Geriatric Mental Health Disaster and Emergency Preparedness

Chapter 18 Disaster Related Elder Mistreatment (DREM) 369
Complex ( RAC). To address the needs of this population, geriatric specialists
within the RAC developed a triage tool called Seniors Without
Families Triage, or SWiFT (BCM & AMA, 2006; Burnett, Dyer, & Pickins,
2007). The purpose of this tool was to “screen for the most in need of help
by assessing the issues of cognition, medical and social services needs,
and the ability to perform activities of daily living” (BCM & AMA, p. 8).
SWiFT was categorized according to three levels, noting appropriate
actions given each level of severity (BCM & AMA). During the course of
2 weeks, over 300 SWiFT assessments were completed, with 68%, 18%,
and 4% placed in Levels I, II, and III respectively (Burnett, et al.). These
results show the utility of the SWiFT tool in postdisaster situations (Dyer,
Regev, Burnett, Festa, & Cloyd, 2008). The developers of the tool also
noted it can be used prior to the occurrence of a disaster as it provides a
hierarchy of disability to allow seniors to prepare for an impending disaster
(BCM & AMA).
While the SWiFT tool is designed to ensure the critical and immediate
needs of older persons are cared for during disasters, there also can
be long-term consequences from disasters, specifically in terms of longterm
mental health and psychological effects (Elmore & Brown, 2007).
Norris, Friedman, and Watson (2002, p. 70) indicated “disasters do have
significant implications for mental health for a significant proportion of
persons who experience them.” However, it is not clear from the research
how older persons are specifically affected. Regardless of the conflicting
research, caregivers must be aware of issues such as PTSD, ASD, and
depression as well as the impact of both personal and material losses
( Elmore & Brown).
An accurate assessment should include stress factors that could highlight
the vulnerability and possibility for mistreatment in older persons
(Bloodworth, Kevorkian, Rumbaut, & Chiou-Tan, 2007). During massive
disasters survivors who have been directly impacted may be exposed
to or witness events that may make them extremely vulnerable to
serious stress reactions. Being aware of these risk factors is important and
could ease the assessment process. Emphasis on postassessment maintenance
or re-establishment of communication with family, peers, and
counselors in order to talk about the experiences is crucial for the older
person’s well-being and as a contingency plan to avoid mistreatment
(Dosa, Grossman, Wetle, & Mor, 2007; Dosa, et al., 2008). It is also a prerequisite,
incumbent upon the professional, to identify key resources such
as FEMA, the Red Cross, the Salvation Army, and local and state health
departments (Elmore & Brown, 2007) for health, housing, and basic