Research mission explores how aged care can withstand natural disasters

Australia’s aged care services are increasingly on the frontlines of natural disasters. In just 2024 and 2025, floods, bushfires, cyclones and heatwaves have all disrupted aged care, forcing hurried evacuations, cutting power to facilities, isolating vulnerable residents and straining a system already under pressure. These lived experiences reveal practical gaps in our disaster preparedness. This editorial examines recent events and what they taught us, and looks at how we might improve, drawing on insights from a 2024 Churchill Fellowship study into aged care disaster responses in the United States. The message is clear: climate-related emergencies are no longer rare events, and aged care leaders must plan for the unthinkable as a new normal.

A surge of disasters disrupting care

No corner of the country has been untouched. In early 2025, severe floods on the New South Wales Mid-North Coast cut off entire towns, isolating an aged care home in Cundletown with 67 residents.

“I came to work on Tuesday and haven’t left,” said a nurse who found herself stranded caring for residents as the facility became an emergency shelter.

Cyclone Alfred struck Queensland in March 2025, a slow-moving tropical cyclone that battered communities from Hervey Bay down to Coffs Harbour. The storm knocked out power lines, plunging half a million properties into darkness and causing a record number of outages. Aged care homes in its path had to activate backup generators and emergency plans. On North Stradbroke Island, one small Indigenous aged care facility decided to evacuate all 11 residents ahead of the cyclone, knowing staff would be unable to reach them once ferries stopped and winds hit 150 km/h . St Vincent’s Care, which had pre-positioned ten days of food, water and medical supplies at its own homes, stepped in to shelter these evacuees in a Brisbane hospital ward until the danger passed.

Other facilities were not so fortunate. Bushfires during the 2023–24 summer and into 2024 have repeatedly threatened aged care services. In November 2024, a fast-moving bushfire near Dirranbandi (south-west QLD) triggered an overnight evacuation of the local multipurpose health service, including five aged-care residents and seven staff who fled as flames approached. All were rescued to safety , but the stressful ordeal underscored how quickly aged care homes can be overtaken by events. A month earlier in Western Australia, a fierce fire in the northern suburbs of Perth forced a mass evacuation of two aged care campuses. In one day, over 100 nursing home residents from the Elderbloom Community Care centres were moved out of the fire’s path – 50 taken home by family members, 56 relocated to a university nursing school hall, and others sent by ambulance to hospital . Remarkably, this complex evacuation was completed in under 24 hours. Staff later won praise for their lifesaving teamwork and preparedness during the Wanneroo bushfires, which destroyed 18 nearby homes.

According to Aged Care Peak CEO Tom Symondson, these emergencies show that “ensuring the safety and well-being of residents in aged care homes is paramount, especially over our summer holidays when bush fires, cyclones, storms and floods can be expected” .

Beyond the dramatic rescues, climate extremes are also testing aged care in quieter ways. Heatwaves in the 2024–25 summer were described by experts as a “silent killer” that causes more deaths than any other natural disaster in Australia. Heat puts frail older people at high risk of dehydration, heat stroke, heart failure and worsening of chronic illnesses. Providers received clinical alerts reminding them that heat-related illness can escalate quickly to confusion, organ failure or death if not recognised early. Periods of extreme heat also strain the broader health system, with hospitals in Western Sydney seeing spikes in emergency cases . The biggest risk is when heat and power loss coincide. A heatwave in November 2024 saw electricity demand soar just as several coal power plants tripped offline, pushing NSW to the brink of outages . The grid only avoided blackouts by calling large batteries into action. Had those outages cascaded, some aged care homes could have lost air conditioning on 35°C+ days. It is a nightmare scenario that became reality in Florida in 2017, when a nursing home’s AC failed after a hurricane, contributing to multiple deaths. Florida responded by mandating backup generators and fuel at all nursing homes to keep temperatures safe for at least 96 hours after power loss. While Australia has not seen a mass casualty event in aged care from heat or power failure, the near-misses and escalating heatwaves are an urgent warning.

Gaps exposed: planning, power and people

Recent disasters have spotlighted practical gaps in how aged care services prepare for and cope with emergencies. Power dependency is the most obvious. Modern aged care homes rely on electricity for lighting, climate control, medical equipment, refrigeration of medicines and communication. When mains power goes down, facilities depend on generators (if available) and fuel supplies. Not all providers have sufficient backup capacity.

Human resources are another gap. Aged care facilities cannot be evacuated or run by skeleton staff as easily as other workplaces. Yet emergencies often occur with little warning or when staffing is already tight. In flood-isolated areas, staff simply had to stay on duty non-stop because replacements could not get in . Evacuations require coordinating transport and maintaining continuity of care, which is enormously complex. Without surge workforce plans, providers are vulnerable.

Communication and coordination with emergency services is also a weak point. Johnstone noted after the 2011 Queensland floods that there was “a significant disconnect between the disaster management system and residential aged care facilities”. Encouragingly, this is starting to change. New Aged Care Quality Standards, coming into effect in 2025, will mandate that providers develop and test disaster management plans and actively engage with emergency services, residents, families and staff .

Learning from overseas: a Churchill Fellow’s mission

Annabelle Johnstone, an Ipswich-based community recovery expert, was awarded a 2024 Churchill Fellowship to investigate how aged care facilities in the United States plan for and respond to disasters. The USA faces a gauntlet of natural hazards – hurricanes, wildfires, floods and tornadoes – often impacting retirement communities and nursing homes.

Johnstone scheduled over 50 meetings across multiple states with emergency managers, health officials, disaster researchers, aged care advocates, nursing home operators and families. She argues that integration is critical, with aged care operators participating in disaster management training and exercises. Some US states legally require nursing homes to maintain backup generators and fuel, while others run annual drills simulating mass evacuations. She is also examining family communication plans, evacuation buddy systems and registries of high-risk older adults to check on during emergencies.

Johnstone will deliver a report to Australian authorities and the sector after her US tour.

“To the best of my knowledge no one has considered the aged care sector in disasters in this way, standing at arm’s length and defining best practice,” she said.

Her findings could not be more timely as climate scientists warn that extreme weather events will continue to intensify.

Leading change: from lessons to action

The experiences of 2024–25 prove that natural disasters can and will reach into aged care facilities and clients’ homes. Disaster preparedness must be treated as core business, not as a compliance exercise. Boards and executives should ask: are we ready for the worst?

Investment in resilience is essential. Backup generators, fire safety upgrades, secure communications and better building design are lifesaving measures. Funding support should help smaller providers meet these standards.

Finally, collaboration matters. Aged care must be part of local emergency planning and share lessons across the sector. The Wanneroo evacuation showed how families, communities and providers working together can achieve the impossible.