Geriatric Mental Health Disaster and Emergency Preparedness

Chapter 8 Self-Help Tools for Older Persons and Their Caregivers 143
et al, 2003). In addition, the 4.3% of older persons living in nursing homes
at any one time are also vulnerable (Pandya, 2001).
Therefore, about one quarter of all persons age 65 or older should be
considered to be unable to provide self-help during an emergency or disaster.
Many of these vulnerable older persons, especially those over age
85, have informal unpaid caregivers.
Interestingly, many of these caregivers are over age 65 themselves
(Spillman & Black, 2005). This underscores the fact that during an emergency
or disaster, 75% of all persons aged 65 or older are available not
only to provide self-help but also to assist vulnerable elders and otherwise
provide assistance and guidance as required.
Most individuals regardless of age or level of disability are resilient;
when faced with disaster or adversity they manage to recover functionally
and psychologically. Some, however, experience prolonged episodes
of hopelessness, helplessness, and PTSD (Bleich, Gelkopf, & Solomon,
2003; Maguen, Papa, & Litz, 2008). They require assistance with developing
successful coping strategies. Strategies that increase feelings of selfsufficiency
(Bleich, Gelkopf, & Solomon) and normal routine (Maguen,
Papa, & Litz) are thought to contribute to recovery.
This chapter presents examples of self-help programs that have been
used successfully to promote optimal health, assess the likelihood of recurrence
of disease, and manage disease. Ideas will be presented about
self-help tools that can be easily adopted to assist vulnerable older persons
to prepare for, survive during, and recover from disasters or emergencies.
This chapter is dedicated to those vulnerable older persons who do not
recover easily from disasters.
DETERIORATION OF HEALTH RESULTING
FROM DISASTERS OR EMERGENCIES
Resiliency is defined as a process by which persons cope and acquire
skills that allow them to overcome adversity (Gerrard, Kulig, & Nowatzki,
2004) and can be easily measured (Connor, 2006). Even under normal
circumstances, older persons are not as resilient as younger persons because
of their reduced reserve capacity (Finkelstein, Petkun, Freedman, &
Antopol, 1983; Katz, et al., 2004). Older persons are more likely to die of
infectious diseases than are younger persons (Morens, Folkers, & Fauci,
2004). A compromised immune system makes older persons more susceptible
to stress, regardless of the source (Barakat, et al., 2002; Bradley,