Geriatric Mental Health Disaster and Emergency Preparedness

222 Geriatric Mental Health Disaster and Emergency Preparedness
of challenges faced in coping with disaster. It is important for the practitioner
to keep in mind that strong emotional responses to a disaster —
including shock, depression, anger, sadness, or confusion — in many cases
should be considered normal. Ironically, it is the older person who experiences
none of these emotions who should cause the most worry for
family, friends, and health care providers. However, it is crucial that caregivers
have enough tools available to be able to control the situation in
the short-term as older persons who experience debilitating mental or
emotional stress during a crisis can endanger themselves and others. As
any practitioner knows, remedies are effective to varying degrees with
different persons, often for unidentifiable reasons. A facility that has the
widest range of modalities and therapies to prepare for a disaster will be
at an advantage.
One crucial aspect to including herbal medicines and other holistic
approaches in disaster preparedness is to incorporate them into practice
in the health care facility before disaster strikes and, in fact, independent
of disaster preparedness. The reasons for this are twofold: (1) many of the
most profound effects of herbs are long-term and preventive in nature,
meaning that their use can mitigate the negative impact a disaster can
have on the mental health of patients, and (2) doing so allows both older
patients and caregivers to become comfortable and familiar with the use
of herbs. Attempting to incorporate new modalities in the stressful and
fast-paced context of a disaster scenario is neither realistic nor recommended.
The benefits of medicinal plants as aromatherapy should also be seriously
considered both in long-term-care settings as well as in acute situations
such as disaster response. Despite their gentleness, essential oils
should never be used in direct contact with skin or mucus membranes and
should be used only by experienced practitioners. Smell is the sense most
directly linked to cerebral function, and aromatherapy — literally breathing
in the myriad chemicals that make up a plant—has multiple and proven
benefits in promoting mental and emotional balance. Aromatherapy has
the advantage of portability, fast patient response time, and a general
gentleness, as well as a reduced likelihood of adverse reactions or interactions,
although this risk is already low with the gentle botanicals that
appear in the list of herbal medicines that ends this section. These are
crucial points for work in a disaster setting, where emotional and mental
disturbances may be exacerbated and can impinge on the safety of others
to a higher degree than under normal circumstances. Essential oils have
the added advantage of potential incorporation into massage oils for use
by massage therapists.