Transcript MODULE 2 Self Study Slides

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.
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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.
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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
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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)
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Treatment of Depression
1. Early identification
2. Early treatment
3. Treatment with medications
4. Therapy
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Anxiety
Occurs from stress and vulnerabilities such as
a terrorist attack or natural disaster.
Mental and emotional symptoms:
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Unrealistic concerns about things and life
Inability to put things off, obsession
Physical symptoms:
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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
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Treatment of Anxiety
• Pharmacotherapy for Anxiety Disorders
• Psychotherapy and Anxiety Disorders
• Cognitive-Behavior Therapy (CBT)
• Biofeedback
• Relaxation Therapy
• Physical Exercise Programs
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Post-Traumatic Stress Disorder
(PTSD)
• Anxiety disorder
• Develops after terrifying event or ordeal
• 3.6% of adults
• 30% of military veterans
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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
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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.
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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
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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
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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
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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
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Community-Based Services
• Outpatient psychotherapy
• Hospital day treatment programs
• Crisis services and counseling
• Case management
• Home-based services
• “Wraparound” Services
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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
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Resources Available to
Older Adults
• The Red Cross
• Disaster Recovery Centers
• Disaster Advocates
• Eldercare Locator
• Families
• Outreach Services
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End of Module 2
Slides