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Transcript
Learning Module 2: Psychological Needs of Older Adults Following A Disaster/Emergency Priority Considerations • Physical or emotional frailty • Personal loss more devastating • Isolation and potential hopelessness • Triggered memories • Chronic health problems • Medication needs • Sensory, mobility, or cognitive impairment • Increased anxiety or confusion • Loss of support systems Slide 2 PREPARE Module 2 Phases of Disaster • Warning and Threat Phase: When there is insufficient warning, evacuation may create anxiety for older adults • Impact Phase: Reactions can include confusion and disbelief. • Rescue/Heroic Phase: Shock or denial, shielding the person from intense emotions. • Remedy/Honeymoon Phase: Share feelings of common purpose and mutual support. Slide 3 PREPARE Module 2 Phases of Disaster • Inventory Phase: Survivors explore the extent of their losses. Older adults may be affected by the loss of property, treasured possessions, and means of mobility. • Disillusionment Phase: Sets in within several months among older adults who feel they have not fared well with official attempts to help. • Reconstruction or Recovery Phase: Survivors come to terms with the need to re-establish homes and life patterns. Older adults may regard these tasks as too difficult. Prolonged feelings can lead to depression. Slide 4 PREPARE Module 2 Typical Reactions to Disaster • Anxiety and depression • Irrational fears • Isolation • Alcohol or drug use •Reliving past traumas • Fear of infection • Problems with sleep • Paranoia • Horror, panic, anger • Guilt, anger, grief • Demoralization • Sensitivity to loud noises Slide 5 PREPARE Module 2 Depression Symptoms: • Loss of interest in activities • Significant weight loss or gain • Sleep disturbances • Agitation • Fatigue • Feelings of worthlessness • Loss of concentration • Thoughts of death or suicide • Feelings of helplessness or hopelessness • Crying spells • Physical complaints (dentures hurt, body is sore, stomach aches, headaches) Slide 6 PREPARE Module 2 Treatment of Depression 1. Early identification 2. Early treatment 3. Treatment with medications 4. Therapy Slide 7 PREPARE Module 2 Anxiety Occurs from stress and vulnerabilities such as a terrorist attack or natural disaster. Mental and emotional symptoms: – – Unrealistic concerns about things and life Inability to put things off, obsession Physical symptoms: – – – Slide 8 PREPARE Module 2 Chest pain Increased heart rate Inability to sleep Anxiety Disorders • 55 yrs. and older: 11.4% • Under-diagnosed • PTSD (post traumatic stress disorder) • Depression 50% after Katrina Slide 9 PREPARE Module 2 Treatment of Anxiety • Pharmacotherapy for Anxiety Disorders • Psychotherapy and Anxiety Disorders • Cognitive-Behavior Therapy (CBT) • Biofeedback • Relaxation Therapy • Physical Exercise Programs Slide 10 PREPARE Module 2 Post-Traumatic Stress Disorder (PTSD) • Anxiety disorder • Develops after terrifying event or ordeal • 3.6% of adults • 30% of military veterans Slide 11 PREPARE Module 2 Symptoms of PTSD Slide 12 1. Fear and anxiety 2. Re-experiencing – night mares, feeling as though the event was happening again. 3. Avoidance/numbing – avoid thoughts and feelings, difficulty with both pleasant and unpleasant feelings 4. Increased arousal – irritability, anger, difficulty concentrating, easily startled. 5. Grief and depression PREPARE Module 2 Assessment of PTSD • Tools to assess PTSD: – Clinician-Administered PTSD Scale (CAPS) – Primary Care PTSD Screen • Recognize symptoms • Make assessments Slide 13 PREPARE Module 2 Treatment of PTSD • Cognitive-behavioral therapy (CBT) - Has 2 components. Cognitive component helps people change their thinking patterns about their fears. Behavioral component helps change their reactions to anxiety-provoking situations through controlled exposure to the source of fear. • Exposure therapy • Group treatment • Pharmacotherapy (medication) - Anti-anxiety drugs are the preferred medication for most anxiety disorders. Slide 14 PREPARE Module 2 Challenges in Diagnosis • Depression is sometimes believed to be a normal part of aging • Physical health problems may make the diagnosis difficult • Older adults may present with different symptoms of PTSD • Older adults are less likely to report mental health problems Slide 15 PREPARE Module 2 Normal Stress Reactions to Trauma Physical Reactions: • Faintness, dizziness • Hot or cold sensations in body • Tightness in throat, stomach, or chest • Nausea or vomiting, headache Behavioral Reactions: Sleep disorders, nightmares, jumpiness, crying, isolation or withdrawal Emotional Reactions: Shock, disbelief, anxiety, fear, sadness, grief, helplessness, anger, irritability, mood swings Slide 16 PREPARE Module 2 Abnormal Stress Reactions to Trauma Physical Reactions: Worsening of illness, sleep disorders, memory problems, somatization disorder (physical symptoms that can’t be explained) Behavioral Reactions: Isolation, reluctance to leave home Emotional Reactions: Depression, despair, apathy, confusion, disorientation, suspicion, agitation, anxiety Slide 17 PREPARE Module 2 Minimizing Transfer Trauma Strategies to minimize transfer trauma: • Provide reassurance • Familiar staff should accompany evacuees • Provide orienting information • Meet physical needs • Ensure that essential resident information accompanies the resident • Help residents reconnect with their families • Use multiple assessment methods to diagnose physical or psychological problems Slide 18 PREPARE Module 2 Community-Based Services • Outpatient psychotherapy • Hospital day treatment programs • Crisis services and counseling • Case management • Home-based services • “Wraparound” Services Slide 19 PREPARE Module 2 Working with Older Adults in a Disaster Strategies: • Provide strong verbal reassurance • Assist with recovery of possessions, arrange for companions • Relocate in familiar surroundings or with friends • Help re-establish familial and social contacts • Assist in obtaining medical and financial help • Re-establish medication schedules • Provide transportation Slide 20 PREPARE Module 2 Resources Available to Older Adults • The Red Cross • Disaster Recovery Centers • Disaster Advocates • Eldercare Locator • Families • Outreach Services Slide 21 PREPARE Module 2 End of Module 2 Slides