For Natalie Geisman, 92, the hardest part about dealing with the hurricane about to hit her city is waiting for it to be over.

She and her husband live in Deerfield Beach, Florida, about four miles from the ocean on the southeastern coastline. The storms trajectory is unpredictable, but theyve done everything they can to prepare: shopped for extra food, stocked up on medicines, and checked to make sure their independent living facility is equipped with a generator and hurricane-proof doors and windows.

But still, theres a lingering sense of vulnerability.

This ones scaring the hell out of me, Geisman said in a telephone interview on Friday. She dreads waiting out the next several days, and shes worried that if the electricity does fail, shell have to navigate four floors of stairs with her walker. But Geisman, like many of the elderly residents who live in her building, feels like she doesnt have much of a choice.

Were all senior citizens, we have walkers, electric scooters, you know, we were all told to stay in our apartments. We have no place to go, Geisman said.

With 5.2 million residents over the age of 60, Floridas percentage of senior citizens ranks among the highest in the country. And many of Floridas elderly residents are concentrated near the southern coast, where Hurricane Irma is expected to make landfall over the weekend.

With winds forecasted to reach 150 miles per hour by the time it hits Florida, Hurricane Irma has already killed at least 20 people, destroying power lines and buildings as it rages through the Caribbean. It is expected to cause unprecedented levels of damage in Florida, a state that has already been hit by major hurricanes.

Preparing for a natural disaster of this scale presents a challenge for anyone but senior citizens can face additional obstacles. Theyre more likely to deal with physical impairments that limit mobility, to require medical devices that require electricity, and to suffer from dementia, making it difficult to plan ahead or respond to a rapidly escalating situation.

A 2012 study found that nursing home residents with dementia who were evacuated during a hurricane faced increased rates of hospitalization, morbidity and mortality in the months that followed. Even in non-disaster situations, traveling can disrupt an individuals sleeping and eating patterns all these changes are amplified when you have a highly chaotic situation, Lisa Brown, the studys lead author, explained in an interview.

Floridas care for its elderly community during natural disasters is the gold standard, Brown said. If youre going to be struck with something like this, I think Florida nursing homes are really ahead of the curve.

Nursing centers in Florida are required to have an emergency preparedness plan that is approved by local government officials responsible for emergency planning. The Florida Health Care Association, an advocacy group that represents 82 percent of the states nursing centers, has been holding daily phone calls to brief facilities on the hurricane. The state has a reporting system that allows nursing facilities to share the number of beds they have available for evacuees.

Guillermo Someillan, the owner My New Oasis, an assisted living facility in Miami, said he has two other facilities within driving distance that he and staff members can evacuate residents to if necessary. We might have to get out and push tree limbs aside, to travel across the roads, he acknowledged.

Someillans main facility is just outside of the mandatory evacuation zone, so for now, he is focused on keeping his residents, some of whom have mild dementia, happy. He recently turned off the news and switched the televisions to show comedies instead. I dont want them to dwell on the worst-case scenario, he said.

Senior citizens who live on their own can be even more vulnerable during natural disasters than those in nursing homes or assisted living communities. People who want to evacuate but require assistance can register in advance with the Florida Special Needs Registry but they arent guaranteed a spot, and not everyone who needs assistance knows how to access it.

Floridas Department of Elder Affairs has a list of people enrolled in state, local, or community programs for senior citizens. As of Thursday, staff members had finished calling everyone on the list, making sure they have what they need to get through the hurricane.

But several of the resource centers that provide transportation, food and medical services to the elderly have already closed, leaving senior citizens largely on their own for the next several days. For those who live in buildings without generators, electricity cuts would mean stifling heat and no elevator to get them downstairs.

Edith Lederberg, the executive director of the Aging and Disability Resource Center of Broward County, has spent the past several days arranging for seniors in the community to receive extra food deliveries from Meals on Wheels in preparation for the storm.

Lederberg has worked at ADRC for more than 40 years, so she knows better than most the needs and concerns of the community. Its a vulnerable population. People get very lonely and frightened, she said.