Geriatric Mental Health Disaster and Emergency Preparedness

144 Geriatric Mental Health Disaster and Emergency Preparedness
1999; Helget & Smith, 2002; Katz, et al.; Madjid & Casscels, 2004; Salerno
& Nagy, 2002; Solana & Mariani, 2000). Even as long as 2 years post
trauma, the physical and psychological well-being of victims are affected
(Maltais, et al., 2000).
Victims of emergencies or disasters are more likely to rate their overall
health as poor or average than are nonvictims and are also more likely to
present with more symptoms of posttraumatic stress and higher levels of
depression and anxiety. These symptoms are exacerbated by prior trauma
and poverty (Chen, et al., 2007 ), language and cultural differences between
victims and rescuers (Shiu-Thornton, Balabis, Senturia, Tamayo, &
Oberle, 2007), economic loss (Acierno, Ruggiero, Kilpatrick, Resnick, &
Galea, 2006), displacement (Acierno, et al., 2007; Chung, Dennis, Easthope,
Farmer, & Werrett, 2005), and preexisting health conditions (Somasundaram
& van de Put, 2006). Strong social support prior to the
emergency or disaster protects against deteriorating physical and mental
health (Acierno, et al., 2007; Lating & Bono, 2008), as does a perceived
degree of control over events (Gerrard, Kulig, & Nowatzki, 2004). One
approach that has been used successfully is self-help programs, which
provide persons with increased control over their medical conditions.
SELF-HELP MODELS IN MEDICINE
Self-help programs have a respectable history in the management of medical
conditions. Many of the programs consist of small interactive groups
led by trained professionals and are designed to encourage sharing personal
experiences and improving health literacy about a disease. Wellknown
self-help groups of this type include the 12-step model for dealing
with overcoming different types of addictions, such as Alcoholics Anonymous,
Eating Orders Anonymous, and Nicotine Anonymous. The effectiveness
of such 12-step programs at sustaining behavior change has been
confirmed ( Vederhus & Kristensen, 2006).
Other programs are more educational and concentrate on teaching participants
to manage chronic diseases by showing them how to actively participate
in their own health care, work more effectively with their health
care providers, and handle the day-to-day challenges of their disease. Arthritis
is a disease for which an effective self-help program with sustained
health benefits and reduced medical costs has been developed (Arthritis
Foundation, 2007; Kowarsky & Glazier, 1997; Lorig, Mazonson, & Holman,
1993). Outcomes for the participants of the arthritis self-help groups include
increased knowledge about their disease, increased self-confidence,