Geriatric Mental Health Disaster and Emergency Preparedness

124 Geriatric Mental Health Disaster and Emergency Preparedness
( White House); to improve the efficiency and effectiveness of emergency
response, these groups must be systematically included in emergency
planning.
Special Concerns for Emergency Preparedness
in the Geriatric Population
Older adults face unique challenges in disasters. In addition to the physiological,
sensory, and cognitive changes that occur during aging, older adults
have an increased burden of chronic disease, making them more physically
and emotionally vulnerable than healthy adults (Aldrich & Benson,
2008). The experiences of the 1995 Chicago heat wave; the terrorist attacks
of September 11, 2001; the 2003 European heat wave; and Hurricane
Katrina in 2005 also highlight social isolation as an important risk
factor for mortality as many older disaster victims were forgotten by their
families and neighbors (Aldrich & Benson; Gibson, 2006; International
Federation of Red Cross and Red Crescent Societies, 2004). Similar to recommendations
for individual preparedness, materials on emergency preparedness
for older adults and the disabled published by AARP, FEMA,
and the American Red Cross focus on the development of a preparedness
kit and a disaster plan and discussion of the plan with family, friends, and
caregivers (AARP, 2006; FEMA & American Red Cross, August 2004). One
component of these plans is identifying a personal support network—several
individuals who will help prepare the older adult for a disaster and
check in with the older adult in the event of a disaster (FEMA & American
Red Cross). Preparedness materials also encourage older adults with disabilities
to register with a local police or fire department and with the
utility company if they need electricity for medical reasons. While preparedness
recommendations for older adults and the disabled do encourage
planning and thinking through disaster situations, they place most of the
responsibility for these actions on the individual, again ignoring the surrounding
community and alternate caregivers.
Relying on frail older adults to be able to activate a personal support
network, be evacuated, and receive appropriate care is shortsighted given
the numerous challenges experienced in a disaster setting. Disability, disease,
and social isolation signal the need for better location and evacuation
strategies for frail older adults in disasters; emergency planning must include
a detailed plan for locating older adults who are confined to their
homes or nursing homes and ensuring shelter, an appropriate diet, adequate
water, and routine medical care (including prescription medication)
throughout the duration of disaster recovery.