Geriatric Mental Health Disaster and Emergency Preparedness

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Table 10.4 LONGER-TERM-DISASTER SYMPTOMS OF ASD AND PTSD BEHAVIORAL AFFECTIVE SENSORY IMAGERY COGNITIVE INTERPERSONAL PHYSIOLOGICAL SPIRITUAL “Deeper” questioning of religious beliefs *** Question of why leading to anger and disappointment *** More grounded appraisal of the magnitude of loss *** “Pointlessness” of the event Disaster-caused injury *** Trauma/stress induced medical complications *** Exacerbated medical issues evolving to chronic status *** Limited access to or desire for engagement in medical/psychiatric medications *** Cued hyperarousal and associated cardiovascular problems *** Aggravation of the above with agingrelated health variables Loss of social and familial support due to death/ injury *** Social and familial self-images radically altered *** Relocation induced social withdrawal and isolation Ongoing, impaired cognitive status and disorientation *** Faulty assumptions based on misinformation that generate excessive fear and hopelessness *** Inability to focus; easily distracted *** Ongoing, aggravation of preexisting memory problems *** Altered, basic attitudes toward world, self, others, and perceived lack of security and safety Frightening, intrusive, and repetitive imagery of disaster based on “re-exposure” to disasterassociated stimuli *** Imagery cued by visual, affective, or other environmental triggers *** Images of selfinadequacy to cope or help others *** Images of death (self and others) Sensory/ perceptual overload; *** Aggravated impairment of capacities across hearing, vision, and other senses *** Pain associated with disasterinduced injury, or disasteraggravated medical conditions *** Sensory disorientation (delirum) Less intense, but still erratic emotions *** Cued mood lability *** Breakthrough emotions vascillating with periodic numbing *** Cued, painful loss of people and possessions *** Rage, terror, fear, guilt *** Aggravation of pre-existing mood problems Skills/capacity for selfregulation, not attending to basic self-care *** Agitation or decreased overall activity level *** Withdrawal and isolation *** Routine disruption/Lack of governing structure life
188 Geriatric Mental Health Disaster and Emergency Preparedness person’s cognition and subsequent affect is to be expected and facilitated by the disaster mental health clinician. Behavioral Interventions Behavioral interventions are well suited for disaster mental health clinical work as they tend to be very basic and focused on symptom reduction and environmental factors that may trigger or maintain problematic issues. Included in this intervention category would be distraction-based interventions; basic coping skill instruction, including deep breathing and relaxation training; and more sophisticated functional analyses of problematic or symptomatic behavior. The latter technique involves a review of the potential environmental triggers that may elicit symptoms; selfmonitoring of the severity of symptoms, sometimes formally measured by a subjective unit of distress scale (SUDS); and careful attention to and notation of those activities that may decrease distress. Avoiding triggering circumstances, employing techniques that reduce distress, and reinforcing or encouraging coping or recovery behavior are all interventions within the behavioral model of intervention. Cognitive Interventions Cognitive interventions are principally focused on adopting thinking that promotes adjustment and wellness. While Beck (1995) and Ellis (2001) have formal, structured methods of helping people change their thoughts and attitudes, these methods would need to be adapted to disaster mental health. The adaptations, while retaining the core principles of the model, would likely focus on the disputation of irrational thinking related to recovery, encouraging a resiliency-focused attitude, and encouraging adaptive rational restructuring of the disaster event itself. Interpersonally Based Interventions Interpersonally oriented interventions focus on promoting connectedness at many levels and may include fostering relations between the affected person and their family, staff who work at their agency, clergy, pets, or, more directly, with the disaster mental health clinician. Many disaster survivors often recount the grounding experience of connection with others during times of crises as paramount to their early and prolonged recovery. As such, this domain should never be underemphasized. In addition, interventions in this category are also very likely to focus on and process or memorialize personal/familial/social loss.
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Geriatric Mental Health Disaster an
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Geriatric Mental Health Disaster an
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Dedicated to Flo Aaroe, who personi
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Contributors xi Foreword by Robert
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14 Geriatric Assessment for Differe
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xii Contributors Terry Fulmer, PhD,
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xiv Contributors Douglas M. Sanders
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Foreword With the increase in the n
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Preface The rage you feel does more
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Preface xxi and (3) influence the d
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Preface xxiii as key to the prepara
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Acknowledgments In connection with
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1 A Primer for Disaster and Emergen
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Chapter 1 A Primer for Disaster and
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2 Older Persons in Disasters and Em
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Chapter 2 Older Persons in Disaster
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NORMAL CHANGES WITH AGING ORGANS/SY
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Immune Function Laboratory Tests Em
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48 Geriatric Mental Health Disaster
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Table 3.3 GEC GEPR COLLABORATIVE PR
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Table 3.3 GEC GEPR COLLABORATIVE PR
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Community Response to the Needs of
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5 National and Cross-National Model
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Chapter 5 National and Cross-Nation
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6 Supervision and Facilitated Refl
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Chapter 6 Supervision and Facilitat
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INTERNATIONAL TREATIES Team Respons
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120 Geriatric Mental Health Disaste
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Page 196 and 197: VOLUNTEERS PROVIDING AND RECEIVING
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Chapter 12 Complementary and Altern
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Self-Care Chapter 12 Complementary
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13 The Interdisciplinary Treatment
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Chapter 13 The Interdisciplinary Tr
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Choose solutions Review literature
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14 This chapter focuses on the ment
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Chapter 14 Geriatric Assessment for
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15 Bereavement and Grief: What Is N
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Chapter 15 Bereavement and Grief 29
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The Length of Mourning Chapter 15 B
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16 The Experience of Vulnerability
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17 Alzheimer’s Disease and Relate
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n Do your best to remain calm. The
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380 Appendix I A Guide to Developin
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390 Appendix II Glossary of Terms C
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A AAGP. See American Association fo
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community initiatives/lessons learn
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depression v., 287 during disasters
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Emergency preparedness, gaps in tra
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adverse reactions to, 226 conclusio
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health care provider training on, 7
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physical changes/resultant weakness
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supervisor component of, 110 -113,
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Spirituality of African Americans/A
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Geriatric Mental Health Disaster and Emergency Preparedness

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