The real test of the army of caregivers for tens of thousands of seniors trapped at home when Hurricane Sandy slammed the East Coast began the day after the storm ended. Eloise Goldberg, the Visiting Nurse Service of New York supervisor for the Bronx and half of Long Island, stepped out of her home about 50 miles east of New York City on Tuesday morning, jumped into her car (her husband’s was crushed beneath an oak tree), and began to figure out how to get 11,000 home health aides and 3,500 clinicians to their patients. “We had been preparing our field staff for several days so they would have cellphone connections with their patients, but now we were up against massive flooding and blackouts and fires.”

On the Rockaway peninsula in Queens, where the Atlantic had cut through to join Jamaica Bay, nurses had begun to call Goldberg’s cell during the height of the storm on Monday. One nurse said she was wading in to reach trapped patients. She walked seven blocks through knee-high water to get to a group home and found medicines had been washed away. She would get prescriptions refilled and return, she promised. But by afternoon, downed wires sparked fires that eventually consumed 60 houses. By nightfall, more than 100 homes were destroyed. Many patients who had refused to evacuate were desperate to escape floodwaters that were climbing past the first floors. Each nurse on Goldberg’s Long Island team was reporting that they couldn’t find several patients. “The majority of our patients have been very calm through the hurricane,” Goldberg told me on Wednesday. “But if this continues—the blackouts, the lost power for communication, no water supply—I anticipate a very different reaction.”

“I’m providing essential emergency services,” she told police. She walked up 12 flights to administer the medicine and calm the patient, who, like tens of thousands of others, was sitting in the dark with no TV, no water or gas service, and (aside from a dying cellphone) completely cut off from the outside world.

With one half of the 1.1 million people on Long Island still without power as of Friday, New York Gov. Andrew Cuomo blasted the Long Island Power Authority, which at first vowed to restore service to 90 percent of its customers by Wednesday. Messina’s advice to distant families with loved ones in this situation is to call a home-care company to get a live-in aide for a week or two, until essential services are restored.