Geriatric Mental Health Disaster and Emergency Preparedness

40 Geriatric Mental Health Disaster and Emergency Preparedness
internal physiologic responses developed through eons of evolution to help
preserve life. These responses are mediated through the nervous and endocrine
systems. In limited application, they can be lifesaving. But they
take their toll on the individual when they are extensive in scope or duration.
And while they may be helpful to a healthy body, they may harm
those with underlying severe illness. A brief description of these processes
follows.
The sympathetic nervous system responds to perceived acute danger
by setting off the fight-or-flight response. In addition to general heightened
mental alertness, this response includes the release of epinephrine
and norepinephrine from the adrenal glands, located just above the kidneys.
Environmental, and sometimes just mental, stimuli perceived as
threatening cause the cerebral cortex to signal the brain stem ( locus ceruleus),
which in turn stimulates the adrenal glands via the sympathetic
nerves. The adrenals then release the hormones epinephrine and norepinephrine
into the bloodstream. Transported throughout the body,
POTENTIAL HARMS OF THE FIGHT-OR-FLIGHT RESPONSE
Increased heart
rate.
Increased
respiratory
rate.
Blood fl ow shunted
away from some
organs (especially
gastrointestinal
tract and kidney)
and heart, brain,
muscles.
Increased production
of glucose,
raising blood sugar.
Assist in physical activity
needed for survival.
Assist in physical activity
needed for survival.
Improve muscle
function.
Increase fuel supply for
muscles and brain.
Table 2.3
BODILY CHANGE POTENTIAL HELP POTENTIAL HARM IN DISEASE
In heart failure, may reduce the
heart’s pumping effectiveness.
In coronary artery disease,
may precipitate chest pain.
May precipitate hyperventilation
syndrome, causing dizziness,
chest pain, inability to
function physically.
In persons with reduced renal
function, further reduces this
function. In persons with
poor circulation to intestines,
may precipitate pain.
In diabetes, raises blood sugar
further.