Academic journal article Generations

Rapid Needs Assessments for Older Adults in Disasters

Academic journal article Generations

Rapid Needs Assessments for Older Adults in Disasters

Article excerpt

Medical, social, ADL evaluations among the cots in the Astrodome.

It has been reported that on average, a disaster takes place somewhere in the world every day (Norris, 2005). Floods, tornadoes, hurricanes, earthquakes, and terrorist attacks cause extensive damage and simultaneously affect and even consume many lives (Norris, 2005). While no one is safeguarded against these ill effects, the most vulnerable, especially frail older people, face the greatest challenges during and after disaster events.

Most studies concerning disasters and older people have focused primarily on the psychological and social impact of these events on older adults (Ford et al., 2006; Anetzberger, 2002; Clinton et al., 1995; Ehrenreich and McQuaide, 2001). Some studies, however, report the unfortunate finding that the older population has the highest casualty rate during disaster events when compared to all other age groups (Dyer et al., 2006; Freidsam, 1960; Browning et al., 2005; Tanida, 1996). A study conducted by Fernandez and colleagues (2002) posits an explanation for the psychological and social effects and higher mortality rate experienced by older people during times of disaster: This study determined that impaired physical mobility, diminished sensory awareness, preexisting health conditions, and social and economic restraints increased the vulnerability of frail older people during disasters. A number of studies resulting from recognition of the imperative posed by the increasing numbers of very old people offer suggestions for special strategic planning and setting of priorities in order to minimize the harmful effects of disasters on vulnerable adults (Gibson and Hayunga, 2006; Fernandez et al., 2002).

Pre-disaster and post-disaster planning are both vitally important for ensuring the safety of vulnerable and frail elders. Knowing the needs of those most at risk for harm and death allows for the proper planning and execution of potentially harm-mitigating and lifesaving actions. For some older adults, even a slight interruption in medical care services can be detrimental and sometimes lethal. For example, Magnum, Kosberg, and McDonald (1989) report the complexity of trying to ensure the safety of older vulnerable nursing home residents in an unplanned response to Hurricane Elena in 1985. Evacuating an already assembled group with known health profiles and impairments still proved to be problematic. The authors report grave issues with lack of continuance of proper medical care during and after evacuation, as impaired elders were separated from care providers and medications, as well as difficulty with transportation and other problems.

Dyer and colleagues (2006) report similar experiences with disaster relief efforts and elders in response to the evacuation of New Orleans following Hurricane Katrina. These authors report that in the shelter setting, it was difficult to determine who needed immediate medical care, and of what type, and it was hard to locate elders who needed assistance in gaining access to care. It was also difficult to protect elders in a shelter from possible exploitation.

Because these are issues that affect the wellbeing of elders and will inevitably be faced during any major disaster, mechanisms for preventing and responding to such problems as described above are essential. One way to reduce potential harmful outcomes experienced by older people during disasters is to implement a rapid needs assessment that can be used to facilitate relief efforts.

WHY A SPECIFIC ASSESSMENT TOOL?

Indeed, development of a rapid and accurate assessment tool specifically designed to identify the needs of older adults in disaster situations is paramount. The physical and social needs of vulnerable elders who are evacuated to disaster shelters vary greatly. Some elderly residents are fully independent, without chronic disease, cognitive impairment, or any limitations in their ability to perform their activities of daily living. …

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