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Elder Abuse and Neglect in Disasters: Types, Prevalence and Research Gaps
Abstract
A systematic review of literature and of information from key organizations was conducted to provide an overview of what is known about elder mistreatment in disaster situations, identify research gaps and to discuss possible policy interventions. While there has been growth in recent years in research on prevalence, incidence and risk factors for morbidity and mortality of seniors in disasters and on elder abuse, research specifically on elder abuse and neglect in disaster situations was limited and only 19 articles were found. The types of abuse most commonly addressed in these articles were financial (theft in shelters and contractor fraud), neglect (primarily abandonment), and physical abuse (domestic violence). Evidence was mainly anecdotal except for contractor fraud, where some prevalence data were available. Research is needed to fill the substantial information gaps. Increase in use of services has been employed to document increases in child abuse and domestic violence during and after disasters. The same methodology could be employed for elder abuse and neglect. Research on best practices (shelter-in-place vs. evacuation) is needed for end-of-life care patients and frail elders in institutional settings. Training and awareness programs for first responders are also needed so that they can better recognize seniors who may have come from abusive environments and to prevent abuse from occurring in emergency housing to which seniors are relocated.
... Massey et al. [24] focused on older people in low-and middle-income countries but covered both natural disasters and armed conflicts. Gutman and Yon's [26] article reviewed publications focusing on the abuse and neglect of older people in disasters. While four of the five previous reviews employed a systematic literature review approach, Bayraktar and Yilmaz [22] performed a narrative literature review. ...
... Only a few exceptional studies explored issues such as economic abuse and negligence. In their systematic review, Gutman and Yon [26] highlighted the financial abuse (i.e. theft and contractor fraud) faced by older people in disasters, in addition to physical abuse (domestic violence) and abandonment. ...
... theft and contractor fraud) faced by older people in disasters, in addition to physical abuse (domestic violence) and abandonment. Therefore, relief workers must be trained to identify, prevent and mitigate economic abuse and neglect of older people in disasters [16,26]. ...
Against the backdrop of rapid population ageing and widespread urbanisation, this review explores older people’s needs in urban disaster response. We conducted a systematic review of 120 publications across several related fields – disaster management, gerontology, and urban governance. We identified five needs of older people in disaster response: health, socioeconomic, evacuation and settlement, information and communication, and cultural needs. We find that older adults’ needs were insufficiently met for four main reasons. First, a lack of understanding of the relationships between different needs poses challenges to coordinating disaster response, particularly when relief aid targets different needs in an uncoordinated fashion. Second, standard disaster response often provides unsuitable aid to older people, leaving them feeling uncomfortable, unequal, and undignified. Third, there is a discrepancy between policy expectations and actual disaster response, resulting in inadequate incorporation of older people’s needs into disaster response at local, national, and international levels. Fourth, there is a relative lack of advocacy that directly gives voice to older people rather than indirectly reflecting their needs through carers and disaster responders. To address research and knowledge gaps, we propose five directions for future research: (1) a need for conceptually informed, contextually salient, and transparent working definitions of older people, (2) a need for nuanced intersectional understandings of older people’s needs, (3) a holistic understanding of the disaster ecology of older people’s different needs, (4) a focus on secondary disasters arising from primary disasters, and (5) a need for more theoretically informed and empirically rigorous research.
... It is estimated that in the next 40 years, the elderly population will have doubled; and the elderly will account for 22 percent of the world's population by 2050 (1). At the same time, the average annual incidence of natural disasters has increased from about 125 in the early 1980s to 500 in early 2006 (2). About 150 major natural disasters affected millions of people worldwide in 2015 (3). ...
... Rather, they are caused by the disaster. These problems include different types of injuries (sprain or strains, fractures, lacerations), falling, trauma, dehydration, dangerous changes in blood pressure, physical impairment, lack of mobility, severe physical fatigue, headache, and stomachache (2,15,22,32,33,40,41,43,46,49). Some studies reported the possibility of falling or injuries after evacuation (2,22,32,33,46,49). ...
... These problems include different types of injuries (sprain or strains, fractures, lacerations), falling, trauma, dehydration, dangerous changes in blood pressure, physical impairment, lack of mobility, severe physical fatigue, headache, and stomachache (2,15,22,32,33,40,41,43,46,49). Some studies reported the possibility of falling or injuries after evacuation (2,22,32,33,46,49). Three studies included in this review reported that many of the injured elderly had disabilities (2,22,42). ...
Background: Older adults are disproportionately affected by natural disasters. The literature on the health needs of older adults after natural disasters is limited. Objectives: The aim of this study was to examine the existing evidence on the health needs of older adults after disasters. This systematic review of the literature was conducted to provide an overview of what is known about the needs of older adults after natural disasters. Methods: An electronic search of the following databases was conducted: PubMed, Cochrane, ProQuest, Web of Science, Google Scholar, and HelpAge International. The final review included 27 articles that were analyzed using qualitative content analysis to identify the health needs of older adults after natural disasters. Results: Limited and sparse literature exists pertaining to the health needs of older adults after natural disasters. In this study, six themes or features of health needs emerged: medical needs, psychosocial needs, assistance in activities of daily living, resources, informational needs, and protective needs. Furthermore, four categories including personal, organizational, socio-cultural, and disaster-related factors could affect the health needs of older adults after natural disasters. Conclusions: Planning for older adults with diverse and special needs in disasters is very important. Health care providers should consider the older adult’s health needs and capacities in the disaster recovery.
... Older adults are disproportionately affected and more likely to die in nearly all natural disasters, as evidenced by recent floods, heat waves, earthquakes, hurricanes, and tsunamis (Gutman & Yon, 2014). Family violence, including child abuse (Curtis et al., 2000) and intimate partner violence among younger adults (Parkinson & Zara, 2013), has also been shown to increase in the aftermath of these disasters. ...
... In most natural disasters, many of the issues involve displacement from living environments, movement to shelters, and then repairing/rebuilding and return. As a result, much of the elder mistreatment surrounding disasters is described anecdotally and, in the limited literature available, has included abandonment of functionally or cognitively impaired older adults unable to leave nursing homes or other living environments, neglect and theft while in shelters, and fraud by contractors and others overseeing repairs/rebuilding and return (Gutman & Yon, 2014). ...
New York City is currently experiencing an outbreak of COVID-19, a highly contagious and potentially deadly virus, which is particularly dangerous for older adults. This pandemic has led to public health policies including social distancing and stay-at-home orders. We explore here the impact of this unique crisis on victims of elder mistreatment and people at risk of victimization. The COVID-19 outbreak has also had a profound impact on the organizations from many sectors that typically respond to protect and serve victims of elder mistreatment. We examine this impact and describe creative solutions developed by these organizations and initial lessons learned in New York City to help inform other communities facing this pandemic and provide guidance for future crises.
... There is a growing literature on how disaster programs can be adjusted to meet the needs of vulnerable groups, in particular programs and policies that are sensitive to the needs of the elderly and disabled (e.g., Barusch, 2011;Gutman and Yon, 2014;Hartog, 2014;Priestley and Hemingway, 2007;Vakis, 2006). However, there is still an information gap, according to Gutman and Yon (2014 The professionals were prosecuted but the jury refused to indict the accused. ...
... There is a growing literature on how disaster programs can be adjusted to meet the needs of vulnerable groups, in particular programs and policies that are sensitive to the needs of the elderly and disabled (e.g., Barusch, 2011;Gutman and Yon, 2014;Hartog, 2014;Priestley and Hemingway, 2007;Vakis, 2006). However, there is still an information gap, according to Gutman and Yon (2014 The professionals were prosecuted but the jury refused to indict the accused. According to Barusch (2011, p. 348), "leaving the doctor free to become a passionate advocate for legislation provides legal immunity to physicians for their actions in times of disaster." ...
The Nordic states have extensive welfare systems in which the local social services are an important component. Despite a growing research on disaster resilience, we lack research examining in systematic way whether and how local social services in the Nordic countries contribute to resilience. Aiming to fill this gap, this article asks whether we can identify a common Nordic model of the role of local social services in disasters, or whether the countries have taken different paths. We use policy documents and legislation to examine the extent to which roles for local social services are embedded in the disaster management systems of the five Nordic countries. We analyze the institutional organization in each country, as well as the models of social services related to disasters from a comparative perspective. We find that the Nordic countries have chosen quite different paths regarding local social services’ role in disaster management and conclude that there is no Nordic model. Another general conclusion is that a more robust position of local social services within the disaster management system might enhance disaster resilience in the Nordic countries as a whole.
... The political influence environmental science and climate activists enjoy today was forged through decades of political action and efforts from (now older) scientists and activists, like those who first observed Earth Day in 1970, or founded Greenpeace in 1971. Furthermore, older persons are among those most vulnerable to the harms of climate change [20][21][22][23][24][25][26]. Today's youth will age on a warmer planet, and thus they too will face the health vulnerabilities of ageing. ...
Why should, and how can, the fields of climate science and geroscience (which studies the biology of ageing) facilitate the cross-disciplinary collaboration needed to ensure that human and planetary health are both promoted in the future of an older, and warmer, world? Appealing to the ideal of ‘wisdom-oriented’ science (Maxwell 1984 In From knowledge to wisdom: a revolution in the aims and methods of science), where scientists consider themselves to be artisans working for the public good, a number of the real-world epistemic constraints on the scientific enterprise are identified. These include communicative frames that stoke intergenerational conflict (rather than solidarity) and treat the ends of planetary and human health as independent ‘sacred values’ (Tetlock 2003 Trends Cogn. Sci. 7, 320–324) rather than as interdependent ends. To foster ‘climate geroscience’—the field of knowledge and translational science at the intersection of climate science and geroscience—researchers in both fields are encouraged to think of novel ways they could make researchers from the other field ‘conversationally’ present when framing the aspirations of their respective fields, applying for grant funding and designing their conferences and managing their scientific journals.
... Additional literature review of disaster disparities supports our health disparity focus on older age and Black/African racial identity. Older adults experience disparities in disaster morbidity and mortality as disproportionately low-income [12], socially isolated [13][14][15][16], and victim to disaster crime [17][18][19][20]. Over 70% of older adults in the U.S. have multiple chronic health conditions [21]. ...
Tailored disaster preparedness interventions may be more effective and equitable, yet little is known about specific factors associated with disaster household preparedness for older adults and/or those with African American/Black identities. This study aims to ascertain differences in the importance features of machine learning models of household disaster preparedness for four groups to inform culturally tailored intervention recommendations for nursing practice. A machine learning model was developed and tested by combining data from the 2018, 2019, and 2020 Federal Emergency Management Agency National Household Survey. The primary outcome variable was a composite readiness score. A total of 252 variables from 15,048 participants were included. Over 10% of the sample self-identified as African American/Black and 30.3% reported being 65 years of age or older. Importance features varied regarding financial and insurance preparedness, information seeking and transportation between groups. These results reiterate the need for targeted interventions to support financial resilience and equitable resource access. Notably, older adults with Black racial identities were the only group where TV, TV news, and the Weather Channel was a priority feature for household disaster preparedness. Additionally, reliance on public transportation was most important among older adults with Black racial identities, highlighting priority needs for equity in disaster preparedness and policy.
... al., 2018;Sundar, Stratman, & Sundar, 2017;Surjan & Shaw, 2009;Sternberg & Batbuyan, 2013;van Laere, 2013;Van Vactor, 2012;Veeramany et. al., 2016;Wei et al., 2018 Assorted themes: aid work; mass death; humanitarian logistics; recovery and reconstruction; vulnerability; sanitation; poverty; health education; resilience; armed conflict; riots; extreme stress; elder abuse and neglect; prison crisis management; wildlife hazard; altitude illness; water distribution; drinking water; mass gatherings; health indicators; social determinants; external experts, learning Ahmad, Ahmad, Sadia & Ahmad, 2017;Aronsson-Storrier, 2017;Atallah, 2016;Atienza, 2015;Bates & Peacock, 1989;Bayer, 2017;Beerensa & Tehler, 2016;Benini, 1993;Boonmee, Arimura & Asada, 2017;Broekema, van Eijkb & Torenvlied, 2018;Broekema, van Kleef & Steen, 2017;Connolly, 2014;Coupet, Nassiri, Aliu & Coppola, 2013;Cuny & Tanner, 1995;Connolly, 2014;Crichton, Ramsay & Kelly, 2009;Darkow, 2018;Dobson, 2017;Fischer III, 1999;Fekete, 2018;Foxell, 1997;Gaillard & Navizet, 2012;Gaillard, van Niekerk, Shoroma, Coetzee & Amirapu, 2019;Gunderson, Crepeau-Hobson & Drennen, 2012;Gupta & Sharma, 2006;Gutman & Yon, 2014;Herrgard, Rabed, Loe, Ragazzonig, Frederick & Burkle Jr., 2017;Ibrion, Parsizadeh, Naeini, Mokhtari & Nadim, 2015;Idris & Soh, 2014;Illiyas, Mani, Pradeepkumar & Mohan, 2013;Kim & Park, 2018;Kim, Deshmukh & Hastak, 2018;Le Dé & Gaillard, 2017;Lefevre, Walter-Garcia, Hanson & Smith-Easley, 2018;Maikhuri et. al., 2017;Marktanner, Mienie & Noiset, 2015;McEntire, 2012;Mignan, Scolobig, & Sauron, 2016;Morotoa, Sakamotoa & Ahmed, 2018;Nazempour, Monfared & Zio, 2018;Nomura et. ...
Pandemics are now the focus of research attention in the fields of preparedness and crisis management.Since pandemics are some of the largest crises to occur, an important question becomes “what were thefield of crisis management thinking about pandemic management”. This paper investigates how the fieldof crisis management have incorporated the body of knowledge arising from pandemics into its science(from 1984 to 2019). We performed a scoping review of 4 journals on crisis management and what theyhave written about pandemics (230 papers). The findings are summarized in 8 different categories. Themain result is that the field of crisis management have shown sparse interest in pandemics. We attributethis to factors such as fragmentation of academic sciences when the problem-solving needs integration,perceived incommensurability and the organization of attention. We argue that the COVID-19 pandemiccan provide a basis for posing new questions in research on, and the political debate around, societalvulnerability at large, and not only restricted to recent experiences of particular crises. Finally, we arguethat this will need a stronger integration of research strands and communities, which in turn require theability to ‘connect the dots’ between different sources of knowledge.
... According to the literature, those primarily impacted by a crisis are those who under normal circumstance are already vulnerable. In many instances, these individuals have previously been involved with social services, such as the elderly, or persons with disabilities, and those exposed to domestic violence (Alston et al., 2019,4;Gutman and Yon, 2014;Sanders et al., 2003;Thomas and Soliman, 2002). Pandemics are not an exception. ...
Comparative international studies show that about half of the deceased in the COVID-19 pandemic were persons living in institutional and residential eldercare. As seniors are the most affected age group, we aim to study if and to what extent the eldercare services were included in the National Pandemic Plans, and how they were included in the response during the first phase of the pandemic in Finland, Iceland, and Sweden. We use the CRISMART approach to crisis documentation and analysis in comparing national response to the pandemic for the eldercare sector. The method enables comparison of extraordinary crisis situations from the decision-making and policy-making perspective. We found that there were both similarities and differences in the preparedness of the three Nordic countries, as well as in how they responded to the pandemic. In all three countries the focus of the national responses framed the problem as a health and healthcare services’ problem. We also found value conflicts in the response between the value of protection versus social contact and self-determination and hence relating to the quality of eldercare. Keeping in mind the proportional increase of elderly people, care challenges, and future crises, we must strengthen the position of local social services within the emergency management systems to enhance disaster resilience and sustainability of our societies.
... In some instances, they lack the deductible amount to take advantage of their insurance payout. Immigrants and elderly residents are more prone to the risk of contractor fraud (Peacock, Morrow & Gladwin, 1997; Nash et al., 2007) as a result of language barriers and seeking secondary help to communicate with contractors, both issues raised in previous studies as well (Gutman & Yon, 2014). Most importantly, our findings emphasize the complexity of communicating disaster aid eligibility to immigrants who are unsure of seeking information from government agencies and non-profit organizations in fear of having to reveal immigration status and lack the basic knowledge to navigate the US bureaucratic system. ...
Tornados are among natural hazards that many towns in the Midwest region of the United States (US) experience frequently, sometimes with relatively overwhelming impacts and little attention and resources from media or government entities. Low-attention disasters that affect vulnerable populations create unique recovery challenges that are rarely addressed in the disaster literature. This paper presents a qualitative case study of impacts and recovery of housing in Marshalltown, Iowa, US after an EF3 Tornado in 2018 which affected a large portion of the town, in particular neighborhoods with high concentration of immigrant, low-income households in old and poorly maintained housing. Our analyses highlight the long-term challenges created by delayed and unsuccessful recovery of housing as a result of the intersection of pre-disaster social and physical vulnerability and inadequate housing recovery policy.
... Some evidence has linked disasters and public health crises (Gearhart et al., 2018;Schumacher et al., 2010), including the COVID-19 and shelter-in-place orders (Nix & Richards, 2021;Piquero et al., 2020Piquero et al., , 2021, with increased prevalence and severity of intimate partner violence. However, similar data on EAN and dementia family caregiving are lacking to guide the interpretation of current reports from service agencies and inform intervention efforts during this public health crisis (Gutman & Yon, 2014). Therefore, the purpose of this study is to examine the impact of the COVID-19 pandemic on EAN within family caregiving for dementia. ...
There is widespread concern that elder abuse and neglect (EAN) incidents increased during the onset of the COVID-19 pandemic due in part to increases in risk factors. Initial reports relying on administrative systems such as adult protective services records produced mixed results regarding whether or not there was a change in EAN incidents. Using data from an ongoing longitudinal study on EAN in dementia family caregiving that started before the pandemic, we assessed the hypothesis that the pandemic is related to a change in probability of EAN and EAN protective factors. Family caregivers to persons with dementia completed two waves of 21 daily diaries, 6-months apart, assessing their daily use of EAN behaviors. The first group (n = 32) completed their first wave before the pandemic and their second wave during the pandemic. The second group (n = 32) completed both waves during the pandemic. For this cohort, the generalized linear mixed logistic model results showed inconsistent associations between the onset of COVID-19 and the probability of a caregiver engaging in elder abuse or neglect behaviors. In terms of protective factors, the use of formal services was not significantly impacted by COVID-19; however, the likelihood of receiving informal support from family and friends increased significantly during the pandemic period. Dementia family caregivers were not likely impacted negatively by initial pandemic restrictions, such as shelter-in-place orders, as anticipated. These findings contribute to our understanding of how distal, disruptive processes may influence more proximal caregiver stresses and the likelihood of EAN.
Supplementary information:
The online version contains supplementary material available at 10.1007/s10896-022-00392-8.
... The ongoing pandemic as well as many previous studies show that disasters affect various population groups unequally (Adams-Prassi et al. 2020;Cherry and Cherry 1997;Drolet and Ersing 2014;Gutman and Yon 2014;Moreira and Pinto da Costa 2020;Bushra et al. 2020;Sanders, Bowie, and Dias Bowie 2003;Thomas and Soliman 2002). The elderly is the most affected population group in the Covid-19 pandemic (Dowd et al. 2020;Shahid et al. 2020). ...
Global warming increases the prevalence of extreme weather events such as heat waves, and the consequences are worst for vulnerable people. The impacts of 2014 and 2018 heat waves on institutional and residential care were studied, as the elderly people in these care services are most at risk. We conducted a survey to all privately produced intensive and residential elderly care services in 2014 and two regionally targeted surveys to both public and private intensive and residential elderly care service providers in 2018 and 2019. Descriptive statistics were used to analyse the data. Our findings show that there are major deficiencies in risk mitigation, preparedness and response to heat waves in Finland. No major improvement in mitigation is found between 2014 and 2018 even though the service units try to do their best in acute crisis to alleviate impacts of heat. Consequently, we recommend that services targeted to vulnerable population groups should be regarded as critical infrastructure and safeguarded like other critical societal functions. Strong public sector leadership and public-private cooperation in the regional and local level in mitigating risk, preparing to, responding, and recovering from extreme weather events are needed.
... They are often less equipped for emergencies and are more likely to be displaced from their home, separated from family, and require assistance to have their basic needs met when disaster strikes (Rufat et al., 2015;Vu & VanLandingham, 2012). During the recovery, socially vulnerable populations are at a disproportionate risk of experiencing abuse and neglect, mental health pathology such as depression and post-traumatic stress symptoms (PTSS), and of contracting diseases due to poor living conditions (Amaratunga & O'Sullivan, 2006;Boscarino et al., 2014;Gutman & Yon, 2014;Jia et al., 2010;Kouadio et al., 2012;La Greca et al., 2013;Parkinson & Zara, 2013). ...
Social service providers play a vital role in addressing the physical and mental health needs of vulnerable individuals, families, and communities during and after disasters. Considering the essential role of social service providers during and after disasters, it is vital to understand the challenges their clients encounter during emergencies. Our study explored social service providers’ perceptions of the barriers socially vulnerable individuals and communities experienced after hurricanes Michael and Irma struck coastal communities in Florida in 2017–2018. Seventeen social service workers who provided direct support to survivors during and after the hurricanes participated in four focus group interviews. Providers described five factors that increased vulnerability of their clients including risk perception, socioeconomic constraints, physical and mental health challenges, language and literacy proficiency, and resource dependency.
... A recent report by the Intergovernmental Panel on Climate Change (IPCC) has substantiated the harmful impacts of global warming on people around the world, including the melting of ice caps, rising sea levels, higher frequency of extreme weather events such as heatwaves, floods, droughts, and wildfires (IPCC 2018). Older adults are disproportionally at risk of suffering harm from these events due to a higher likelihood of pre-existing medical conditions (McCann and Ames 2011), vulnerability to abuse or neglect (Gutman and Yon 2014), lower mobility (Fernandez et al. 2002), and higher susceptibility to diseases (Wu et al. 2015), and consequently face risks of mortality during such natural disasters (see ▶ "Climate Change, Vulnerability, and Older People", ▶ "Older Adults in Situations of Conflicts and Crises"). Social and economic factors may further exacerbate the disadvantages of older adults and reduce their ability to respond to stresses stemming from climate-related events (See ▶ "Climate Change, Vulnerability and Older People"). ...
... In addition, according to the findings of the present study, "increasing dependency" was another concept related to the idea of "re-victimization". In their research, Guttman et al. (2014) noted the dependence of the elderly after accidents and disasters in economic affairs, in daily activities, including housework (sweeping, washing, cooking, etc.) matters related to personal hygiene (baths, toilets, changing clothes, etc.) and instrumental daily life activities (activities that are somewhat more complex than normal daily activities and require a higher level of autonomy and ability to negotiate with the environment, such as shopping, repairing damaged roofs, and managing money) [20]. ...
Background: The growth of the elderly population, on the one hand, and the increase in exposure to accidents and disasters, on the other hand, have highlighted the attention on the issues of the older adults in disasters. This study aimed to investigate the changes in the lives of the elderly after the earthquake.
Materials and Methods: The present qualitative study was conducted using the content analysis method. The study data were collected through in-depth and semi-structured interviews. In total, 26 participants were interviewed in this study, including 4 specialists (an accident and disaster specialist, an elderly specialist, a psychologist, a social worker), 18 older adults, and 4 caregivers of the older adults. The data collection and data analysis process were performed simultaneously, and the Granheim and Lundman approach was used in this regard.
Results: In this study, two main categories were found about changes in the lives of the elderly after the earthquake: re-victimization and post-accident growth. Re-victimization category consisted of the subcategories of “increased dependency”, “declining physical and mental health”, “poverty and deprivation”, and “avoidance of work and family activities”, and post-accident growth included the subcategories of “individual growth”, “self-regulatory behaviors”, and “reinforcing the houses”.
Conclusion: Clarifying the nature and life changes of the elderly after the earthquake can enhance the knowledge of service providers. This information helps them make the necessary plans to prevent and reduce the problems that the elderly face after the earthquake.
... In the international field of natural disaster management, various kinds of boundaries have been suggested and then studied. A few researchers have seriously analysed some of these research boundaries within their respective fields, each applying a unique model or theory of research boundary to his or her specialised topics (Alcantara-Ayala, 2002;Donovan and Oppenheimer, 2015;Gutman and Yon, 2014). ...
... In the international field of natural disaster management, various kinds of boundaries have been suggested and then studied. A few researchers have seriously analysed some of these research boundaries within their respective fields, each applying a unique model or theory of research boundary to his or her specialised topics (Alcantara-Ayala, 2002;Donovan and Oppenheimer, 2015;Gutman and Yon, 2014). ...
... Their preparation and response may be affected if they are unable to use or readily access practical technologies (such as computers, airconditioners, and mobile phones) (Hansen et al., 2011;Howard, Blakemore, & Bevis, 2017b). They may be more vulnerable to abuse, theft, and contractor fraud in the postdisaster period (Gutman & Yon, 2014). Children have increased risk of injury, disease, psychological effects, and death during disasters primarily due to their reliance on others for care, as well as developmental and physiological vulnerabilities (Johnson, Gaskins, & Seibert, 2013;Tang, Liu, Liu, Xue, & Zhang, 2014). ...
Natural disaster impacts on populations already experiencing significant health, income, and social disadvantage, are both more intense and longer lasting than for the general population. The intersection of social isolation and poverty for some groups often results in significant risks during the immediate crisis of a disaster and ongoing challenges for recovery. This article reports on qualitative research examining natural disaster preparedness with five “at-risk” populations in regional Australia. The research was undertaken as part of a project sponsored by a regional organisation of local councils in New South Wales to map and understand spatial and social factors shaping natural disaster risks and responses. Seventeen focus groups were held with 111 participants; older people, people with disabilities, families with children under five, low-income households, and people from culturally and linguistically diverse (CALD) backgrounds. Findings illuminated participant experiences of the intersection between sociogeographic disadvantage with social isolation in the context of natural disaster preparation and response.
IMPLICATIONS
• Social isolation—or the intersection of social and geographic disadvantage—appears to be a complex contributor to vulnerability in disaster preparation and response.
• Disaster risk needs to be assessed as part of social work support for vulnerable people.
... At the same time, as the population of older adult population is growing, the number of occurrences natural disasters is far faster than risk reduction strategies can be developed (Gutman & Yon, 2014). ...
Objectives:
In many areas, natural disasters are a major challenge for life and property of people. Earthquake is one of the most devastating natural disasters. This study aimed to explore how older adults responded to challenges after the earthquake in Iran.
Methods:
This study was based on qualitative analysis. Data were collected through in-depth and semi-structured interviews. 29 participants including 18 older adult survivors of the earthquake-stricken areas, four lay caregivers, and three health professionals in disasters, one social worker, two relief worker and one disaster psychologist were interviewed. The interviews were recorded and transcribed. The transcribed texts were analyzed using inductive qualitative content analysis recommended by Graneheim and Lundman (2004).
Results:
The study explored two main categories regarding older adults' responses to challenges after the earthquake: adaptive and maladaptive responses. Adaptive response has been developed by four factors including; religious coping, sharing feelings and information, coping with new activities, roles and place. Also, maladaptive response was included; the lack of motivation to search for relief supplies, undue dependency, and decrease of social activities.
Conclusion:
Service providers are recommended to identify the patterns of vulnerability and cultural sensitivities in older adults' responses to manage the negative consequences of disasters on older adults. Furthermore, older adults can make a substantial contribution in recovery programs based on the adaptive responses, such as helping in the rescue efforts and psychological support from family and community after disasters.
... Data for disasters such as Japan's tsunami in 2011 and hurricane Katrina in 2005, as well as the heat waves and other increasingly significant weather changes noted in Europe and North America, show that although seniors form a minority of overall populations, they are overrepresented in the death and injury tolls associated with these events. [5][6][7][8][9] It appears, moreover, that certain seniors are especially vulnerable to the impacts of disaster events, [10][11][12][13][14][15][16] in particular individuals affected by health problems, loss of physical or cognitive autonomy, and hearing and mobility impairments. 3,6,[17][18][19] Research has shown that seniors are more vulnerable than other age groups to the risk of injury and death during and in the aftermath of exposure to natural disasters. ...
The article aims to describe the medium-term impacts of a major earthquake event (Chile, February 27, 2010) on 26 seniors. The authors adopted a qualitative study approach. Data obtained using the Impact of Event Scale–Revised (IES-R) show the presence of manifestations of posttraumatic stress in the majority of respondents. In addition, data collected in interviews demonstrated a progressive deterioration of the health of respondents over a period of 4 years following the disaster. Seniors are particularly vulnerable to the effects of material loss, emotional stress, and postdisaster health complications. These impacts are exacerbated by low economic status. Furthermore, broader research is necessary involving elderly living in poverty who have survived natural disasters and others without such experiences, in order to better identify and differentiate between health complications associated with exposure to disaster events and those linked more strictly with natural aging processes.
... 20 Further, information gaps have been identified concerning issues such as seniors' reactions to evacuation and the risk for being abandoned by staff, 21 as well as their susceptibility to abuse in a crisis situation. 22 However, there is a growing amount of literature on how emergency intervention programs can be adjusted to meet the needs of vulnerable groups such as seniors. 23 The general lack of knowledge in the area of elderly care in relation to emergencies leaves considerable gaps to be filled in. ...
Objective
The aim was to investigate the interface between elderly care and emergency preparedness from the elderly care staff’s perspective.
Methods
A web-based questionnaire was sent to elderly care staff in 4 Swedish municipalities. The questions involved experiences of extraordinary events, education and exercises, and risk and vulnerability analyses, evaluations of main risks and emergency preparedness, and familiarity with preparedness plans. In total, 568 elderly care staff responded.
Results
Between 15% and 25% of the respondents claimed experiences of extraordinary events, exercises and education, and risk and vulnerability analyses. The same number claimed familiarity with the organization’s preparedness plan, whereas ~85% answered that they need more education and exercises. Emergency preparedness was evaluated as important. The experiences and risks referred to pertained to both official categories used within emergency preparedness and issues such as work conditions, seniors’ fall accidents.
Conclusion
Elderly care staff, though highly motivated, do not seem to be involved in emergency preparedness and are not targeted to a large extent when education and training are organized. A development of the interface between emergency preparedness and elderly care could require a clarification of the scope and context of emergency preparedness and of differing understandings of central concepts. ( Disaster Med Public Health Preparedness . 2017;page 1 of 8)
This chapter delves into the reciprocal connections between climate change and the mental well-being of older individuals. The initial section underscores the adverse effects of climate change on the mental health of older adults. Subsequently, I explore how preexisting mental health conditions in older individuals can influence efforts to adapt to and mitigate climate change. I also examine additional vulnerabilities that expose older people, particularly those with mental health conditions, to risks. These vulnerabilities operate at both individual levels, such as poverty or female gender, and societal levels, encompassing physical and social environments. The exploration extends to differences between low- and middle-income countries (LMICs) and high-income countries (HICs). This chapter investigates the application of the theory of social justice concerning climate change and older people with mental health conditions, addressing the temporal aspects of social justice. This chapter stresses the crucial role of policy and emphasizes the responsibility of social, financial, and political institutions in safeguarding older individuals, particularly those with mental health conditions, from the risks associated with climate change.
The aim of this study was to explore the post-earthquake experiences, difficulties, and coping strategies of older adults who experienced the Kahramanmaraş earthquakes that occurred in Türkiye in 2023. This research was designed as a qualitative descriptive study. The study was conducted with 21 (13 female and 8 male) older adults and the mean age of the participants was 70.2 (in the range of 65–85). In line with the data obtained from the participants, “ Fulfilling Basic Needs of Older Adults, Emotional Turmoil in Later Life, Healthcare Disparities in Aging, Adaptive Response of Older Adults” themes and sub-themes related to the theme were formed. Both physical and socio-emotional challenges, as well as coping strategies and support systems that older adults face in the aftermath of earthquakes, demonstrate unique characteristics for this demographic group. Therefore, it is recommended to plan programs by considering these differences while planning intervention programs before, during, and after the disaster.
This study examines how service providers in Victoria, Australia, undertook early intervention and response to elder abuse during the COVID-19 pandemic in 2020–2021. This study comprised two phases: (a) interviews with 29 staff members from 23 frontline service organizations about their experience responding to the needs of vulnerable older people during COVID-19; followed by (b) a co-design workshop with 15 service providers to discuss and endorse recommendations to improve sector preparedness for early intervention and responses to elder abuse during disasters. Participants reported that the severity and frequency of elder abuse increased during the pandemic, and that remoteness of services undermined comprehensive risk assessments, especially for older people who were not proficient in English and/or current digital platforms. Service providers endorsed a range of recommendations to improve sector preparedness for responses to elder abuse during disasters, primarily to upskill providers and improve the service system and direct support for individuals.
Las personas mayores son las principales víctimas de los efectos del cambio climático en América Latina y el Caribe. Una región que se verá seriamente afectada por los eventos climáticos adversos, agravados por la alta desigualdad y las limitadas capacidades de las políticas públicas enfocadas a una sociedad que envejece en vulnerabilidad. Precisamente, el hilo argumental de esta obra se desarrolla a través del abordaje de las relaciones entre el cambio climático y el envejecimiento de la población, así como sus implicaciones en políticas sociales y de salud en este vasto territorio. A lo largo de sus páginas se intenta dar respuesta a interrogantes cruciales, como: ¿qué amenazas climáticas aguardan a los países de la región y cuál es su capacidad de adaptación?; ¿qué repercusiones sociales y ambientales se asocian al proceso de envejecimiento demográfico regional?; ¿qué factores determinan la vulnerabilidad de los adultos mayores a los fenómenos climáticos adversos?; ¿de qué forma este colectivo vulnerable, sobre todo mujeres de edad, está siendo integrado en los programas de gestión del riesgo?; ¿qué papel están desempeñando las personas mayores en la protección de sus comunidades?; ¿cuál es el panorama actual de las estrategias nacionales sobre cambio climático y políticas sobre envejecimiento?; ¿cuáles son los vínculos entre la crisis climática y las políticas de protección económica, cuidados y salud para personas mayores?; y ¿qué componentes determinan la adaptación climática de las políticas de envejecimiento en la región? A través de su lectura, investigadores, académicos, estudiantes, profesionales, gestores, agentes sociales y público en general, encontrarán una insinuante invitación a la reflexión y algunas de las claves para desentrañar los nexos, no siempre perceptibles, entre los desafíos climáticos y demográficos, y proporcionar nuevas alternativas en tiempos de incertidumbre que podrían ser extrapolables a otras regiones del mundo.
Older people are the main victims of the effects of climate change in Latin America and the Caribbean. A region that will be seriously affected by adverse climatic events, aggravated by high inequality and the limited capacities of public policies focused on a society that is aging in vulnerability. Precisely, the story line of this work is developed through the approach of the relations between climate change and the aging of the population, as well as its implications in social and health policies in this vast territory. Throughout its pages, an attempt is made to answer crucial questions, such as: what climate threats await the countries of the region and what is their adaptation capacity?; What social and environmental repercussions are associated with the regional demographic aging process? What factors determine the vulnerability of the elderly to adverse climatic phenomena? How is this vulnerable group, especially older women, being integrated into risk management programs? What role are older people playing in protecting their communities?; what is the current panorama of national strategies on climate change and policies on aging?; What are the links between the climate crisis and the policies of economic protection, care and health for the elderly?; And what components determine the climate adaptation of aging policies in the region? Through its reading, researchers, academics, students, professionals, managers, social agents and the general public will find an insinuating invitation to reflection and some of the keys to unravel the links, not always perceptible, between climate and demographic challenges. , and provide new alternatives in times of uncertainty that could be extrapolated to other regions of the world.
Vulnerability assessment associated with natural hazards is a complex process that needs to account for multiple dimensions of vulnerability, including both physical and social factors. Physical vulnerability is a function of the intensity, magnitude, and frequency of the hazard, the degree of physical protection provided by the natural and built environment, and/or the resistance levels of the exposed elements. On the other hand, social factors such as preparedness and institutional and non-institutional abilities for handling natural hazards events are also important elements for a society’s vulnerability to natural hazards. Social vulnerability refers to the underlying factors leading to the inability of people, organizations, and societies to withstand impacts from the natural hazards. The concept of social vulnerability has been used widely to understand individuals’ and groups’ vulnerability in terms of preparing and recovering from natural disasters.Geohazards, such as earthquake, landslide, sinkhole, land subsidence, coastal erosion, etc., are not the only natural hazards with large uncertainties at the extreme end of the hazard spectrum and with potentially large impacts on humanity. Increasing global resilience and reducing the disasters induced by the occurrence of extreme hazards at an acceptable economic cost requires a solid-scientific understanding of the hazards: from understanding of the physics of different geohazards, their analysis and monitoring, through interpretation, modeling, hazard assessment, and forecasting of single or concatenated events, to delivery of the scientific forecasts to disaster management authorities. However, the detrimental impact of specific types of geohazards on vulnerable and marginalized groups has not been studied further.The proposed book chapter will review and investigate implications of social vulnerability to different geohazards. It can be hypothesized that social vulnerability is likely to vary with the type and mode of the geohazard, the rate of onset of the geohazard, the velocities, the area affected, and the geohazard’s temporal persistence in the environment. First, the book chapter will present how the concept of social vulnerability can be applied to expand our understanding on the specific geohazards’ socio-economic impact. Additionally, the book chapter will cover the literature that examined the differential impacts of geohazards on various groups within our society caused by the differences in socioeconomic status (SES). Last, the chapter will present specific domestic and international case studies to illustrate examples of geohazards and introduce the detrimental socio-economic impacts on the given community. Examples include, but not limited to, sinkholes in central Florida, land subsidence in South Korea, earthquakes in California, and more.KeywordsGeohazardsSocial vulnerabilityGlobal resilienceDisasters
In the past 20 years, climate-induced disasters have significantly increased in severity and frequency. Disasters can cause catastrophic damage, destroying homes and displacing individuals, families, and communities, often evoking psychological distress among survivors. Children and youth are among the most vulnerable during and after a disaster with risk and protective factors playing an important role in post-disaster adaptation. Risk factors that increase the likelihood of short- and long-term distress include higher level of disaster exposure, pre-existing mental health challenges, maladaptive coping, and family conflict. Conversely, protective factors such as social connection, healthy family relationships, self-efficacy, and positive coping reduce the likelihood of post-disaster distress. Evidence-based prevention and treatment interventions can also play an important role in helping children and youth recover after a disaster. Effective post-disaster interventions include activities that aim to increase emotional and behavioral regulation, adaptive coping skills, and peer and caregiver connections. It is well documented that interventions can aid in a young person’s recovery. However, limited funding and challenges with participant recruitment and retention are inherent in post-disaster service delivery and research.KeywordsRisk and protective factorsEvidence-based interventionsDisaster mental healthChildrenDisaster recoveryPost-disasterJourney of Hope
Child and spousal abuse rates tend to increase during various disasters. This study sought to determine the prevalence and determinants of older adults’ experiences of increased verbal or physical conflict (+VPC) as a proxy for elder abuse during the COVID-19 pandemic. Data stem from the Canadian Longitudinal Study on Aging (CLSA), a prospective cohort study of 51,338 Canadians aged 45–85 at baseline. We analyzed the data of participants aged 55 or older at core follow-up 1 who also participated in a CLSA COVID-19 substudy ( n = 24,306). Experiencing +VPC was the main outcome variable; explanatory variables included gender identity, sexual orientation, age group, race/ethnicity, educational attainment, marital status, household income, working status, living arrangement (alone vs. with others), social support availability, cohesion in the community, self-rated health, anxiety, depression, and previous history of elder abuse. The overall weighted prevalence of +VPC was 7.4%. Gay/bisexual men, 55–64 age group, living with others, low social support, poor social cohesion, low self-rated health, poor mental health, and history of psychological or physical abuse were each significantly associated with +VPC. Weighted multivariable logistic regression revealed that male gender, living with others, higher depression and anxiety scores, and a history of psychological abuse were independent predictors of +VPC. Implications for postpandemic recovery and prevention strategies during future disasters include targeted outreach programs for the most vulnerable group, which included males and younger older adults between 55 and 64 years as well as those with mental health issues and/or history of elder psychological abuse.
Climate change threatens the basic prerequisites for wellbeing, including clean air and water, food supply and the adequacy and security of shelter. Climate change is a powerful and ongoing presence in the lives of older persons, both creating and exacerbating vulnerabilities. The absence of a legally binding international instrument specifically protecting the human rights of older persons and minimal references to older persons in key international climate instruments attest to the lack of attention to and visibility of older persons in national and international law. There is a need to integrate the areas of older people and environmental sustainability to ensure that the rights of older people are preserved especially now, as the effects of the climate change crisis become more pronounced.
Elder abuse affects many older adults and can be life threatening. Older adults both in the community and long-term care facilities are at risk. An emergency department visit is an opportunity for an abuse victim to seek help. Emergency clinicians should be able to recognize the signs of abuse, including patterns of injury consistent with mistreatment. Screening tools can assist clinicians in the diagnosis of abuse. Physicians can help victims of mistreatment by reporting the abuse to the appropriate investigative agency and by developing a treatment plan with a multidisciplinary team to include a safe discharge plan and close follow-up.
Individual climate resilience is the ability of a person to anticipate, reduce, accommodate, and recover from climate-induced hazardous events (IPPC 2014). Older adults are known to be at higher risk for death and disability in extreme weather situations and to be disadvantaged in recovery assistance (Kwan and Walsh 2017;
Gutman and Yon 2014). A changing climate and an aging population mean that a greater number of older people may be at risk from the impacts caused by climate-induced weather events such
as heatwaves, ice storms, flooding, and tropical cyclones. Older persons require a range of individual resilience capacities if they are to
prepare for, avoid, and recover from climate related threats to health and wellbeing (Haq and Gutman 2014).
Introduction: Understanding the challenges of daily life in older adults after a disaster is a necessary precondition to manage the consequences of disasters in this vulnerable group. Aim: The purpose of this study was to explore the challenges of daily life of older adults after an earthquake in Iran. Materials and Methods: This qualitative study was conducted using a content analysis approach. A purposeful sampling method with maximum diversity was applied until reaching data saturation. In total, 18 older adults, four experts and four caregivers participated in the study. Data were collected using in-depth and semi-structured interviews. Data analysis was done with an inductive approach and with the help of the recommended principles. Results: By analysing 564 primary codes, three main categories; losses, ageism and disruption in usual routine life were extracted from the experiences of older adults. Each of these categories included several subcategories, which were categorized according to their significant characteristics. Conclusion: Clarifying the challenges in the daily lives of the older adults after disasters can help to create an age sensitive approach for recovery and thus, more effectively addressing their needs. Based on the findings of the research, it is recommended that further research is needed to investigate the life processes in older adults after disasters and to extract their experiences in different contexts. © 2018, Journal of Clinical and Diagnostic Research. All rights reserved.
The main objective of the paper is to introduce a methodology for a quantification of social costs of elder abuse and neglect (EAN). Economic aspects of EAN have not been studied in the Czech Republic yet, and also abroad this is a quite unexplored area. Qualitative research methods are employed – the systematic review (worldwide), focus groups, and expert interviews. A modification of the Social Return on Investment (SROI) method is suggested for EAN social costs estimation; the modification allows to calculate the resulted losses. For the SROI calculation, EAN is divided into three groups: financial abuse, domestic abuse, and neglect of care for elderly. In the first group of financial abuse, the social loss was estimated to be CZK 5.8-7.7 million for Prague in 2016. The second group of domestic abuse was assigned the loss of CZK 0.9-1.9 million for Prague in 2015. The resulting loss was not determined for the third group, neglect of care for elderly, because the available data are so limited that they do not allow the calculation. According to the experts´ opinion, these costs should be considered for a minimum estimation of real costs, since the issue is rather hidden and the real extent is unknown. For full text see: http://cefe.ekf.tuke.sk/CEFE2017.pdf
Feminist practice, activism, and scholarship have played critical roles in bringing the problems of domestic violence to light, shaping legislation to empower victims and championing improvement in advocacy and outreach. Yet many women and children not only continue to suffer from this form of personal violence, but suffer doubly when large-scale catastrophes strike—even as large numbers of volunteers turn out to respond, donors overwhelm local communities, and people open their hearts to those in need. This paper examines domestic violence and disaster in post-Hurricane Katrina New Orleans while concomitantly contributing to the literature that demonstrates ways in which feminist orientations can make vital differences in disaster contexts. We show that by listening to the voices of victims in postdisaster contexts, new insights can be gleaned as to how to make all women safer during disasters. Domestic-violence survivors often experienced heightened levels of violence during the hurricane and its aftermath; however, even in that difficult context, some women made the choice to leave abusive situations and advocates responded in new ways to help these women meet their unique needs.
In this meta-analytic review of 31 laboratory studies, we examined if relatively older adults showed lower or higher cardiovascular
reactivity compared with relatively younger adults. Results revealed that age was associated with lower heart rate reactivity
but higher systolic blood pressure (SBP) reactivity during emotionally evocative tasks. Consistent with the predictions of
dynamic integration theory, the result for SBP was moderated by the degree of task activation. These data are discussed in
light of existing self-regulatory models and important future research directions.
Hurricane Katrina struck the US Gulf Coast on August 29, 2005, causing unprecedented damage to numerous communities in Louisiana and Mississippi. Our objectives were to verify, document, and characterize Katrina-related mortality in Louisiana and help identify strategies to reduce mortality in future disasters.
We assessed Hurricane Katrina mortality data sources received in 2007, including Louisiana and out-of-state death certificates for deaths occurring from August 27 to October 31, 2005, and the Disaster Mortuary Operational Response Team's confirmed victims' database. We calculated age-, race-, and sex-specific mortality rates for Orleans, St Bernard, and Jefferson Parishes, where 95% of Katrina victims resided and conducted stratified analyses by parish of residence to compare differences between observed proportions of victim demographic characteristics and expected values based on 2000 US Census data, using Pearson chi square and Fisher exact tests.
We identified 971 Katrina-related deaths in Louisiana and 15 deaths among Katrina evacuees in other states. Drowning (40%), injury and trauma (25%), and heart conditions (11%) were the major causes of death among Louisiana victims. Forty-nine percent of victims were people 75 years old and older. Fifty-three percent of victims were men; 51% were black; and 42% were white. In Orleans Parish, the mortality rate among blacks was 1.7 to 4 times higher than that among whites for all people 18 years old and older. People 75 years old and older were significantly more likely to be storm victims (P < .0001).
Hurricane Katrina was the deadliest hurricane to strike the US Gulf Coast since 1928. Drowning was the major cause of death and people 75 years old and older were the most affected population cohort. Future disaster preparedness efforts must focus on evacuating and caring for vulnerable populations, including those in hospitals, long-term care facilities, and personal residences. Improving mortality reporting timeliness will enable response teams to provide appropriate interventions to these populations and to prepare and implement preventive measures before the next disaster.
The aim of this research was to investigate if there is a higher incidence of child abuse following major natural disasters.
Child abuse reports and substantiations were analyzed, by county, for 1 year before and after Hurricane Hugo, the Loma Prieta Earthquake. and Hurricane Andrew. Counties were included if damage was widespread, the county was part of a presidential disaster declaration, and if there was a stable data collection system in place.
Based on analyses of numbers, rates, and proportions, child abuse reports were disproportionately higher in the quarter and half year following two of the three disaster events (Hurricane Hugo and Loma Prieta Earthquake).
Most, but not all, of the evidence presented indicates that child abuse escalates after major disasters. Conceptual and methodological issues need to be resolved to more conclusively answer the question about whether or not child abuse increases in the wake of natural disasters. Replications of this research are needed based on more recent disaster events.
Feminist practice, activism, and scholarship have played critical roles in bringing the problems of domestic violence to light, shaping legislation to empower victims and championing improvement in advocacy and outreach. Yet many women and children not only continue to suffer from this form of personal violence, but suffer doubly when large-scale catastrophes strike—even as large numbers of volunteers turn out to respond, donors overwhelm local communities, and people open their hearts to those in need. This paper examines domestic violence and disaster in post-Hurricane Katrina New Orleans while concomitantly contributing to the literature that demonstrates ways in which feminist orientations can make vital differences in disaster contexts. We show that by listening to the voices of victims in postdisaster contexts, new insights can be gleaned as to how to make all women safer during disasters. Domestic-violence survivors often experienced heightened levels of violence during the hurricane and its aftermath; however, even in that difficult context, some women made the choice to leave abusive situations and advocates responded in new ways to help these women meet their unique needs.
This paper presents an exploratory study of woman battering in the Grand Forks, North Dakota flood of April 1997. Based on my qualitative research of women's experiences in this flood, I present two case studies of battered women to enhance understanding of what intimate partner violence means to women in the face of a natural disaster. The case studies illustrate how battered women make sense of their situations and how factors such as class and disability play a role in how women experience domestic violence. The case studies also show why services for battered women, such as emergency shelters and crisis counseling, are crucial during a disaster period. Even though we do not know if domestic violence rates increase in a. disaster, we do have evidence that the demand for domestic violence services increases during disaster times. In light of this, I argue that there is a need to prepare for that situation.
In this article written during and immediately after the trial of Salvador and Mabel Mongano, the owner-operators of the St. Rita's nursing home in St. Bernard's Parish, Louisiana, the author addresses the ethical elements in two types of analytical techniques - moral-hazard analysis and difficult-decision algorithm-as they have application to the human-services field.
The concept of resilience is central to understanding how technology might have a role to play in reducing the disproportionate vulnerability of older adults in natural and human-made disasters. Resilience has been defined in various ways by different theorists and researchers, but the common thread is the idea of adaptive capacity and the ability to recover from adversity (Norris, Stevens, Pfefferbaum, Wyche, & Pfefferbaum, 2008). Resilience is not simply a personality style or a characteristic of individuals but a product of the interplay among various determinants of population health: income and social status, social support, education, employment, social and physical environments, health practices and coping skills, developmental factors, biological and genetic endowment, health services, gender, and culture (Public Health Agency of Canada [PHAC], 2003). Disasters are large-scale disturbances or sources of adversity that tax the resilience not only of individuals but of whole communities and broader societies. All members of a population can be at risk depending on the nature of the crisis (InterInter-Agency Standing Committee [IASC], 2006). As would be expected given the multiple interacting determinants that come into play, the pathways from risk vulnerability to disaster resilience are complex (International Federation of Red Cross and Red Crescent Societies [IFRC], 2004). Similar to other population health challenges, the availability of appropriate resources, effectively implemented, is likely to contribute to more desirable outcomes for individuals and groups who are responding to and attempting to recover from disasters (Lindsay, 2003). Disaster resilience is increasingly in the public eye as the number of catastrophic natural and human-made events continues to rise. This chapter examines the potential for technology to promote disaster resilience among older adults. They are a population subgroup with increased vulnerability in emergencies not because of age per se, but because they are more likely to live with a constellation of risk factors for increased vulnerability, including health problems, dependence on healthcare and social services, lower socioeconomic status, and restricted social networks. In addition, with increasing age, higher proportions of older adults are women, a population subgroup with heightened vulnerability across the life course (Powell, 2009).
Natural disasters are a growing threat to human populations, particularly to vulnerable groups such as the elderly. A review of the literature on how the elderly respond in disasters indicates there are patterns of vulnerability in the social, psychological, and physiological dimensions. Research studies from sociology, psychology, and medicine, examining disaster loss and harm as it relates to age, form the basis for the differential vulnerability reviewed within this paper. Differential vulnerability between elderly and nonelderly disaster victims is summarized and discussed in the following areas: actual loss versus relative need, the perception of loss, service stigma and threats to independence, psychological vulnerability, and morbidity and mortality. Minimizing the disaster vulnerability of the elderly requires a solid understanding of the specific needs and traits of the elderly population, and identification of the risk factors that lead to their vulnerability. Effective disaster policies and programs will specifically target the elderly population, establish strong connections between the elderly and available resources, and evaluate the efforts to ensure that vulnerabilities are being modified.
Fraud is a complex and multifaceted crime and the financial losses related to its numerous forms are enormous. Despite the well-publicized accounts of property and person-related crime, the financial losses and the total number of fraud victims far exceeds “normal” crime in America. Natural disasters present fraudsters a rich environment for contractor fraud. Prevention efforts can warn citizens, especially the elderly, that natural disasters present unique opportunities for criminal acts. The research findings reported here represent the first step in a developing research agenda on the relationship between natural disasters and criminal victimization.
Objectives: To examine the perceptions of elder abuse among older Australian adults and general practitioners, a topic that has not been explored to the same extent as elsewhere.
Methods: Forty‐eight general practitioners, 40 independent older adults, 38 older adult caregivers and 36 older care‐receivers completed a modified version of Moon and Williams’ (1993) questionnaire, which describes 10 potential elder abuse scenarios.
Results: Split‐plot analysis of variance showed significant differences in the perceptions of severity of elder abuse scenarios across groups and gender. General practitioners tended to view the scenarios as less severe than the older‐aged groups. Within the older adult groups, caregivers generally perceived the scenarios as less abusive. Females generally perceived sexual abuse scenarios as more severe compared to males.
Conclusions: With such differences in views evident, the development of effective assessment strategies will require more targeted efforts to increase the awareness of elder abuse in the community.
The aging population of Canada and the associated caregiving demands highlight the need for elder abuse research. The objectives of this article are to provide a review of literature while identifying recommendations and directions for future research. Significant gaps in the knowledge base are identified that preclude the development of effective programming and policies. Future research directions include prevalence studies in community and institutional settings; studies on correlates, risk, and protective factors; research to clarify definitional issues and to develop psychometrically sound measurements; qualitative studies; and the need to support elder abuse research through capacity building and appropriate resource strategies.
RÉSUMÉ
Cet article examine les développements dans le domaine de la maltraitance et de la négligence des aînés depuis la publication de Elder Abuse and Neglect in Canada (Butterworths, 1991). Les arguments présentés ici sont de deux ordres : d’abord, nous n’avons aucune idée de la taille ou de la nature du problèmes de la violence et de la négligence dans la communauté ou dans les institutions et, d’autre part, nous ne savons pas comment résoudre ces problèmes ou leurs questions connexes qui ont été masqués par la rhétorique et le recyclage de l’information pendant les 20 dernières années. C’est le temps d’avancer au-delà de la « phase de sensibilisation ». Ce à quoi nous devons nous attaquer à l’avenir est aussi évident aujourd’hui qu’il ne l’était il y a 20 ans. Notre connaissance est incomplète parce qu’il nous manque le type d’enquêtes dont le besoin se fait le plus urgent: les études de prévalence dans la communauté et les institutions, un développement théoriquement solide, et des essais cliniques randomisé pour tester à la fois nos interventions socialement et juridiquement.
I examined evacuation plans from 2134 nursing homes and analyzed national data to determine the types of nursing homes cited for deficiencies in their evacuation plans.
Evacuation plans were assessed according to criteria developed by an expert panel funded by the Office of the Inspector General. Deficiency citations came from the Online Survey, Certification, and Recording database, collected from 1997 to 2005. Four specific citations, for written emergency plans, staff training, written evacuation plans, and fire drills, were examined with multivariate logistic regression.
Most plans had water supply provisions (96%). Only 31% specified an evacuation route. The rate of citations was relatively stable throughout the study period: each year approximately 0.6% of facilities were found to be deficient in written emergency plans, 2.1% in staff training, 1.2% in written evacuation plans, and 7.9% in fire drills.
Some nursing homes need more specific evacuation plans. Water supply was the most and evacuation routes were the least well-addressed areas.
After Hurricane Katrina hit the Gulf Coast on August 29, 2005, thousands of ill and injured evacuees were transported to Houston, TX. Houston's regional disaster plan was quickly implemented, leading to the activation of the Regional Hospital Preparedness Council's Catastrophic Medical Operations Center and the rapid construction of a 65-examination-room medical facility within the Reliant Center. A plan for triage of arriving evacuees was quickly developed and the Astrodome/Reliant Center Complex mega-shelter was created. Herein, we discuss major elements of the regional disaster response, including regional coordination, triage and emergency medical service transfers into the region's medical centers, medical care in population shelters, and community health challenges.
Pre- and post-event data on the long-term effects of the 1966 Topeka tornado revealed a complex pattern of responses by the elderly. In comparison to younger victims, older victims: regarded the loss of exterior items and house-related damage as being more important; received aid from community resources far less frequently; were less likely to use insurance and other economic sources in recovery; less frequently increased insurance coverage, savings, bank credit, or the use of credit cards; and did not perceive any significant long-term negative consequences regarding their physical or mental health.
Twelve months after Hurricane Hugo, 1,000 disaster victims and nonvictims were asked about social support they exchanged following the hurricane. Victims of disaster received and provided very high levels of tangible, informational, and emotional support. Disaster exposure (loss and harm) was a strong predictor of help received and a modest predictor of help provided. However, postdisaster help was not distributed equally and disaster exposure was more strongly related to social support in some groups than in others. Race, education, and age most consistently moderated the impact of disaster exposure on receipt of postdisaster support. Blacks and less educated victims received less help than similarly affected victims who were white or more educated. Relative disadvantage of being old in receiving support was not the case for those elderly disaster victims who experienced threats to their lives or health. Some subgroups of victims were relied upon disproportionately for providing assistance. Implications for social support research are addressed.
Prehospital emergency medical services (EMS) personnel, as initial responders to calls for assistance, are in an ideal position to identify abused or neglected elderly. A survey of prehospital personnel in Michigan was conducted to determine the scope of this problem, levels of awareness, and willingness to report cases of elder abuse.
The study population was a random sample of 500 prehospital personnel throughout one state. A blinded, self-administered survey was completed by emergency medical technicians (EMTs) and paramedics outlining their practice characteristics, prevalence of abuse in their community, and training available specific to elder abuse. Attitudes concerning the understanding and reporting of geriatric abuse were measured using a Likert-type scale.
A total of 156 surveys (31%) was completed; 68% of the respondents were paramedics. Respondents had an average of 8.7 years (range: 9 months-30 years) of prehospital emergency-care experience, and evaluated an average of 11 patients (range: 1-59) older than 65 years of age each week. Seventy-eight percent had seen a suspected case of elder abuse or negligence during their careers; 68% had seen a case during the past 12 months (mean: 2.3 cases/yr; range: 0-24 cases/yr). However, surveyed personnel reported only 27% of suspected cases to authorities last year (mean: 0.62 cases/yr). Reasons for not reporting included 1) unsure which authorities take reports; 2) unclear definitions; 3) unaware of mandatory reporting laws; and 4) lack of anonymity. Ninety-five percent of respondents stated that training related to elder abuse was not available through their EMS agency.
Paramedics and EMTs lack complete understanding of their role in the identification and reporting of elder abuse. This information should be emphasized during EMS training and reinforced through continuing education.
The current issue of Eurosurveillance updates and provides additional context to the report in early 2004 of an estimated 22 080 excess deaths in England and Wales, France, Italy and Portugal during and immediately after the heat waves of the summer of 2003 [1]. While estimates for England and Wales [2], France [3], and Portugal [4], are largely unchanged from those reported earlier, to these should be added 6595-8648 excess deaths in Spain [5], of which approximately 54% or 3574-4687 occurred in August, and 1400-2200 in the Netherlands [6], of which an estimated 500 occurred during the heat wave of 31 July-13 August. Data for Italy, provided here for the cities of Bologna, Milan, Rome, and Turin, are compatible with the earlier estimate that 3134 excess deaths occurred in the 21 Italian regional capitals during the period 1 June-15 August [1,7]; the Italian National Institute of Statistics however, reported an excess of 19 780 deaths country-wide during June-September 2003 as compared to 2002 [8]. Reports elsewhere indicate that approximately 1250 heat-related deaths occurred in Belgium during the summer of 2003 [9], that there were 975 excess deaths during June-August in Switzerland [10] and 1410 during the period August 1-24 in Baden-Württemberg, Germany [11]. At this point, it seems reasonable to speculate that with evidence of heat wave-associated deaths beyond England and Wales, France, Italy, and Portugal, the previously published estimate of 22 080 early August excess deaths should be revised upward by at least 50% for all of western Europe, and by 100% or more if heat events that occurred during June and July 2003 are also taken into account.
To assess and compare three types of assessment tools for identifying elder abuse: direct questions to elicit disclosure of abuse if it exists, identification of evident signs of abuse, and assessment of high risk for abuse.
Cross-sectional.
Rambam and Hadassah medical centers, Israel.
Seven hundred thirty persons aged 70 and older hospitalized in general hospitals in 2004/05 and their principal caregivers.
Expanded indicator of abuse (E-IOA) tool, questionnaires looking for evident signs of abuse, and direct experience of abusive behavior.
Although 5.9% of respondents disclosed experiencing abusive behaviors, 21.4% were identified with evident signs of abuse, and 32.6% were classified as being at high risk for abuse. More than 70% of those who disclosed abuse were identified with evident signs and were at high risk for abuse. Those who disclosed being abused suffered particularly from physical and sexual abuse. According to logistic regression, higher caregiver subjective burden was a predictor of disclosure (odds ratio (OR)=1.81, 95% confidence interval (CI)=1.19-2.74), evident signs of abuse (OR=1.86, 95% CI=1.45-2.35), and high risk of abuse (OR=1.55, 95% CI=1.27-1.88); heavier objective caregiver load was a predictor of evident signs of abuse (OR=1.14, 95% CI=1.05-1.24) and of high risk (OR=1.18, 95% CI=1.06-1.38) only; and respondent functional status was a predictor of evident signs of abuse (OR=1.88, 95% CI=1.70-2.37).
The use of the three assessment tools is needed for optimal identification of abuse, whereas assessment for high risk proved an efficient method in the absence of respondent disclosure or professional detection of signs of abuse. Hospitalization provides an excellent opportunity for identifying elderly persons at risk of abuse.
This Note examines the legality of physicians treating patients near the end of life with risky pain medication, specifically during an extreme emergency situation. The issues discussed include whether such treatment should be criminalized and, if criminalized, what standard should be used to determine culpability. This Note proposes that physicians should not be shielded from the criminal justice system, but that the standard of double effect intent should be expressly adopted in the adjudication of such cases.
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