Geriatric Mental Health Disaster and Emergency Preparedness

362 Geriatric Mental Health Disaster and Emergency Preparedness
by a caregiver or other person who stands in a trust relationship
with the elder
2. Failure by a caregiver to satisfy an elder’s basic needs or to protect
the older person from harm during a time of disaster
During a disaster actions such as the following can lead to trauma responses
that can endanger the life of the older person (Islam, Muntner,
Webber, Morisky, & Krousel-Wood, 2008):
1. Physical, sexual, or emotional abuse (Graziano, 1997, 2003)
2. Neglect
3. Financial or material exploitation
4. Abandonment
This chapter will examine the traits of older persons that put them at risk
for DREM, along with the steps that aid public health response to recognize
and prevent this type of mistreatment.
VULNERABILITY OF THE OLDER POPULATION
Old age is a time of transition in terms of both physical and psychosocial
changes. These changes, along with existing cultural and underpinning
sociodemographic characteristics, make the older population particularly
vulnerable to mistreatment (Geroff & Olshaker, 2006). During times of
disaster, these vulnerabilities are exacerbated and stretched to their limits
(Kohn, Levav, Garcia, Machuca, & Tamashiro, 2005), increasing the importance
of recognizing such traits and ensuring the older population is
cared for (Castro, Persson, Bergstrom, & Cron, 2008).
Altered Physical Functioning
The most vulnerable older persons are those with a physical disability .
According to Rothman and Brown (2007, p. 16), “people with any disability
are the ones most likely to suffer a decline in their functional status during
or after a disaster.” Physical disability can take many forms, such as general
frailty (Cefalu, 2007), a lack of mobility, or even impaired hearing
or vision. Such functional impairments hinder the frail older person from
performing basic ADLs such as preparing meals, using the restroom,
or managing their medications and, in effect, make them dependent on
outside caregivers, family members, or friends and neighbors (BCM &
AMA, 2006; Krousel-Wood, et al., 2008; Rothman & Brown). In a disaster,