Geriatric Mental Health Disaster and Emergency Preparedness

Chapter 18 Disaster Related Elder Mistreatment (DREM) 373
(Geroff & Olshaker). An appropriate planning structure should be the
platform for a detail-oriented elder mistreatment assessment. Possible
markers of neglect and abuse, including bruises, pressure sores, fractures,
burns, and abrasions, are not the only identifiers of abuse (AMA,
1992). It is important to note and document every particular as a key to
the interpretation of these markers; identifying their presence as well as
their characteristics — such as anatomic location, extent, morphology, severity,
and multiplicity —may help differentiate between an intentional
injury and an avoidable one (Fernandez, Byard, Lin, Benson, & Barbera,
2002). Therefore, training and educating both health care personnel (clinical,
behavioral, and forensic assessors) and older persons would help
identify evidence of mistreatment as caused by the conduct (acts or omissions)
of an abusing person.
CONCLUSIONS
Disaster preparedness and careful planning for older persons are integral
for the prevention of DREM. Referral to experts is important for
those who do not feel competent in this new area of practice. For all clinicians,
the focus of a health assessment must be on the needs of the older
person and may sometimes simply involve asking if the individual feels
neglected or inappropriately treated. This may set the stage for the next
steps in the DREM-care planning process and provide useful information
on appropriate protocol development.
ACKNOWLEDGMENT
Special credit goes to the National Library of Medicine, The Frederick L.
Ehrman Medical Library at New York University, and Itty Mathew, disaster
informationist for the research and data mining support for this
chapter.
REFERENCES
AARP. (2006). We can do better. Lessons learned for protecting older persons in disasters.
Retrieved May 29, 2009, from http://assets.aarp.org /rgcenter/ il / better.pdf
Acierno, R., Ruggiero, K. J., Kilpatrick, D. G., Resnick, H. S., & Galea, S. (2006). Risk
and protective factors for psychopathology among older versus younger adults after