westphalia to further develop our crisis preparedness: In December 2022, the Ministry (MAGS) issued a decree allowing inpatient care facilities to refinance emergency power generators. Initially up to 25,000 euros, the amount was later increased to 50,000 euros because the pot was not exhausted. We used this for our two homes because it is simply logical: yes, there are conditions attached – maintenance, proof, regular checks. But you accept that if it means you can create security of supply.
What still baffles me to this day is that so few institutions have even taken up this offer. And at the same time, many people rely on the fact that ‘someone will come’ in an emergency – the fire department, civil protection, the local authority. But that is precisely what is not guaranteed.
For us, there is also the added factor: We not only have the care facility at one location, but also our parent company and the kindergarten, for which we provide the premises. If there’s a power outage, we’re not just talking about comfort, but about responsibility – regardless of whether the legislator puts us in the “KRITIS” category or not.
Thank you for the interview!
Click here for the homepage of the Congregation of the Franciscan Sisters of Salzkotten https://fcjm.de
Apps for Germany:
Warning app NINA
Warning app KATWARN
Emergency call app Nora
Author: Anja Herberth
Chefredakteurin
