Geriatric Mental Health Disaster and Emergency Preparedness

Chapter 4 Coordinating Services 75
personal property records, providing for tracking individuals who may be
required to move to alternative locations, and coordinating disaster planning
and response across community and regional agencies (Mangum,
Kosberg, & McDonald, 1989; Reed, 1998). A study of the evacuation plans
of 213 nursing homes, for example, found that only 31% had specified
evacuation routes (Castle, 2008).
Adequate planning for evacuation also requires consideration for provision,
transportation, reinstallation, and use of any specialized equipment.
A post-Katrina study conducted in the New Orleans region identified
24,938 community-dwelling older persons who would require assistance
to evacuate as well as shelter in sites that could accommodate special equipment
such as wheelchairs, oxygen units, and other specialized health equipment
(McGuire, Ford, & Okoro, 2007).
The U.S. Centers for Disease Control and Prevention’s (CDC) January
2008 bulletin reported their review of the best recommendations for
communities to consider in preparing for disasters. The report placed specific
emphasis on addressing the needs of vulnerable older Americans and
those with chronic disease (Aldrich & Benson, 2008). The first and most obvious
CDC recommendation was to develop strong formal relationships
between various agencies, including public health, aging, and first responders.
A strategy for fulfilling this recommendation remains elusive.
Two other important recommendations made by the CDC were to develop
backup communication systems and to provide storage for redundant
medical and personal information. This includes the storage of medical
and personal information at locations other than in the immediate region.
To enhance response rates, the use of geographic information systems
(GIS) and other mapping systems can provide first responders with invaluable
information on the location of individuals likely to need assistance
and less likely to be self-sufficient. Comprehensive GIS systems can link
responders to data banks that contain relevant patient medical information
such as the need for oxygen concentrators, wheelchairs, and other devices,
which will allow them to arrive with appropriate equipment.
The development of alternative shelter locations should include design
alternatives including accessible locations for older persons and those
with special needs. To get older persons to the shelters, there must be planning
for the transportation of critical medical equipment and locating and
securing medications and medical supplies. It is critically important that
pharmacological services are included in plan development as it is likely
evacuees will not have direct access to full medical and prescription drug
histories without a GIS system.