Geriatric Mental Health Disaster and Emergency Preparedness

68 Geriatric Mental Health Disaster and Emergency Preparedness
number of older persons living in the community are geographically isolated
from family and friends due to migration patterns, disasters pose a
particular challenge. Access to disaster areas is often controlled for safety
issues; thus, family members seeking to enter an area to provide assistance
may not be able to do so. And, as various staging and shelter areas reach capacity,
the movement of survivors to outlying areas, sometimes several
states away, complicates this access.
Because of the lack of immediate family support systems, older persons
become highly dependent upon rescue and recovery personnel for
activities ranging from relocation to support for ADLs. Those with higher
levels of physical, medical, and/or mental impairment, who may have been
able to function reasonably well in their relatively controlled home environment,
are at significant risk of becoming highly vulnerable to isolation
and underserved in recovery shelters. The shelter environment is often
understaffed and relies heavily upon the self-sufficiency of shelter occupants.
Vulnerable older individuals often require assistance for even basic
survival services such as eating, toileting, and hygiene, and such assistance
may not be available on demand (Fernandez, Byard, Un, Benson, & Barbera,
2002; Hurricane Katrina Community Advisory Group & Kessler, 2007;
Laditka, Laditka, Cornman, & Chandlee, 2008; Laditka, Laditka, Xirasagar,
et al., 2008; Mori et al., 2007; Rami, Singleton, Spurlock, & Eaglin, 2008).
EVOLUTION OF STATE PLANS
During the 2005 rescue and recovery operations for hurricanes Katrina
and Rita, the largest displacement of persons in the history of the United
States was undertaken. Many older persons from both inner city and rural
locations were relocated, often at significant distance from their homes
and isolated from other family members ( Lamb, O’Brien, & Fenza, 2008).
This experience should have been a clear call for the development of appropriate
plans for helping all individuals, especially the most vulnerable,
in even the most localized disaster. Unfortunately, at the time of this writing
in early 2009, only 28 states had official plans specifically addressing
preparedness for older persons ( U.S. Department of Health and Human
Services, 2007).
The county of Santa Clara, California, Department of Emergency Services’s
Tips for Preparedness for the Senior Population (2009), developed
at the county level, is reflective of state plans that do exist and offers an excellent
summary of the available research regarding older individuals and