Geriatric Mental Health Disaster and Emergency Preparedness

44 Geriatric Mental Health Disaster and Emergency Preparedness
for the possibility of higher death tolls in older persons, and leaders
should be trained in making difficult decisions of rationing if resources
are inadequate.
Contrasting with their increased physical susceptibilities, older persons
may be more resilient in dealing with the emotional stresses of disasters.
But the effects of acute and chronic emotional and physical stress,
with their consequent hormonal and diffuse physiologic changes, have
greater potential to negatively affect those with weaker cardiovascular and
other organ systems — symptoms markedly more common in older persons.
Accordingly, older persons should be included in any programs designed
to reduce emotional reactions to disasters.
Despite concerns about their frailty, a large proportion of older persons,
especially those under 75, will be able to contribute positively and
significantly to relief efforts. Although with reduced strength and stamina,
they are often still relatively robust physically and can do lighter but important
physical tasks. They also have a wealth of knowledge and experience
from work and life in general. Even very old persons often have
wisdom and emotional strength that can be of great assistance to younger
people facing a disaster. Planners and managers of disaster relief programs
should include this great resource in their plans and activities.
NOTES
1 . Experts in the study of aging and older persons in society.
2 . Physicians specializing in elderly medical care.
3 . Function may also be used to describe the status of various organs and capacities—
e.g., cardiac function or cognitive function—but the broader definition is used here.
4 . Those wishing to learn more about potentially harmful medicines for the elderly
should consult The Beers List (Fick et al., 2003).
REFERENCES
Anand, P. ( 2009). Adult disaster psychiatry: Clinical synthesis. Focus, 7, 155 – 159.
Barden, N. (2004). Implication of the hypothalamic-pituitary-adrenal axis in the physiopathology
of depression. Journal of Psychiatry and Neuroscience, 29, 185 –193.
Campbell, A. J., & Buchner, D. M. (1996). Unstable disability and the fl uctuations of
frailty . Age and Ageing, 26, 315 – 318.
Cook, J. D., & Bickman, L . (1990). Social support and psychological symptomatology
following a natural disaster. Journal of Traumatic Stress, 3, 541 – 556.
Fick, D. M., Cooper, J. W., Wade, W. E., Waller, J. L., Maclean, J. R., & Beers, M. H.
(2003). Updating the Beers criteria for potentially inappropriate medication use in