Disaster and older adults
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Public outreach talk April 2017
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Disaster and older adults
- 10. Japan, 2011
- 13. New York, 2001
- 14. New York, 2001
- 18. Alberta, 2016
- 19. Alberta, 2016
- 22. Public Health role after an emergency Preserve life Ensure safe water and food Ensure sewage disposal Control infectious disease Control environmental risks What’s missing?
- 42. PLAN
- 43. PREPARE
- 45. PILLS
- 46. PETS
- 47. PEOPLE
- 48. PEOPLE
- 49. …what scares me is the human reaction to [natural disasters] and how people behave when the rules of civility and society are obliterated. - Eli Roth
Editor's Notes
- Quantify it before we start addressing it
- Temps reached 43C with significant humidity, leading to a humidex of 64C Most elderly poor Couldn’t afford air conditioning or couldn’t afford to run it Didn’t open windows or sleep outside due to fear of crime Blacks more likely to die than whites Hispanics least likely – social cohesion Urban heat island – raised temps by more than 2C 35% more ED visits by >65yo during the week – majority for dehydration, heat stroke and heat exhaustion
- France: 14802 heat wave related deaths 8 consecutive days >40C Most people don’t have air con Public unaware of hydration etc. Many people on holidays – elderly relatives left alone Statistically improbable survival rates – frail elderly more likely to survive! (in care homes with others to make adjustments) Main issue was locating older adults
- Death toll unclear – estimated at 1836, most in Louisiana Most roads into and out of the city were destroyed Airport closed, remained closed for several weeks to commercial flights First 3 deaths – from nursing home – dehydration Many areas without fresh water or power for week+ Hundreds of prisoners unaccounted for after the event
- 215 bodies found in nursing homes and hospitals
- Magnitude 9.1 earthquake 4th most powerful ever, most powerful in Japan Tsunami waves reached 133ft 16,000 deaths 228,800 displaced Over 1000 aftershocks, still continuing 92.5% died from drowning 24% of RIPs aged 70+ 70% of those still missing over 60yo
- April 27 – 218 tornadoes, 317 deaths, 2000+ injured 4 EF5s – normally see 1 per year! Deaths across 6 states Most of Northern Alabama without power for 2+ weeks Did you know that being older than 65 is an independent risk factor for death and injury from tornadoes?
- 233 deaths in 8 countries Millions without power
- 2500 deaths
- Dust has caused over 18,000 cases of respiratory diseases
- Roads washed away in QC Rainfall >100mm Local flooding ON, QC
- 1 touched down in Ontario! EF0 – light damage winds to 116km/h – Fergus, Wellington, 20km north of Guelph – ON gets around 12 per year
- 2 killed in ON, 1 due to flying debris, 1 hydro worker significant damage in ON and QC 150,000 without power
- Prolonged displacement Smoke exacerbates respiratory conditions in older adults
- Accommodation, transport and food – could you make 1250 work?
- Katrina - 43% indicated that they were supposed to be taking a prescription medication; and 29% of those who were supposed to take prescription drugs said they had problems getting prescriptions filled Krousel-Wood et al. (2008) indicated that 7% of patients reported not bringing their blood pressure medications when they evacuated, 28% ran out of blood pressure medications
- Could you survive here?
- Uscher-Pines et al. (2009) demonstrated that displaced victims had 1.53 (95% CI: 1.10-2.13) greater odds of sustaining a hip fracture in the year after Hurricane Katrina and 1.24 (95% CI: 1.07-1.44) greater odds of sustaining other fractures after adjusting for other risk factors
- Will they be met with emergency provisions? Diets may not be possible in shelter Older adults have different ability to digest certain foods Disaster relief food often about calories versus nutritional value
- Ishiki et al. (2014, 2015) found an increased prevalence of dementia in elderly persons living in temporary apartments after the great east Japan earthquake in 2011 (36% versus 22.5% in general population). Iijima et al. (2011) also speak to the risks to older persons’ mental health and wellbeing associated with moving to temporary accommodation.
- Parker et al. (2015) demonstrated that older adults were 2.11 times more likely to experience PTSD symptoms and 1.73 more likely to develop adjustment disorder when exposed to natural disasters when compared with younger adults. Females and older persons are more susceptible to mental health issues after a disaster event. It is estimated that Hurricane Katrina resulted in a reported 60% increase in serious mental illness from baseline levels in older adults (Sakauye et al. 2009).
- three weeks after Hurricane Sandy, thirty to fifty percent of households were without basic utilities including electricity, heat, and telephone services.
- nursing and long-term care homes need more specific evacuation plans Evacuation routes were the least well-addressed areas in nursing home emergency plans SIP ideally Ensure adequate infrastructure
- Shelter in place if possible Know safe places in your home Know utility shut offs for your home – gas needs professional to turn back on! Detailed evacuation plan made with trusted family or friends Smoke alarms and CO alarms Never run a generator indoors Never run a BBQ indoors Have someone check in with you Be honest and open about your limitations If evacuation spot is nearby, may also be affected Transport may become an issue Familiarise yourself with your local emergency planning guidelines Plan evacuation from your neighbourhood Have adequate insurance coverage
- Minimum 72 hours of supplies in case you need to evacuate 2 weeks worth of food for your home Canned goods that you will actually eat, and have eaten before! Avoid pre-packaged emergency kit food due to issues with motility etc. Easily accessible Not stored where it is at risk ID tag with your name and contact info Label any equipment you need to bring Flashlight, spare batteries Multitool – with can opener! Personal hygiene items Hard copies of personal documents, plus photocopies Hard copy list of contact information Cash Maps Whistle Change of clothing Spare keys
- Be careful of prepackaged foods – significant sodium levels, require ++ water, can cause dehydration, may not deliver nutrition required
- Minimum 7 days of medication supplies – NOT 72 hours Prescription in hard copy in event pharmacy is affected/computer systems are affected Emergency supply with family/friends of most essential medications (e.g. ant-hypertensives)
- Have a plan to evacuate them They may be afraid or become aggressive Food and water supplies Medications if required Shelter accommodation may not be able to accommodate them – what will you do?
- Most are trying to help Get to know neighbours and community volunteer groups If you’re able – volunteer!
- Be aware after an event Documented cases of those trying to take advantage Refugees in Mediterranean – fake lifejackets