Geriatric Mental Health Disaster and Emergency Preparedness

250 Geriatric Mental Health Disaster and Emergency Preparedness
total costs, fewer hospital admissions, physician visits, emergency department
visits and x-rays.” Toner (2006, p. 218) reviewed the evidence-based
studies of interprofessional education and interdisciplinary team training
provided by Barr and colleagues (2005) and concluded that the researchers
“have succeeded in synthesizing the evidence base and in so doing
have established a knowledge base related to good interprofessional education”
(p. 218).
Improved quality of care has for a long time been the raison d’etre of
the interdisciplinary team and teamwork. Quality of life is less often discussed
in relation to interdisciplinary teams but may be implicit. In recent
years, serious attention has been given to the ways in which quality of life
should serve as a central and unifying theme in interdisciplinary teamwork
in health care and specifically within geriatric interdisciplinary teamwork.
Two major streams of activity are revolutionizing health care for older persons:
(1) the recognition of quality of life as a field of science with its own
language, methods of inquiry, and applications to clinical practice (Banerjee
et al., 2009; Gurland & Gurland, 2008a, 2008b; Gurland & Katz, 2006)
and (2) an increased reliance on patient-centered interdisciplinary teamwork
strategies that might “relieve restrictions or distortions of the choice
and choosing process imposed by aging, ill health, or a restricting environment”
(Gurland, Gurland, Mitty, & Toner, 2009, p. 110), all of which are
exacerbated during disasters. This is accomplished only through an understanding
on the part of interdisciplinary team members that they must empower
older persons to define for themselves, as much as is feasible, and
for the interdisciplinary team, the appropriate methods and goals of care
related to their quality of life. In cases when older persons are unable to
express their needs because of communication deficits and/or cognitive
decline, the interdisciplinary team must be the advocate for the older person’s
needs and perceived wishes. In the context of quality of life and the
choice and choosing process (Gurland & Gurland, 2008a), the interdisciplinary
team “offers a single protean pathway for effectively helping people
to improve their quality of life through opening choices within the
range of their preferences and assisting their exercise of choosing” (Gurland
et al., 2009, p. 112). Clark (1995) indicated that as health care has moved
from an acute illness model of care, with an emphasis on sustaining life at
all costs, to a chronic disease model of care, with its focus on quality-of-life
issues, conflicts between disciplines on the treatment team and communication
problems among health care providers have created important
challenges. While the field of interdisciplinary team collaboration has become
more widely appreciated and more health care professionals have
received training and experience in interdisciplinary teamwork, little is