ASHEVILLE, NC — More than three weeks ago, Hurricane Helene knocked out the power and running water at James Greene's nursing home in Asheville, North Carolina.
Today, Greene, 84, and his fellow residents at Brooks-Howell Home still do not have regular access to safe, running water for their daily activities.
"For two weeks we've been unable to shower or wash hands," Greene wrote in a letter to family and friends, which was shared with ABC News. "Maintaining hygiene with hand sanitizers is a constant must."
"Another example is having to pour a bucket of water into the tank of the toilet in order to flush. And keep in mind that our residents are old and not used to such physical activity," wrote Greene.
Greene's nursing home is not the only one in North Carolina affected by the ongoing water crisis in Asheville. While bottled water is adequate for cooking and drinking, the lack of municipal running water places severe restrictions on activities like handwashing, showering and laundry.
In nursing homes particularly, infections can travel quickly, making access to clean running water an even more urgent necessity.
According to the Centers for Disease Control and Prevention (CDC), floodwater from hurricanes can contaminate local water sources with "germs, dangerous chemicals, human and livestock waste" and other contaminants that can cause disease.
On Oct. 16, the City of Asheville Water Resource Department issued a Boil Water Notice for all water customers that is still in effect, meaning "there is contamination due to impacts from Hurricane Helene including the potential for untreated water in the distribution system," according to the notice.
The elderly are particularly at risk of infection due to many factors, including reduced immunity, existing chronic illness, and exposure to pathogens in hospitals and nursing homes.
Kimberly Smith is the vice president of operations for Ascent Healthcare Management, a company that runs six retirement facilities in Western North Carolina. As of Oct. 18, three of the company's Asheville locations still do not have running water, Smith told ABC News.
Even after running water returns, Smith said that she anticipates her facilities will be under the Boil Water Notice for quite some time.
Libby Bush, president and CEO of Deerfield Episcopal Retirement Community, located in Asheville, said her facility is also currently under the Boil Water Notice.
"It has been challenging to keep up with the current and most accurate information," she told ABC News.
Greene said he and other nursing home residents are deeply appreciative of the nursing home staff and government assistance in the wake of Hurricane Helene. While he now understands the scale of Helene's destruction, Greene said in his letter that his initial days during and immediately after the storm were spent in seclusion, with the initial lack of internet, landline, and cell phone service contributing to "an utter sense of isolation."
"The fact that no [one] called in, or could call out, made it worse," he told ABC News.
Smith added that many nursing home residents suffered "an emotional toll" because they weren't able to get in touch with their families.
Phone and internet services have been largely restored, Smith and Bush separately told ABC News.
Smith is also grateful for the shower trailers, portable toilets, hand washing stations and extra generators provided by the North Carolina Department of Health and Human Services, the state's Office of Emergency Medical Services, and the Federal Emergency Management Agency (FEMA).
They brought "a lot of things that we tried to get on our own and couldn't," Smith said. "All the regulatory people have kind of come together to help the nursing homes."
Still, there's a long road to recovery ahead for senior care facilities in Asheville.
Greene visited a Red Cross/FEMA disaster assistance center in Asheville and was impressed by the resources provided.
"It distresses me and others to see the negative reporting on FEMA and the Red Cross," he said.
"The senior citizens here, many of them retired deaconesses and missionaries, dealt well with the hardship conditions," Greene added of his fellow nursing home residents. "No doubt we are a bit traumatized, but God was good to us."
Sejal Parekh, M.D. is a board-certified practicing pediatrician and a member of the ABC News Medical Unit.
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