Geriatric Mental Health Disaster and Emergency Preparedness

372 Geriatric Mental Health Disaster and Emergency Preparedness
8. Plan for evacuation of residents of long-term-care facilities.
9. Prepare disaster plans and conduct readiness drills.
While the authors do specifically mention that abuse and fraud are
possibilities that need to be prevented, they do not provide specific recommendations.
Similarly, research on elderly mistreatment has provided
guidelines for identifying and treating abuse but not specifically with regard
to disasters (BCM & AMA, 2006).
HelpAge International (2006), an organization dedicated to caring
and advocating for older persons, has developed guidelines that specifically
address DREM that include these recommendations:
1. Be aware of the possibility of elder abuse and provide protection
( Aldrich & Benson, 2008). This applies not only to caregivers and
aid workers but also to members of the community (Andresen,
et al., 1997) who can help reduce the possibility of intimidation,
exploitation, and theft of older persons.
2. Be knowledgeable about the power dynamic between men and
women, especially in shelters, where a need to fi ll quotas may
create a gender imbalance. The authors stress that the risk of
sexual abuse of older women increases when shelters have mixed
genders without the informed consent of women.
3. Avoid the presence of large cohorts of older people without families,
either due to loss, abandonment, or isolation (Weinstein,
Fletcher, & Stover, 2007 ). Steps should be taken to fi nd support
for these people either through community organizations, foster
families, or extended family via family-tracing services.
4. Be sure to account for the sociodemographic and cultural characteristics
of older persons when dealing with situations of possible
abuse (HelpAge International, 2006).
Medical personnel have an important role to play in the early detection
and identification of elder abuse (Geroff & Olshaker, 2006). In the
case of DREM, due to the lack of disaster and older persons mistreatment
research, medical practitioners follow the AMA’s (1992) guidelines, which
urge early detection and proper assessment of older persons. The implementation
of such a structured protocol to DREM, however well intentioned,
could be costly and counterproductive in the absence of careful
planning and training for first responders and health care workers.
Therefore, appropriate intervention and planning measures are critical