Disaster Response and Needs of Older Victims Sue C. Jacobs, Ph.D. Ledbetter Lemon Counseling Psychology Diversity Professor School of Applied Health and Educational Psychology Oklahoma State University, US 3rd Annual International Congress of Gerontology and Geriatric Medicine, New Delhi, India November 27-29, 2015

Context Over the past several decades, national and international communities have experienced an increase in large-scale natural (e.g., earthquakes, floods, hurricanes, tsunamis) and man-made disasters (e.g., wars, terrorist attacks) (World Health Organization [WHO], 2015). The trauma and upheaval caused by these disasters often have the potential to overwhelm local communities and their resources, including providing for the needs of older adults.

Overview and apology Brief review some of the varied research and anecdotal evidence of the needs of older persons who are victims, the resiliency of some older adults surviving disasters, and some lessons learned in previous disasters. Suggest assessing needs of older disaster victims in context using an adaptation of Bronfenbrenner’s Ecological model and provide an example. Possible future directions for international cooperation for gerontologist, geriatric practitioners, older adults, and others who work with older adults

Disaster examples My background as victim, psychologist responder, supervisor, researcher, community member, community responder Others here today? Almost all large scale disasters, natural or man made will impact older adults, the healthy older person, the one with some chronic health conditions or dementias, community dwelling, in hospitals, or in nursing home or extended care facilities. Live alone or with families. We most likely have all seen photos or pictures in the news of older hospital patients and their physicians and nurses, being trapped after Katrina in New Orleans, older refugees fleeing Syria with their families or being left behind, old adults in various Tsunamis, nuclear accidents, and so forth .

Responses of older adults and their needs Varied, depending upon the disaster and both the individual strengths and resources of the individual and their pre-disaster health or frailty, mental health, emotional stability, and family or other support networks. Some community-dwelling older adults well into their late 80s or 90s fare well. They demonstrate resilience and some growth and increasing vitalization when they use their own skills and talents and engagement with their community to help others. Grand Forks example and student dissertation. Katrina example and relocation to other communities Others begin to decline and researchers have found increases in death rates in the few years following a disaster among older adults, some speculated to be because of individual resources or lack their of, or lack of old social networks or familiar institutional/community support (example church communities in Katrina) or lack of community resources.

Some lessons learned from previous disasters Older adults have a life of dealing with negative as well as positive events; for most well older adults, they have strength, experiences and ability to process this and are resilient. They help others and their communities in disaster recovery. For all individuals needing medications for physical or mental health needs, loss of access to health care providers, caregivers, prescription exacerbates conditions. Gaining access to medical records is an issue in disasters where access to records is lost. Needs to be advanced Preparation and planning, example post- Katrina discussions by psychologists in the 5 US states impacted. Recovery for community and individuals enhanced if outside relief agencies able to use pre-disaster community networks and resources (example Tsunami in South India-OSU researchers)

Disaster response In the U.S., the American Red Cross cooperates with other relief agencies and local communities. Physicians, Nurses, Psychologists, Social workers, school counselors can all serve as medical, mental health responders for shortened 2 week periods of time. Students n this disciplines can serve under the license of a supervising faculty member, Several organizations (i.e., Red Cross, WHO,) have advocated for sustainable mental health and psychosocial supports during and after disasters. This has resulted in an increased effort in developing guidelines and training models for disaster response services. Psychosocial First Aid (PFA), intended to reduce initial distress and acknowledged by the major U.S. and international response agencies is expected to occur within the first four weeks of the disaster (CDC, 2012). Translated into various languages (e.g., Spanish, German, Japanese, Chinese), the PFA training models have been developed for professionals and lay persons to become competent in providing disaster mental health work. Although the PFA provides a general framework and principles of disaster response services, limited attention has been given to cultural implications of such interventions, especially in international settings, and to my knowledge attention had not been specific to older adults. Existing training models are often target broader audiences (e.g., public health workers) or lack the unique delineation of disaster relief care beyond PFA which would be expected to lead to an initial stabilization. Is there a need for gerontology and geriatric medicine to provide training resources?

Assessment of older adults after disaster The American Red Cross has also adopted a triage-type approach to assess needs of individuals and families post disaster. These questions assess resources and strengths (housing, family support) as well as basic needs, pre-existing health needs, etc.). Are there more specific things needing assessment in older adults? Or more specific expertise. Colleagues and I in Counseling Psychology have proposed again using the Bronfenbrenner Bioecological model to assess individual, family and and resources post disaster. It also can provides a framework for research on which older adults are likely to do well following a disaster and which are not.

Reconsider ecological model to assess needs, possible interventions or alternatives for older adults and their families or other loved ones post disaster.

Examples Example of applying to children available: in interested I can provide the reference.

Possible future directions Develop public information more specific to needs, assessments of older adults in disasters International networks….Counseling Psychology example Develop in cooperation with other non-geriatric providers systems to provide some continuity of care (prescription, other interventions) post-disaster Research? An excellent opportunity to better understand older adults strengths and resiliencies

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