Why is disaster preparedness important?
It is evident from recent headlines that the number of major disasters are on the rise. During the past decade, federal agencies report that new records for both magnitude as well as the number of major disasters have been reached. It seems as if a week does not go by without news reports of widespread destruction from wild fires, industrial explosions, extensive power outages, earthquakes, hurricanes, and tornados that have caused distress, disruption, and death. Despite these frequent reminders, older adults out of all age groups are the least likely to prepare but the most likely to experience serious and negative outcomes during and after disasters.
With the demand for emergency services increasing, refining and expanding disaster preparedness plans, safeguards, and disaster assistance to more fully target the needs of older adults is critical. The combination of an aging population, inadequate citizen preparedness, and the growing number of major disasters warrant attention from:
the general public,
governmental and non-profit organizations,
long-term care employees,
home health care workers, and
Vulnerability Yet Preventability
Across disasters, older adults are at increased risk for morbidity and mortality due to a variety of risk factors. With advanced age, some people have chronic physical and mental health conditions, live in social isolation, experience cognitive decline, have low literacy, or limited financial resources. These vulnerabilities predispose many older adults to a greater level of danger during all phases of a disaster, from life-threatening challenges when evacuating to negative psychological consequences during the recovery period.
Sensory deficits such as impaired sense of smell, vision, or hearing can compound these risk factors, leaving some older adults unaware of disaster warnings (e.g. smoke or sirens), unable to escape (e.g. impaired mobility or inability to drive), incapable of easily and quickly comprehending evacuation instructions, or more easily overwhelmed during quickly evolving disasters. Those who are frail or rely on wheelchairs, walkers, and canes may find it difficult to stand in line for services, climb stairs, or sleep on a shelter cot. Loss of electric power may leave some stranded by dysfunctional elevators or unable to charge electric scooters needed for mobility. More susceptible to the effects of extreme temperatures, many older adults are also at greater risk for heat stroke and hypothermia. Because of financial constraints, some older adults live in older homes that don’t have modern upgrades for protection against fire, wind, and rain. Fortunately, many fatalities, injuries, and damages caused by disasters can be mitigated with adequate resources and advance planning.
Tips for Disaster Planners, Responders, and Policymakers:
Involve older adult healthcare professionals (e.g., geropsychologists, home health care workers, long-term care staff) in all stages of disaster preparedness planning and delivery of services that includes educating and training front-line workers and first responders to best address the needs of older adults.
Develop an integrated and well-organized tracking system for vulnerable older adults that can be utilized at both local and state levels during disasters.
Create coordinated regional plans to help evacuate residents of long-term care facilities or homebound older adults with specific needs (e.g., those who depend on ventilators).
Account for language and literacy barriers, particularly in diverse areas. Hire translators and use pre-made pictorial signage with key messages for older adults with vision difficulties or varying levels of literacy.
Avoid elaborate or detailed explanations and provide steps that are actionable by older adults in brief, simple, and concrete terms.
Implement and evaluate a cohesive, efficient, and effective public health triage for pre and post-disaster situations.
Designate locations for shelters that specifically serve older adults.
Establish transparent and dependable lines of communication between emergency shelters and aging services personnel (e.g., walkie-talkies and ham radio for power outages).
Require regular disaster preparedness drills as standard public health practice.
Expand tailored pre- and post-disaster financial assistance programs for older adults, including tangible services such as grant programs, aid application agencies and advisors, and preparedness initiatives to equalize opportunities for post-disaster economic recovery.
Be alert to older adults who may be at risk for post-disaster financial abuse by unscrupulous people posing as contractors and offering other recovery schemes (e.g., repair of damaged vehicles).
Invest in insurance and recovery platforms that are easily navigable by older adults that are not solely reliant on technological ability. Requiring that all claims be submitted digitally may bar access to resources that some older adults need to survive and recover.
Obtain the opinions and perspectives of older adults at all stages of disaster planning. When feasible, pilot test educational materials and programs prior to a disaster to make needed refinements that increase the likelihood that information and services will be accessible and usable by the intended audience.
Older Adults as Volunteers: An Untapped Resource
Even in advanced age, many older adults can be effective volunteers during a disaster. Older adults can serve as models of resilience to younger people and supports to their families and friends. Those who have aged in place may know how to reach out to other older adults who are socially isolated through their social networks.
Unfortunately, older adults are often not asked to serve as volunteers and planners. Yet, a lifetime of experience can be a valuable resource during disasters. In fact, research suggests that some older adults prefer to obtain information from peers versus professionals. Many feel more comfortable asking questions of others who are similar in age and life experience.
Older volunteers can inform disaster planning, provide support during disasters, and assist with recovery efforts, by:
identifying older adults in their neighborhood or social network who may be homebound or socially isolated
offering practical assistance
serving as a source of emotional support
demonstrating a model of resilience
working as peer educators
Knowing who is willing and capable of volunteering provides a valuable resource during a time when assistance is needed most. Knowing who is vulnerable helps to prioritize limited resources, support resilience efforts, and reduce risk for adverse outcomes. Older adults should be seen as mainstays of strength, resilience, and wisdom who have an enormous amount to offer disaster planners, policymakers, and their communities.
American Psychological Association. (2018). Older Adults and Disasters: How to Be Prepared and Assist Others. Retrieved from http://www.apa.org/pi/aging/resources/older-adults-disasters.pdf
American Psychological Association. (2018). Older Adults and Disasters: How Caregivers Can Be Prepared and Assist Others. Retrieved from http://www.apa.org/pi/aging/resources/caregivers-disasters.pdf
American Psychological Association: provides links to information about mental health, aging, and disasters at http://www.apa.org/pi/aging/aging-resource-facts.pdf
Centers for Disease Control and Prevention: provides links to tools and information to assist with disaster planning for older adults at https://www.cdc.gov/aging/emergency/
Ready.Gov offers a variety of downloadable guides for older adults, caregivers, and planners at https://www.fema.gov/media-library-data/1392389833272-75460345a2f4adcc5418a1da7cb25eef/2014_PrinterFriendly_OlderAmericans.pdf
AARP, “We Can Do Better: Lessons Learned Protecting Older Persons in Disasters,” 2006 at https://assets.aarp.org/rgcenter/il/better.pdf
Administration for Community Living, “Disasters don’t Plan Ahead. You Can,” 2017 at https://www.acl.gov/news-and-events/acl-blog/emergency-preparedness-month-disasters-dont-plan-ahead-you-can
Jessica Walsh is a PhD candidate in Clinical Psychology at Palo Alto University in California, specializing in the Trauma Program. She received her B.A. in Social Studies from Harvard University in 2010 and her M.Sc. Psychology from the University of East London in 2013. She is a psychology extern at the San Francisco Veterans Affairs Medical Center, Women’s Clinic and PTSD Clinical Team, and will soon be beginning her clinical internship at the Veterans Affairs Medical Center Northern California. Her research interests focus on trauma, aging, resilience, and moral injury, particularly in the context of improving public policy and clinical services in response to acts of terrorism, war, killing, and disasters.
Lisa M. Brown, PhD, ABPP is a professor of psychology and director of the Trauma Program at Palo Alto University. She is licensed in Florida and California and is board certified through The American Board of Professional Psychology (ABPP) in Geropsychology. Dr. Brown’s clinical and research focus is on trauma and resilience, aging, health, vulnerable populations, disasters, and long-term care. Her research has been funded by the National Institute of Aging, the Centers for Disease Control and Prevention, Department of Veterans Affairs Health Services Research and Development Service, USGS, and the Agency for Healthcare Administration.
Image source: Getty