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Terrorist activities, natural disasters, and technological catastrophes seem to be occurring with increasing frequency. Data reported by the World Health Organization reveals that on average, a disaster occurs every day somewhere in the world. Fortunately, there is also a growing awareness by agencies and organizations involved with disaster preparedness and response of the importance of appropriate mental health intervention for disaster affected populations. Because nursing home residents usually do not stay in public shelters and are evacuated to other facilities where they can receive needed skilled nursing care, residents typically do not interact with first responders and relief workers who provide Psychological First Aid. To address this gap in care, the Psychological First Aid Field Operations Guide for Nursing Homes was developed for nursing home staff to use with residents. The 2nd edition of the guide, like the 1st edition, reflects a multidisciplinary approach to care. The changes made to the 2nd edition of the Psychological First Aid Field Operations Guide for Nursing Homes broaden the scope of how, when, and where the intervention should be applied. Based on consultation with experts in disaster planning and response, nursing homes, mental health, and aging, three new sections have been added to the 2nd edition: palliative care and end-of-life issues; behavioral interventions for people with dementia; and use of Psychological First Aid to help older adults deal with significant life changes, events, or losses. Experiencing a disaster or traumatic event may be especially difficult for residents with compromised coping abilities due to cognitive impairment, end-of-life issues, and loss and change. Residents who are likely to have a more favorable outcome are those who receive timely support and appropriate resources. The recent threat of an H1N1 pandemic highlighted the need for information on palliative care and end-of-life issues. Moreover, large numbers of people may require comfort care and help with end-of-life care if exposed to radiation poisoning, biological agents, weapons of mass destruction, or pandemic illness. In the years since the publication of the 1st edition, there have been numerous requests for an additional section that describes behavioral interventions to use with residents who are cognitively impaired. It is estimated that 50% to 70% of nursing home residents have some type of cognitive impairment, including dementia. To meet the needs of staff who provide care to people with dementia, content that highlights considerations and interventions for people with mild, moderate, or severe cognitive impairment have been added to the 2nd edition. In addition to high profile disasters covered by the media, people of all ages experience a variety of personal traumas, losses, and changes that can result in significant emotional distress and sometimes escalate to a state of crisis. Death of a loved one or friend, accidents, suicide, violence, and illness are a few examples of the types of traumatic events that commonly occur over the lifespan. In recognition that personal emergencies happen with relative frequency, the core components presented in the 1st edition of the guide have been expanded and adapted to encompass these individual life events and to encourage staff to use Psychological First Aid to assist people who are in need of this support, regardless of the magnitude or nature of the cause.
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There is growing evidence that a constellation of factors related to life stage, including health, social processes, and environmental ecology, create circumstances that lead to disproportionate mortality risk for older adults in disasters. There is a related risk that the palliative care needs of seniors who are already at the end stage of life or who die in the aftermath of a disaster can become lost when there is a sudden surge of people requiring acute intervention or a shortage of resources. This chapter is directed to the pressing need to facilitate the integration of palliative care practices within emergency preparedness and disaster response for seniors.
we will breathe out through our mouths. When we breathe out, our stomachs are going to suck in and up like this
  • Then
Then, we will breathe out through our mouths. When we breathe out, our stomachs are going to suck in and up like this [demonstrate].