Geriatric Mental Health Disaster and Emergency Preparedness

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17 Alzheimer’s Disease and Related Disorders JED A. LEVINE AND BETH A. KALLMYER After a harrowing 8 hours in the car leaving Galveston prior to Hurricane Rita, Brenda Hernandez was at a loss. Her 85-year-old father with Alzheimer’s disease was extremely agitated and kept repeating, “Take me home, I want to go home.” They arrived at an emergency shelter. It was loud and crowded. Brenda knew that the shelter environment was likely to further upset her father. She only had 2 days worth of her father’s medication and was running low on his incontinence products. She kept thinking to herself, I wasn’t prepared for this. OVERVIEW OF ALZHEIMER’S DISEASE AND DEMENTIA Dementia is the leading cause of cognitive impairment in older Americans today. It is a clinical syndrome of loss or decline in memory . . . and (decline) in at least one of the following cognitive abilities: 1. Ability to generate coherent speech and understand spoken or written language; 2. Ability to recognize or identify objects, assuming intact sensory function; 341
342 Geriatric Mental Health Disaster and Emergency Preparedness 3. Ability to execute motor activities, assuming intact motor abilities, sensory function and comprehension of the required task; and 4. Ability to think abstractly, make sound judgments and plan and carry out complex tasks. The decline in cognitive abilities must be severe enough to interfere with daily life. (Alzheimer’s Association, 2008) There are a number of common causes of dementia, including Alzheimer’s disease (AD), vascular dementia, Lewy-Body disease, frontotemporal lobe dementia, Parkinson’s disease, mixed dementia, and others. Each has its own unique pattern of symptoms and distinguishing biological markers. Alzheimer’s disease is the most common cause of dementia and can last anywhere from 3 to more than 20 years; the average length of illness from onset of symptoms to death is 8 to 10 years. Although people with Alzheimer’s and related disorders experience the disease idiosyncratically, there are predictable patterns of loss, beginning with mild forgetfulness and confusion leading to increasing difficulty managing usual activities of personal care, financial management, verbal and written communication, and social and occupational functions and ending in total dependence on someone else for all activities of daily living. The disease is usually described in four stages: early, middle, late, and terminal. The statistics and projections regarding the prevalence and incidence of Alzheimer’s disease in the United States and the world are alarming. According to the 2009 Alzheimer’s Disease Facts and Figures (Alzheimer’s Association, 2009), every 70 seconds someone in the United States will develop Alzheimer’s disease. There are an estimated 5.3 million Americans who have the disease, and that number is projected to increase to approximately 16 million by mid-century. Age is the greatest risk factor; 50% of those aged 85 years and over have Alzheimer’s or a related dementia. Ten million Baby Boomers are expected to develop AD, with an additional 4 million developing other dementias, if the progression of the disease is not stopped. Internationally, the numbers are significant and growing. According to Alzheimer’s Disease International (2009), there are an estimated 30 million people in the world affected by the disease; that number is expected to grow to 100 million by 2050. India and China, with their large populations, are facing a sizable increase in the numbers of persons with AD. There is no medical cure for AD at this time. There are four drugs approved by the Federal Drug Administration (FDA) for the treatment of
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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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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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Chapter 9 Volunteers 167 nizations
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VOLUNTEERS PROVIDING AND RECEIVING
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Chapter 9 Volunteers 171 Gibson, M.
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Clinical Response to the Needs of O
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Table 10.1 PRE-DISASTER/BASELINE DO
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Table 10.2 DURING-DISASTER SYMPTOM
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Table 10.3 POSTDISASTER SYMPTOM DOM
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Table 10.5 POSSIBLE BENEFITS OF SEL
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12 Complementary and Alternative Ap
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Chapter 12 Complementary and Altern
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Where to Find a Therapist Chapter 1
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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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392 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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