DISASTER PREPAREDNESS FOR GERIATRICS

DISASTER PREPAREDNESS FOR GERIATRICS

Introduction

Senior adults are usually more vulnerable to disasters and epidemics. Such disasters include natural disasters like hurricanes and earthquakes and manmade disasters like terrorism and fires. Epidemics like the current virus coronavirus also get the old generation first because of their age that comes along with either disability or pre-existing disorders. Public health departments are unable to provide care to the older generation during and after disasters due to various factors such as lack of resources and qualified staff to conduct such operations. Therefore, it is essential for public health departments always to be set aside resources and strategized interventions in preparation of any disasters to protect the older generation from pre and post-disaster vulnerabilities.

Disaster preparedness in geriatrics

As one grows older and older, the body’s immune system continues to be weak. The body becomes vulnerable to illnesses, disability, and cognitive decline. Pre-existing vulnerabilities may include diabetes and high/low blood pressure, heart diseases, kidney diseases, etc. At such a physical state, the elderly person is more helpless when natural or manmade disasters such as earthquakes, floods, fires, or terrorism emerge. It becomes the public health department’s obligation to intervene and support these people to reduce pre and post vulnerabilities as well as morbidity. However, responding to such tragedies has proven to be a real challenge for health departments due to a lack of preparedness.

The lack of resources by the public departments and the state at large affects the ability to manage a disaster adequately. Lack of resources leaves the state to experience problems with mass communication, shortage of emergency support systems, and lack of qualified skills, and this only leads to adverse impacts on the elderly generations. According to research, disaster responders do not understand the care that the elderly needs and are not usually well equipped to respond effectively. This problem is caused by a lack of prior planning because disasters do not have warnings, but if planned for earlier, the state could set a significant amount of resources to develop intervention strategies for disaster response. The older generation is exposed to post-disaster vulnerabilities if there is an effective response. These include post-traumatic stress disorders, deaths, suicides, physical disabilities, being abandoned, etc.

Providing care for the elder during a disaster may also be faced with a number of challenges. Given that the elderly vary in needs, coming up with interventions that will suit all these needs, bearing in mind that some have very special needs, may prove to be quite difficult. Resources may also be minimal compared to the population of elder persons involved. Taking care of the needy may also prove to be challenging as they need special care and attention to reduce the feeling of isolation and loneliness as they have to move from their families.

Research questions

• What are the problems disaster responders go through that may limit their effectiveness in caring for the older generation during disasters?
• What vulnerabilities are the older persons exposed to during and after the occurrence of disasters?
• Which disaster interventions should be put to place in disaster preparedness for the geriatrics?

Annotated bibliography

Kar, N. (2016). Care of older persons during and after disasters: meeting the challenge. Journal of Geriatric Care and Research. 3.

The author’s aim in this article is to identify the risk factors, challenges that come along with providing care, and the intervention strategies that are connected to providing care to older persons during a disaster. The author states that older persons are usually more fragile, just like the infants, and are therefore more vulnerable to calamities, unlike the younger generation. He also states that there are usually challenged with physical and mental illnesses or disabilities. Others usually rely on machines to survive. Yet others have special needs that require more resources to meet, and this proves to be one challenge care providers face. He highlights some of these vulnerabilities as chronic conditions, heart conditions, or kidney failures.

According to Kar, older persons are also under the risk of experiencing post-disaster vulnerabilities. They could develop more physical complications such as visual or hearing disabilities, may be left in financial constraints, lack of social support, lose their homes, or even be abandoned, and this can increase the chances of morbidity. Therefore the older generations need special attention during and after disasters to help them and reduce the risk of morbidity. The author states that lack of resources is a major challenge when it comes to disaster response. The state undergoes financial constraints and a lack of resources that can drive disaster management. The researcher also highlights the challenges staff experience during disaster response. They lack basic knowledge about handling the older generations. He states that some support machines are too expensive for the responders to afford. This is especially when elderly persons need special care. Staff also lack training on how to care for these people.

There are various disaster interventions that disaster taskforces can implement in response to calamities. These interventions involve providing relief food consumable by the elderly, medical interventions, shelter, and clothing. Some countries have put up shelters and buildings purposely for disaster responses. These buildings should, however, be equipped fully to sustain the elderly persons, and especially those with disabilities. Another intervention mentioned is electing and training a disaster preparedness task force specifically to identify and address the needs of the elder during and after catastrophes. He author also states that it is the role of the government as well as non-government agencies to short arms and plan for the ways through which disasters can be addressed. Resources should be set aside for such a project instead of being caught off guard.  He concludes that even if the older generation is acknowledged as a vulnerable group, they haven’t been prioritized, and actions need to be taken immediately to reduce their mortality during disasters.

Center for Disease Control and Prevention. (n.d). Emergency Preparedness for Older Adults. Retrieved from https://www.cdc.gov/features/older-adult-emergency/index.html

CDC gives a guideline through which older adults can protect themselves during a disaster. According to the article, during natural calamities, people are forced to leave their homes at short notice, and it is essential to be aware of how to handle the matter before the occurrence of the calamity. It recognizes that during a calamity, an elderly person is in more risk to suffer challenges than a younger person. These challenges include chronic conditions, movement due to disabilities or feebleness, or lack of care from family. Also, they may not be able to follow the emergency response instructions as given carefully. Therefore, the CDC gives a plan that an older person can regularly review to get a basic knowledge of responding to a disaster by themselves.

An older person can be helped by a friend or family member in writing this plan. Firstly, the older person ought to choose an emergency contact that they can rely on during a disaster. Contact information is also needed, which can be stored on the phone an in the supply kit so that in case one is lost and found; they can be directed to their friends. A plan on how to leave home should be listed too. Physical conditions and disabilities should also be listed. An emergency kit should be well equipped with first aid supplies, hearing aids, the contact information of the family member, some extra personal documents too. The CDC also offers a template that can be used to come up with a standard plan for the elderly people to prepare them to respond and take care of themselves during a disaster and not necessarily wait for the government task force.

Cornell, V.J., Cusack, L., and Arbon, P. (2012). Older people and disaster preparedness: a literature review. The Australian Journal of Emergency Management Volume 27, No. 3.

The authors acknowledge that the most vulnerable people during the preparation, response, and recovery phase of a disaster is the elderly people. They, therefore, focus on identifying how the council of the Australian government (COAG) and the emergency department can build resilience for this vulnerable group in society.  According to the article, natural and manmade disasters are still the major challenges that the emergency department in Australia continues to face. The previous events, e.g., Victorian Bushes and floods, have magnifies the essence of involving the vulnerable groups during preparedness and response planning. They state that older people should not only be planned for but should also be involved during planning to prepare them psychologically. According to the article, one major mistake the authorities make is to prepare to respond to the calamity instead of the individual. This way, the effects of the disaster and mostly psychological are not tackled.

The authors also post interesting questions, who is responsible for protecting the older people in their own homes or for ensuring their preparedness? The authorities? The older people or the mixture of both? According to them, the responsibility should be shared between the government and the old people themselves, and therefore they insist on their involvement. They also state that the older generation is much experienced due to their age. Therefore, they could serve as a source of information on how to respond to various calamities. The world health organization emphasizes the essence of taking care of the older generation as they are the background of knowledge and guidance in society. The authors conclude that it is essential to understand and engage the old as it helps in building their resilience. Paternalism should be reduced in Emergency management planning and more involved advocated for if resilience is to be achieved.

John, A., Therese, M., Judith, L. (2012). Geriatric Mental Health Disaster and Emergency Preparedness.

The aim of the book is to highlight the mental implications of disasters to the old generation and recommend evidence-based care practice effective when handling older people in response to disasters. The authors state that the older generation is the fastest-growing demographics in the US. By 2025, 18.2% of the US population will be more than 65 years. This figure will double by 2050. The aged population will be more pronounced in the disaster-prone states such as Florida and Mississippi. The authors state that there is little knowledge about the psychological impacts on the older generations. Also, there is the availability of enough information on the rescue interventions effective for the older population. Research has shown that one major psychological implications are PTSD. Many older people suffer from PTSD, which increases the morbidity of these people. Other mental disorders include generalized anxiety disorder, panic disorder, depression, and dementia. The authors state that from the findings from previous research, more rational and effective interventions are needed. Another implication is feeling lonely and sad and may develop suicidal thoughts or hopelessness.

In the book, the authors state that evidence-based care practices have been tested since the 11^th century, but interventions on the field of health have been addressed in the 20^th century. These care practices include the establishment of a qualified task force that will conduct medical treatment or screening. The task force should also be trained in giving counsel and treating PTSD. Mediation should also be used, such as antidepressants, in case the therapy does not work. The authors conclude that during disasters, negative implications should be expected, and especially, the psychological wound may take longer to heal than the physical wound. Therefore, even if it is important to prepare physically and allocating aside resources for medication and other finances, the psychological wound also needs attention and counseling, love and comfort can help to support the aged population during the recovery of a disaster.

Banks, L. (2012). Caring for Elderly Adults during disasters: Improving Health Outcomes and recovery. 0038-4348/0Y2000/106-94DOI: 10.1097/SMJ.0b013e31827c5157

The aim of the article is to address the unique challenges that the elderly go through during disasters and epidemics and to pinpoint the various mitigations that the healthcare providers can put to place to help the elderly get through the disasters. The authors highlight previous studies that have indicate the population percentage of the elderly and how they have been affected during previous disastrous events. It states that in 2010, 9.7% of the population is over 65 years, according to the US census. According to previous research, the heatwave in Chicago in 1995 mostly killed those who lived alone and confined in beds. In hurricane Katrina kills, 47% of the deaths were aged 74 and above. The authors pinpoint that the elderly are more vulnerable than the young due to their physical and financial status. Some have visual or hearing impairment limiting them from understanding response instructions. Others are too weak to move or have disabilities. Also, others have no resources to relocate or are living in social isolation. These factors increase the chances of death.

The authors state that the major problem that these elderly people face comes from the government and the public health departments as they are responsible for helping the elderly during such circumstances, yet there is poor or non-existent disaster planning. Moreover, there lacks coordination between the responsible departments, and the old are left to fend for themselves. According to previous research, hurricanes Katrina and Rita caught the department unawares, and there were no enough resources to respond to the disasters, and this led to many deaths, and 47% were older adults of above 74 years. Research also stated that community emergency managers viewed the bursting facilities as private agencies are did not offer assistance during the disasters, showing a lack of coordination.

According to the authors, there is the essence of disaster planning and training as mandated by Medicare and Medicaid services. The older citizens should always be encouraged to stay prepared training as mandated by the offer assistance during the disasters. Plans like transportation and evacuation should be made. They should write down a list of their medical statuses, such as disabilities, allergies, etc., medication, personal information, and emergency contact that would help direct the older person home. Home healthcare services should make a point of joining community emergency planning and also join forces with government agencies to come up with interventions necessary for disaster response. Training is also a major precaution to equip staff with skills and knowledge to handle the elderly and provide care during disasters. The authors conclude that being prepared can improve health outcomes and recovery in older people. The older patients need support, medical care protection from financial constrains, abuse, and fraud to protect both their physical, emotional and psychological health.