Geriatric Mental Health Disaster and Emergency Preparedness

74 Geriatric Mental Health Disaster and Emergency Preparedness
n SWiFT 1 are those who are unable to perform daily activities and
need immediate placement where direct care can be provided—
nursing homes, care homes, or assisted living locations.
n SWiFT 2 are those individuals who need assistance in accessing
benefi ts or in fund management and who can be linked to appropriate
services.
n SWiFT 3 are individuals who simply need to be connected to families
or who have issues easily addressed by volunteer agencies.
The SWiFT form quickly assembles information on physical and mental
health issues and status and information on case management needs.
Working with the AMA, the SWiFT team also evaluated the effectiveness
of the response in relation to the services provided to older persons.
Their recommendations for best practices in the management of older
disaster victims were derived from their experiences in dealing with over
10,000 cases and include designating separate shelter areas for older persons,
using a triage system like the SWiFT, and protecting older persons
from abuse and fraud (Baylor College of Medicine and the American Medical
Association, n.d.).
Research related to large-scale man-made disasters in the United
States is limited to events surrounding the September 11, 2001, combined
terrorist attacks on the Twin Towers. These events did not result in largescale
population evacuation or large disruption in living spaces. However,
they did result in changes in employment and movement within the affected
areas. But these impacts were largely limited to the New York City
area. Similarly, the airplane collision into the Pentagon did not affect residential
areas, and the impact in Pennsylvania occurred in a largely rural
area. This research suggests that for this type of event, adults of all ages are
largely resilient, with low evidence of PTSD or low evidence of increase in
substance abuse. Resilience was found to be related to complex interactions
of sex, age, race, level of education, degree of exposure to the trauma,
income and subsequent change in income, social support, chronic disease
presence, and recent and past life stressors (Bonanno, Galea, Bucciarelli, &
Vlahov, 2007). This complexity of mitigating variables makes it very difficult
to develop targeted preparedness plans.
Even in high-risk natural disaster areas, there remains insufficient
planning for dealing with older persons (Dosa, Grossman, Wetle, & Mor,
2007; Lach, Langan, & James, 2005). There is a lack of preparedness in
identifying vulnerable individuals, noting specific anticipated needs and
mobility issues, providing for the protection of important medical and