Geriatric Mental Health Disaster and Emergency Preparedness

Chapter 10 Psychosocial and Pharmacological Interventions 185
and Mass Violence Review,” is a set of strategies focused on reducing the
immediate impact of disaster-related stress (NIMH, p. 24). Hobfoll and
colleagues’ (2007) hierarchical focus for effective intervention also applies
to the next phase of disaster response.
POSTDISASTER SYMPTOM DOMAINS
AND COMPREHENSIVE ASSESSMENT
Table 10.3 lists symptoms commonly experienced by older individuals in
response to disaster after the immediate threat posed by the disaster has
waned. While many symptoms may persist from a person’s during-disaster
response, new symptoms typical of this stage may also appear. While there
is considerable overlap in these symptoms, this provides the first opportunity
for clinicians to begin to assess those individuals who may need a
greater level of clinical care than that provided by baseline disaster outreach
interventions. The clinician should look for the first signs of possible
acute stress disorder (ASD) and possible PTSD-related symptoms,
which would emerge and be diagnosed at least 6 months post-event. While
PFA-type interventions may still be helpful for many of the listed symptoms,
more formal intervention—such as more traditional psychotherapy
and pharmacological interventions—may be indicated.
LONGER TERM POSTDISASTER SYMPTOMS
AND THEIR ASSESSMENT
Table 10.4 lists symptoms experienced by individuals who have ongoing
deleterious responses to disaster long after a disaster and its immediate
effects have subsided. While it is rare for people to experience this persistence
of symptoms from their during- and immediate postdisaster response,
lingering chronic symptoms may arise, particularly if untreated
at an early stage. The focus of assessment here is ASD and PTSD symptoms
and their treatment. Table 10.4 assembles the symptoms of ASD
and PTSD into an analogous multimodal chart form.
Viewing these symptom areas as interactive, as opposed to isolated
events, leads to more precise and effective treatment indications. While
the following interventions are broken down into basic psychotherapeutic
categories, the effects of interventions, like symptoms, are interactive.
For example, a synergistic result of behavioral interventions affecting a