The firefighters came on Monday. They went up and down the halls, knocking on every apartment in the six-story Ansonborough House building in downtown Charleston, S.C., and leaving notices on the doors of those who didn't answer: This area is under mandatory evacuation.
The manager of the building heeded the warning and left a note on the window in the lobby explaining that the building would not be staffed all week.
And yet, on Wednesday morning, small groups of residents stood in the parking lot and on the sidewalk out front, enjoying the light rain and fresh air. "I think everybody is still here except a handful," says Clara Hale, a pastor in her 70s who lives on the second floor.
As coastal communities from Florida to Virginia order or consider evacuation for residents, emergency officials are being forced to grapple with a difficult coincidence — many of the places most prone to Atlantic hurricanes are also popular retirement locations for a ballooning number of seniors.
"Evacuating for older adults is definitely a more challenging situation," says Sue Anne Bell, an assistant professor at the University of Michigan School of Nursing who studies how older Americans are affected by disasters.
Bell also worked with seniors during Hurricane Irma in Florida and Hurricane Maria in Puerto Rico, and she says one barrier to evacuation is that people who are living on a fixed income might not have the financial flexibility to pay for transportation or a hotel room.
Slow-moving, wet storms such as Dorian — storms that are more common as the climate changes — can be especially frustrating because they linger for many days, increasing both the emotional and financial cost of evacuating.
But staying in the path of a storm is dangerous.
"We often think of disasters as immediate emergencies," Bell says. "But really what I see more of is people with chronic medical conditions that need routine care that they're not able to get." That includes people who need dialysis or chemotherapy or who rely on medication to treat cardiovascular disease.
Many of those risks apply to the residents of Ansonborough House in Charleston, which was built to provide affordable independent housing for seniors.
On Wednesday morning, Hale's neighbor woke her up at the crack of dawn asking for a lift to the dialysis clinic she goes to three times a week. Hale is still working as a pastor and she has a car, so many people rely on her for rides.
"I'm the Uber for this place," she laughs. It's potentially life-saving work. The cab that Hale's neighbor had called to pick her up never arrived, and the dispatcher wasn't answering the phone. Most businesses in town closed after the evacuation order went out.
"I don't know what she would have done if I didn't take her [to her dialysis appointment]," Hale says. "Probably just not go. Which is bad, you know?"
Hale's neighbor, Judith Allen, has lived in the building for 14 years and says there are at least a dozen residents who rely on medical devices that use electricity and who are worried that the building will lose power.
A new poll of more than 2,200 people between the ages of 50 and 80 nationwide found that about 9% of respondents use medical devices that require electricity, such as oxygen concentrators. However, only 25% of those people had a backup power source for their device.
"A power loss could have big consequences for those who depend on those devices," says Bell, who helped develop the poll. A study of nursing homes after Hurricane Irma in 2017 found that power outages from that storm contributed to the deaths of at least eight people in Florida.
"It's so stressful," says Allen, who says she feels responsible for her neighbors who use such devices. She thinks about a dozen people in her building rely on oxygen. "It affects them catastrophically. They just panic. And I can't blame them."
The poll also found one big bright spot when it comes to seniors and disaster preparedness: The majority of respondents had a seven-day supply of water, food and medication.
Still, there's clearly room for improvement when it comes to planning ahead for major disasters. Fewer than half of those polled said they had spoken to loved ones about a plan for evacuating or otherwise dealing with a storm, fire or other disaster. For more information, visit the federal government's disaster preparedness site dedicated to seniors.