Geriatric Mental Health Disaster and Emergency Preparedness

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Chapter 12 Complementary and Alternative Approaches 217 ing, and yoga. Informal practice includes everything else — eating, sleeping, working, and playing can all be done with awareness. Acquiring mindfulness skills is the result of cultivation and practice implemented over time as a preventative measure. Programs such as Mindfulness-Based Elder Care (McBee, 2008) are excellent resources for both older persons and caregivers. Skills that lead to increased resilience offer a disaster prophylactic for older persons and caregivers. Administrators, staff, and professional and family caregivers also benefit from mindfulness training (McBee, 2008). An ability to be calm, present, compassionate, knowledgeable, and decisive, and to communicate these states verbally and nonverbally, is important to leadership, especially during a crisis. Stress is contagious, but a calm presence is also contagious. Following a disaster, aromatherapy, hand massage, creative therapies, and humor may be excellent tools for reducing stress and anxiety. Aromatherapy promotes healing and well-being by using pure essential oils from plants. Our sense of smell is linked to the limbic brain, connecting directly to memory and emotion. Essential oils have been found to evoke common responses and symptomatic relief from a variety of conditions. Lavender is the most all-purpose essential oil and would be a simple, effective tool for reducing the distress associated with crises and disaster. 1 (See the “Use of Herbal Medicine” section for a more complete discussion on essential oils and lavender.) Hand massage is also an excellent tool that may calm not only the person receiving the massage but also the person giving the massage. For older persons, a very gentle slow massage is best, with careful attention to skin, circulation, and other conditions. Creative therapies and humor may offer tools for coping with meaning and healing in a disaster. Music, art, poetry, and drama are common responses to tragedy, and even older persons with extreme cognitive and physical frailties can access their creative nature. In a poetry group for older persons with physical disabilities, older persons used prewritten words on large pieces of cardboard similar to magnetic poetry to evoke memory and feelings. In the feelings art group on a dementia unit, older persons with dementia participated in art projects designed to evoke feelings and memories (Bober, McClellan, McBee, & Westreich, 2002). Creative modalities are also discussed in the “Music Therapy and Other Creative Arts Programs” section. The use of humor during a crisis may seem like an oxymoron, and yet laughter can be profoundly healing and connecting (DeWitt Brandler, 2007 ). Again, it may also be a way to connect with older persons who are
218 Geriatric Mental Health Disaster and Emergency Preparedness confused and frail. In the midst of a stressful situation, a good laugh together connects us all. It offers not only mental but also physical relief by allowing us to breathe deeply and massage our internal organs. Laughter is also contagious. The mindful use of all these skills may form a first aid kit for disaster preparedness. Mindfulness groups help older persons and caregivers cope with daily stressors and inoculate them from the stress of a disaster. Other CAM modalities may be useful during a crisis or in the aftermath. In the hours following the World Trade Center disaster, some older persons were evacuated from nearby residences and senior centers. One anecdotal report describes the use of humor to cope with the stress of these moments (DeWitt Brandler, 2007; Mariano, Sherman, & Sherman, 2007 ). Mindfulness is not so much what we do but how we do it. The most important tool we bring to older persons is our complete presence in each moment. GENERAL OVERVIEW OF CREATIVE ARTS THERAPY APPROACHES All creative arts therapies provide services to a broad population including children, adolescents, adults, older adults, groups, and families. The difference is the medium used to assess and facilitate the therapeutic process. Treatment may be directed at mental health problems including anxiety, depression, and other mental and emotional problems and disorders; addictions; family and relationship issues; abuse and domestic violence; social and emotional difficulties related to disability and illness; physical, cognitive, and neurological problems; or psychosocial difficulties related to medical illness. Such problems may have preceded the disaster or trauma or may have developed as a result of the traumatic experience of disaster. Creative arts therapy programs are found in a number of settings including home care, skilled nursing homes, subacute care, clinics, hospitals, public and community agencies, educational institutions, businesses, wellness centers, and private practices. Creative arts therapies encompass a large and varied group of therapies. This section describes a wide variety of specific creative arts therapies and focuses on music therapy most comprehensively as one example of the application of creative therapies for older adults coping with trauma or disaster. It deserves mention here that in all cases, creative arts therapies should be directed by trained therapists.
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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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6 Supervision and Facilitated Refl
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INTERNATIONAL TREATIES Team Respons
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120 Geriatric Mental Health Disaste
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8 Self-Help Tools for Older Persons
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Chapter 8 Self-Help Tools for Older
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9 Volunteers: Who Are They and What
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Chapter 9 Volunteers 159 munity com
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Chapter 9 Volunteers 161 RECRUITING
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Chapter 9 Volunteers 163 et al.). O
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Chapter 9 Volunteers 165 cial effor
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14 This chapter focuses on the ment
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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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