Geriatric Mental Health Disaster and Emergency Preparedness

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Chapter 17 Alzheimer’s Disease and Related Disorders 353 may not expect a person in the early stages of dementia to exhibit adverse reactions because the person’s functioning in everyday life has not yet become significantly impaired. However, the impact of a disaster can bring about unexpected challenges for a person with early-stage AD. In order to avoid being caught unaware, families and caregivers need to be sensitive to possible reactions and institute safeguards, including checking in frequently to ensure the person understands the situation, keeping close watch, orienting the person to new surroundings, and staying alert to possible indicators the person is becoming upset or agitated. Supportive Responses Overall, caregivers can help the person with dementia manage reactions through close attention and awareness of the person, utilizing knowledge about what calms the person, understanding the potential causes of adverse reactions, and knowing how to respond. Another helpful technique is to establish a consistent schedule as soon as possible. Knowing what to expect helps people with dementia feel safe. During the course of an emergency or disaster this may be difficult to achieve, but it is important to institute a schedule with structured activities as soon as possible. If it isn’t possible to establish a consistent schedule, try to involve the person in activities suitable to his or her abilities. Even after things seemingly return to normal, continue looking for episodes of confusion or agitation. Caregivers may feel relief that the disaster has passed, but the person with dementia may experience difficulty readjusting even to what was previously normal. CONSIDERATIONS FOR RESIDENTIAL FACILITIES Disaster planning and response in residential facilities poses additional challenges for residential care administrators and staff. While licensed skilled-care facilities are required to have disaster plans in place, the lessons of hurricanes Katrina and Rita highlighted the importance of ensuring the disaster plans are practical, up-to-date, and not merely documents gathering dust on a shelf. Coordinating the plan with local and state disaster management agencies and other nearby facilities is essential. If all the facilities in one area are planning on using a particular bus service for evacuation, administrators need to know there are enough buses. Additionally, ensuring all the facility’s staff are trained and know their roles in a disaster or emergency is imperative.
354 Geriatric Mental Health Disaster and Emergency Preparedness Sixty-nine percent of residents in long-term-care facilities have Alzheimer’s or some other form of dementia. Further, only 5.2% of all nursing home beds are part of special dementia care units (Alzheimer’s Association, 2008). This means that even if a facility does not specifically cater to persons with dementia, it is essential that they consider this population in their disaster plans. Because administrators and staff are responsible for the safety and well-being of large groups of people during a disaster, it is even more important that all staff, including nonclinical care staff, have some knowledge and awareness of how to work with people with dementia. It may be that the facility needs to call on office, housekeeping, or janitorial staff for help during an emergency. Providing basic training on Alzheimer’s disease and other dementias to all staff can help prepare the facility for a disaster and can lessen the impact of the disaster for residents with dementia. Basic training consists of recognizing dementia, the stages of dementia, appropriate communication and interventions, and managing inappropriate responses. Table 17.1 provides some advance-planning recommendations that can be helpful in advance of a disaster. Person-Centered Care An important aspect of quality of life as well as quality care for the person with dementia is called person-centered care . This means getting to know the residents’ personalities along with their preferences and ways of interacting. It also means fostering the choice and choosing process in the caregiving setting to promote quality of life. Findings suggest that personcentered care enhances quality of life particularly when the choice and choosing process is incorporated in care (Gurland & Gurland, 2008a, 2008b; Gurland, Gurland, Mitty, & Toner, 2009). Furthermore, quality of life may be facilitated particularly well for those with Alzheimer’s disease through the use of reliable and valid quality of life assessment tools (Barrett & Gurland, 2001; Barrett, Gurland, Chin, & Rattau, 2000; Gurland & Katz, 2006). During a disaster, nonclinical care staff may not know personally the residents who are assigned to their care; the development of a personal information form for each resident can be helpful. This form can be placed in an easily accessible place inside a closet door or attached to a folder in the resident’s room. A nonclinical care staff member can quickly read the form and gain insight into how best to work with the particular resident. Information on the form could include: what the resident likes
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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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15 Bereavement and Grief: What Is N
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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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Geriatric Mental Health Disaster and Emergency Preparedness

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