Academic journal article Generations

Planning for and Responding to Special Needs of Elders in Natural Disasters

Academic journal article Generations

Planning for and Responding to Special Needs of Elders in Natural Disasters

Article excerpt

What we have learned.

Older people are among the most vulnerable in the general population to the direct impact of natural disasters, as pictures from New Orleans following Hurricane Katrina illustrated so graphically. In fact, elders are more likely to have impairments that limit their ability to plan, respond, or seek help, and they are less likely to recover from the economic impact of a natural disaster than is the general public (Administration on Aging, 2004).

Risk factors that particularly apply to elders include decreased sensory awareness (smell, touch, vision, and hearing) and impaired physical and mental ability, chronic health conditions, and social and economic limitations (Oriol, 1999).

While these factors, some of which describe progressive changes that occur as people age, do not prevent continued independence of healthy older adults under normal circumstances, they can affect an older person's ability to communicate, comprehend extent of the danger, and comply with safety procedures under adverse conditions. Moreover, frail elders (that is, those with serious physical, cognitive, economic, and psychosocial problems) utilize most of their functional reserve on daily survival, dealing with health conditions, economic constraints, social isolation, and impaired mobility, for example. As a result, they are likely to have difficulty coping with additional stress and may be even more adversely affected by disasters than is the general elder population (Fernandez et al., 2002).

This article explores the special needs of healthy and frail elders in relation to planning for and responding to natural disasters, including hurricanes, tornadoes, ice storms, heat waves, influenza, wildfires, floods, and earthquakes.

INCREASED VULNERABIIJTY, INCREASED RISK

As compared to the general population, even healthy elders are at increased risk of dropping below the level of physical and cognitive ability required for safe, independent, and efficient care of themselves in a disaster. Many require help from other people and assistive devices to carry out one or more activities of daily living, such as eating, bathing, dressing, grooming, and using the toilet. Many also need help with transportation, cooking, telephoning, housekeeping, and management of medication regimens (Albert, 2004).

Older people experiencing age-related slowing of cognitive and motor activity cannot react as quickly as the general population to alerts requiring immediate actions (Huxhold et al., 2006). Liver disease, diabetes, bladder or bowel incontinence, and other chronic physical conditions, increasingly prevalent as people age, may require special diets, ongoing care, and specialized treatment regimens. Moreover, older adults are highly susceptible to dehydration, hypo- and hyperthermia, falling, and dangerous changes in blood pressure (Fernandez et al., 2002).

Cognitive impairment is present in 10 percent to 30 percent of elders (Albert, 2004), may affect their ability to communicate or process information, articulate their needs, and understand or resolve problems (Massey, 1997). The disruption of routine that often accompanies disaster response can exacerbate such difficulties. Elders with mental health problems may wander, have poor impulse control, or resist medical care or assistance with personal care tasks and daily activities, and sometimes require immediate medical treatment. Existing and event-induced depression may also affect an older person's memory as well as impair ability to respond to and recover from disasters (Ostroff, 2002). (For more on this topic, see Brown, this issue.)

IMPACT OF TRAUMA

Older people have been shown to display a variety of behavioral, physical, and emotional reactions to trauma, which often comes with disasters. Behavioral reactions may range from withdrawal and isolation to reluctance to leave home, mobility limitations, and relocation adjustment problems. …

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