DISASTER ISSUES

Care of the elderly

 

·       What challenges and issues does a volunteer disaster preparedness worker need to understand in working with the elderly?

·       The elderly should not be categorized by age but by functional capacity to deal with the activities needed to prepare  for a  disaster

·       How do we asses these functional capacities?

o      Basic activities of daily living

§       Can they take care of themselves (eat, mobility , hygiene, dress themselves)?

§       Independence  --   capacity to manage household preparation before a disaster.

 

Functional Continuum

 

Ascertaining level of capacity:

 

·       Stages that will guide assistance needed and level of intervention

o      Independence: can they remain at home and take care of themselves?

o      Independence vs. interdependence: may need some help to prepare  difficult chores

o      Semi-dependent: community group living providing safety

o      Dependence (partial to full): shelter/institution/hospital.

 

 Disaster impact presents an insult to the already declining functioning in the elderly. The aid worker must ascertain how much and how best to help?  How do we structure the system to help minimize impact whether the individual remains in the home or in a shelter?

 

Premise: Change in function is expectable in the elderly. Different physiologic systems have different rates of change. We need to measure each individual needs.

 

Have the Elderly Fared Differently in Disasters From Other Groups?

 

Not much research has been published on this subject, but the elderly can fare well if they are healthy, have a perceived support group that has a good “fit”, and obtain assistance in dealing with their reactions to loss, change and grieving. They need help due to a lack of capacity to anticipate and cope with potential dangers.  They may be vulnerable to the difficulties produced by the imminent danger and have increasing difficulty in recovering from the effect of the disaster.

  

The elderly population’s motivation to adequately prepare for the distant threat of a hurricane must be determined. Is motivating the elder populations more of a challenge and if so, how should that challenge be addressed?

 

Communication with the elderly population is a process that requires receiving, understanding, believing and personalizing the contents of the message.  These processes influence motivation.

 

In our multi-cultural population, it is not sufficient to simply transmit disaster warning signals, as the message content will be interpreted differently within the socio-cultural context of the individuals hearing the message. Variables such as language, literacy, household and family status, and immigration situation must be considered during the “warning” and “watch” periods when interacting with individuals. Economics, job status, health capacity and lack of information how to proceed are barriers to preparedness.

 

Most individuals will move through a multi-stage decision-making process, which includes comprehension, believing the danger is real, and deciding that acting is beneficial and necessary. For action to occur, the individual must be convinced that protective behavior is necessary and possible. The content of the warning messages must be personalized to motivate the desired behavioral response. 

 

In the elderly population, active seniors can be recruited and used as volunteer disaster preparedness and response workers. What are the challenges in fully engaging them as volunteers?

 

The elderly can be reached through churches, clubs and educational organizations.  They must understand what is expected of them, be provided with a specific schedule of their commitment, receive assistance with transportation, and get supportive and detailed training.

  

Training which can make volunteers more effective in disaster preparedness work (Train the Trainers Curriculum):

 

·       Personalized approach with small number of participants

·       Content knowledge - how to train and motivate

·       Tailor message to meet needs of community

 

·       General introduction to the training course

·       Trainers introduce themselves

·       Describe the day’s activities

·       Trainees introduce themselves and express their needs

·       Explanation of why special training is needed to prepare volunteers to help individuals in the community

o      Psychosocial and emotional issues impeding action in preparedness

o      Historic development of disaster impact - individual and community

o      Discuss:  stressor-stress reactions; loss and bereavement; coping; resiliency

o      Training content objectives using the textbook Are You Prepared - present and discuss content

 

·       Present and review

o      Planning: necessity for information - how do they obtain updated factual content?

o      Preparation: necessary resources - who provides them?

o      Protect: requires capacity and energy - who helps?

o      Practice: who provides assistance?