Geriatric Mental Health Disaster and Emergency Preparedness

15
Bereavement and Grief:
What Is Normal in Disasters and
Emergencies?
D. PETER BIRKETT
Disasters kill the young and bereave the old. To some extent, this is a matter
of definition. Deaths of the young are regarded as more disastrous
than those of the old. The deaths of 116 children from a landslide at
Aberfan, Wales, in 1966 that engulfed a school and of 186 children from
a terrorist massacre at Beslan, Russia, in 1994 horrified the world. An influenza
epidemic that increases deaths among the aged by several thousand
barely registers on public consciousness.
PTSD VERSUS GRIEF
In many cases, the most common psychiatric disorder caused by a disaster
is PTSD, but it also may be grief in one of its forms. The distinction is
not always complete. Those who were not in danger themselves may suffer
grievous loss. Sometimes both physical danger and bereavement occur
at the same time so that ASD and PTSD are combined with grief.
On September 11, 2001, those killed ranged in age from 3 to 85 but
were mainly young adults. We still see people affected by the aftermath
of the 2001 event . In some cases, survivors were in terrifying danger.
Many young adults escaped with resulting acute stress or PTSD but were
not bereaved of close family members. Typical older victims, on the other
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