Geriatric Mental Health Disaster and Emergency Preparedness

146 Geriatric Mental Health Disaster and Emergency Preparedness
administer them to their charges to determine depression or suicide risk.
The information can then be shared with health care providers. These instruments
have been shown to improve clinical decision making because
of improved patient / provider communication and the ability of the patient
to know when to seek professional care because a crisis is looming (Valente
& Saunders).
Zimmerman and colleagues (2006) have developed and validated a
brief, single-item assessment of three domains important to consider when
treating depressed patients: symptom severity, psychosocial functioning,
and quality of life. The assessment was determined not to be burdensome
for patients to complete, and informal caregivers can administer it.
Patient providers reported that the patient-administered assessment was
incorporated easily into clinical practice and was used to collect data on
treatment effectiveness. Postal questionnaires (delivered by mail) that require
patients to self-report depressive symptoms have been shown to be
as effective as questionnaires administered by physicians (Mallen & Peat,
2008). Self-rated instruments are now available for individuals who are at
risk for the development of PTSD (Connor, Foa, & Davidson, 2006).
Web-based self-help therapy is also popular with people with anxiety
disorders (Farvolden, Denisoff, Selby, Bagby, & Rudy, 2005). Participants
self-report on screening questionnaires and then complete dynamic sessions
weekly. Upon completion, they are asked to self-report on a second
screening assessment and are encouraged to continue to use an online
diary and support group along with individualized email support. This program
has been shown to reduce panic attack frequency and severity. Depression
self-help and information programs can be delivered effectively
online (Griffiths & Christensen, 2007 ).
FOSTERING RESILIENCY
Morbidity and mortality can be minimized by enhancing and promoting
resilience (Lating & Bono, 2008; Nucifora, Langlieb, Siegal, Everly, &
Kaminsky, 2007). Fostering resiliency in older persons concerning disasters
can occur along a disaster timeline by developing confidence inspired
by careful precrisis preparation (Boscarino, Figley, & Adams, 2003), developing
interventions early in a crisis (Lating & Bono), carefully monitoring
persons and their health post crisis (Bryant, 2006; Chung, Werrett,
Easthope, & Farmer, 2004; Connor, 2006), and encouraging victims to
confront their trauma (Foa, 2006). Confidence heightens resiliency, and