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Coping with the Stress of Relocation After a Disaster (Part 5): Helping Elderly People

Issues and Tips Regarding Stress Effects in Older People

Several issues need to be taken into account when helping elderly friends and family who may be under stress after a disaster and who are suffering from the effects of a sudden relocation. Consider the following concerns.

Communication Problems

Some older persons in shelters or in new surroundings may have difficulty

• Understanding family and friends
• Talking to people or answering questions

These communication problems may be caused by normal, age-related problems with memory, seeing, and hearing, and the reduced ability to physically move because of illnesses or the effects of medications. Make sure that the older person has the eyeglasses he or she needs and that hearing aids are on before talking to him or her. Be patient and calm. Speak loudly enough to be heard, but do not shout. Keep your messages simple and clear. Repeat information, and make sure that the person in your care hears and understands what is said.

Danger from Falls

Be aware that in unfamiliar settings, clutter and poor lighting could cause an elderly person to fall. Balance problems, muscle weakness, and medications can add to the risk of falling. Check new living quarters for anything that could lead to a fall (e.g. loose throw rugs). Make sure stairs and hallways are well lit. Provide walking assistance if needed.

Chronic Illness and Dietary Considerations

Arthritis may prevent an elderly family member from standing in a line. Some medications can cause mental confusion or a greater susceptibility to problems such as dehydration. Memory problems can cause communication problems. Neglect of special meal needs in certain illnesses can lead to medical crises.

As soon as possible, make sure the elderly family member

• Has all of his or her medicines
• Eats the foods required to manage illnesses
• Has written diet and medication information along in case he or she is separated from you
• Establishes contact with his or her medical care provider, or finds a new one and provides his or her medical history to the care provider

Disoriented Behavior

At night, when nearby surroundings are not seen as well as in the day, some elderly people with mild or moderate dementia or problems thinking clearly can become confused about where they are. You may need to orient them to time and place.

Make sure the elderly person has a clock and a calendar in his or her room. If you have any of his or her familiar things, place those in the room. Be sure that there is some soft, nonglaring light in the room and that it is as quiet and calm as possible. If you cannot reorient the elderly person to where he or she is and your efforts are upsetting, just reassure him or her and distract the person with other activities.

Multiple-Loss Effect

The elderly family member who may have lost his or her spouse, income, home, or physical capabilities may have difficulty "bouncing back" from the loss. Show empathy for the person's situation by listening. Give comfort by your presence, and let him or her know you are there and care. Do not minimize what he or she has lost.

Worries About Loss of Independence

Loss of the ability to live independently because of a disaster-related injury or loss of a home can be the biggest blow that a disaster deals older people. Within the constraints of the situation, allow them to do what they can for themselves and keep as much dignity and independence as is possible.

Welfare Stigma and Unfamiliarity with Bureaucracy

Many older family members are unwilling to accept government welfare assistance because they have always "paid their way" In a disaster, however, government help may be needed. Their unwillingness to accept help may be made worse by unfamiliarity with government services for which they are eligible, particularly during disasters. If the person is reluctant to accept assistance, relate the assistance to a time when he or she helped someone in need, or explain that this help comes from taxes he or she has paid.

Getting Too Hot or Too Cold

Older people may not handle extremes of heat or cold well. Either too much heat or too much cold can have marked effects upon them. This becomes critical in disasters that close down furnaces or air conditioners. Be aware of the need to keep elderly family members out of extremes of heat and cold.

Dehydration

Elderly people are more susceptible to dehydration. They do not feel thirsty as quickly as young people and do not drink water and other liquids as often. Some of the medicine they take can also lead to water loss. Check to make sure that your elderly relatives have access to safe, clean drinking water and that they are drinking it. Watch for signs of dehydration such as sunken eyes, no tears, and dry mouth.

Language and Cultural Barriers

Lower reading skill levels among some elders and inadequate command of the English language among speakers of other languages can cause confusion and frustration at relief centers or in new housing locations. Try to match the elderly person with someone fluent in his or her native language.

Dealing with Change

Remember that elderly people have strengths gained from a lifetime of coping with adversity. Know also that elderly people tend to underreport problems, both to family and physicians, as they may want to cope on their own. Therefore, it is important to pay attention to how they feel and act in times of change and relocation.

Signs of Stress in Older People

Elders can suffer various symptoms from worsening of preexisting medical problems, problems with medications, new illnesses, or psychological stress. Therefore, it is important to make sure that they are medically stable before deciding that these symptoms are due to emotional stress.

Under stress, whether from physical or emotional sources, people who are elderly can

• Become mentally confused
• Tire easily
• Withdraw from friends and family
• Undergo personality changes in severe cases

You should also know that older people might tend to complain of bodily symptoms rather than emotional problems when under stress. Again, remember not to dismiss any bodily symptoms as just due to stress.

Special Issues for Frail Elders

Many elderly are very healthy, well-functioning, capable adults. For example, according to the U.S. Agency for Toxic Substances and Disease Registry, at age 60 years, only 15 percent of elderly people suffer from dementia; at age 85 years, 50 percent of the elderly are affected by dementia. The older, frailer elders are the ones who may be more vulnerable in a disaster due to medical illnesses.

How to Help Older People Deal with Stress

In general terms, these principles will help guide you when helping an elderly person deal with the stress of evacuation and relocation:

• Provide strong and persistent verbal reassurance.
• Assist with recovery of physical possessions as is safe, make frequent home visits, and arrange for companions.
• Give special attention to suitable residential relocation, ideally in familiar surroundings with friends or acquaintances.
• Help reestablish contact with family and friends.
• Assist in obtaining medical and financial assistance.
• Help reestablish medication and any dietary regimens.
• Provide transportation to the doctor, grocery store, and the like.