Mitigation. Presented by Brenda D. Phillips, Ph.D. Kathy H. Thomas, Ph.D. Tammy L. Henderson, Ph.D.

Transcription

1 Disaster Preparedness For Older Adults: Four Points of Intervention Presented by Brenda D. Phillips, Ph.D. Kathy H. Thomas, Ph.D. Tammy L. Henderson, Ph.D. Brought to You by The Oklahoma Geriatric Education Center In simplest terms, emergency management is the management of risk so that societies can.deal with the disasters that they cause. Waugh (2000, p. 3; see also National Governor s Association 1979) Preparedness Mitigation Response Recovery NGA Definition Activities that eliminate or reduce the probability of a disaster Mitigation Structural Non structural s 1

2 Planning how to respond to an emergency or disaster, develop capabilities for more effective response; writing plans, conducting exercises, offering public education, establishing mutual aid agreements, inventorying resources. Preparedness (Waugh, 2002 ) The elderly may be deprived or inoculated. Less able to afford protective actions. May fear requesting help will lead to loss of independence and institutionalization. Elderly & Disasters: what do we know? Sources: Friedsam 1962; Bolin 1988; Childers Nursing Homes (GAO, 2006) If hospital and nursing home administrators decide to evacuate, they face the challenge of securing sufficient and appropriate transportation to move their patients or residents., damage from TS Erin, Caddo County, OK 2

3 Response (FEMA) Activities that are designed to provide emergency assistance, reduce casualties, reduce the chance of secondary damage and to speed recovery. Hurricane Ike, Elderly Response to Warnings (Peek, 2010, p ) Home Disability Resources Response Infoseeking Isolation Pets RX Elderly and Evacuation The elderly are more likely to be represented among the transportation disadvantaged because they are more likely to have a low income, or choose not to drive. (GAO, 2006). frail elderly are dropped off at shelters and nursing homes without care instructions or medical records. (Fernandez et al., 2002). 3

4 Elderly issues related to evacuation Key issues for transfer: Sensory deprivation Delayed response Transfer trauma Nutrition. Social Support Sources: Poulshock and Cohen 1975; Kilijanek and Drabek 1979; Eldar 1992). 10 Transportation solutions that worked during Katrina (GAO, 2006) Pre existing citizen networks. Community outreach activities. Neighborhood watch networks. Home health organizations. Physicians. Red Cross. A Functional Approach (Kailes & Enders 2007) What are the functional needs? Communication Medical support Maintaining independence Supervision Transportation by Andrea Booher 4

5 Recovery (FEMA) Returning systems to normal Restoring vital life support systems Rebuilding, restoring Improving, mitigating Photo courtesy of the Mennonite Disaster Service (Greensburg, KS) Issues for the Elderly Institutionalization. Pride. Independence. Self reliance.no no charity. Paper burden. Isolation. Transportation., Northridge Earthquake 14 Emergency Bags ( Health card. Key docs: SSN, will, bank # (copy with friend/family). Medications for 7 14 days. Flashlight. h Signaling device (whistle). Batteries & DME. Appropriate food. Pet emergency kit. Comfort items. Store where reachable. Photo: American Red Cross. 5

6 Consider Registries a list of people in need of assistance Minimal empirical research. Issues: People move and do not update. People s status changes. Access to the list and confidentiality. Maintenance, costs, staff time. Mitigate Risk Florida/Alabama Safe Center/Senior Centers Blue roofs Multi purpose Ties directly to the population in need. Source: National Council on Disability 2009 General Recommendations (Phillips 2010) Involve gerontologists, geriatricians, geriatric nurse practitioners and others in disaster planning. Seek disaster training for those who interact with elderly disaster victims (home health, meals on wheels, senior centers). Protect seniors from abuse and fraud. Plan carefully for the frail elderly, the homebound, and those in nursing homes. Conduct disaster readiness as part of overall health screenings ( 6

7 Shelters Volunteer for shelter planning efforts. Educate staff on what to expect for a range of conditions. Help assess shelters for mobility, security, nutrition, etc. Coordinate with the shelter manager to participate in routine and specialized medical care. Encourage shelter providers to stockpile basic equipment useful to senior citizens and help them to acquire it. Discharge Planning from Shelters Can the client go home? Does the client need assistance? Assistive i devices? DME? Home health? What agencies, organizations can help you with this? Getting People Home Volunteers Faith based organizations Community based organizations Civic Organizations Medical Community Home health care Medical professionals s 7

8 Continuity of Care (Phillips 2010) Insure that medical records can be transferred easily. Develop a crisis plan to expedite prescription refills, sometimes at considerable distances. Store extra supplies for those on low incomes. Assist congregate facilities. i Provide continuity of care, particularly for dialysis, cancer care, and related treatments. Help not just during response but during the long recovery period. Health Care Offices & Staff (Phillips 2010) Internally business continuity planning Downtime and displacement can be costly. Determine how many new patients or clients you can add. Develop MOUs to support your offices and theirs. Externally Plan within existing experts and efforts (DMAT). Develop a staff release plan to send medical personnel to affected areas. Education and Training Degree programs FEMA online courses American Red Cross EM conferences List serves ards FEMA materials CPG 101 (April 2009) CPG 301 Special Needs (Soon) Disaster Prevention and Management International Journal of Mass Emergencies and Disasters Disasters Journal of Emergency Management Environmental Hazards 8

9 References Bolin, Robert Older People in Disaster. International Journal of Aging and Human Development 26(1): Childers, Cheryl Elderly Female Headed Households in the Disaster Loan Process. Pp in Women and Disasters: from theory to practice, eds. B. Phillips and B. Morrow. Philadelphia: International Research Committee on Disasters. Eldar, R The Needs of Elderly Persons in Natural Disasters. Disasters 16(4): Government Accountability Organization Transportation Disadvantaged Populations: Actions Needed to Clarify Responsibilities and Increase Preparedness for Evacuations. Washington D.C.: GAO Report GAO Fernandez, Lauren, et al Frail elderly as Disaster Victims. Prehospital and Disaster Medicine 17(2): References Friedsam, Hiram Older Persons in Disaster. Pp in Man and Society in Disaster, eds. G. Baker and D. Chapman. NY: Basic Books. Garbarino, James Children and Families in the Social Environment. NY: Walter de Gruyter. Kailes, June and A. Enders Moving beyond Special Needs : a function based framework for emergency management and planning. Journal of Disability Policy Studies 17(4): Kilijanek T. and Tom Drabek Assessing long term Aspects of a Natural Disaster: a focus on the elderly. The Gerontologist 19(6): National Governor s Association Comprehensive Emergency Management. Washington D.C.: NGA. Peek, Lori Age. Pp in Social Vulnerability to Disasters, eds. B. Phillips, D. Thomas, A. Fothergill and L. Blinn Pike. Boca Raton, FL: CRC Press. References Phillips, Brenda Special Needs Populations. Pp in Disaster Medicine, eds. K. Koenig and C. Schultz. London: Cambridge. Poulshock, S. and E. Cohen The Elderly in the Aftermath of Disaster. The Gerontologist 15(4): Waugh, William Living with Hazards, Dealing with Disasters. NY: M.E. Sharpe, Inc. 9

10 NCD report Available as pdf at wsroom/publications/2 009/pdf/NCD_Emergen cymanagement.pdf Organized by the four phases. Searchable Series of recommendations Internet Resources National Council on Disability Effective Emergency Management: making improvements for communities and people with disabilities. Available as pdf download at df/ncd_emergencymanagement.pdf. Administration on Aging. Disaster Preparedness Manual for the Aging Network, ces_network/manual/disaster_assist_manual.aspx. Internet Resources FEMA and DHS, FEMA Independent Study Courses, International Research Committee on Disasters, International Journal of Mass Emergencies and Disasters, (Back issues available as pdf). 10