Geriatric Mental Health Disaster and Emergency Preparedness

22 Geriatric Mental Health Disaster and Emergency Preparedness
and evaluation because the underlying medical condition may be lifethreatening.
The risk of developing delirium can be reduced by preventing
and correcting dehydration, minimizing unnecessary noise and stimuli, promoting
good sleep hygiene, and repeated reorientation (Miller, 2008). The
treatment of delirium centers on the identification and management of the
medical condition that triggered the delirious state. Antipsychotic agents
may be needed when the cause is nonspecific and other interventions do
not sufficiently control symptoms such as severe agitation or psychosis.
Also, a patient who develops delirium can become agitated and aggressive.
Using haloperidol in agitated patients with dementia can decrease the degree
of aggression (Lonergan, Luxenberg, Colford, & Birks, 2002).
Insomnia
In a disaster zone, older persons may end up in a noisy and overcrowded
shelter where sleep may be difficult. As such, they may develop insomnia,
which can affect their well-being in a negative way. Bringing back a normal
sleep pattern is of extreme importance. The simplest approach is adherence
to some basic rules of sleep hygiene: avoiding daytime napping,
maintaining adequate nighttime pain relief; addressing environmental conditions;
avoiding alcohol and caffeine late at night; and minimizing noise,
light, and excessive heat during the sleep period. However, the chaos and
disorganization caused by a disaster can make it difficult to implement these
basic rules. CBT can have a mild positive impact on different aspects of insomnia
in older adults (Montgomery & Dennis, 2003). Several pharmacological
treatments are also available for the symptoms of insomnia, and the
most commonly prescribed group of sleep-promoting drugs are benzodiazepines.
Short-acting benzodiazepines such as temazepam and triazolam
are favored to reduce impaired functioning the next day. Benzodiazepines
with a longer half-life are avoided since they can have serious hangover effects,
including drowsiness, confusion, and unsteady gait.
CONCLUSION
The importance of the mental health consequences of disasters on older
persons is underlined by these early findings. However, the large gaps and
uncertainties in our knowledge base present major challenges to professionals
and caregivers in the face of disasters and emergencies. This book
aims to address these public health and clinical challenges and fill in some