effective preparedness and response for older adults and ... 20_09 shea.pdf · effective...

8/29/2012

1

Effective Preparedness and Response for Older Adults and Persons with Disabilities

Annual Summer Series on Aging June 5, 2012

Moira M. Shea, MPA

Senior Program Analyst Division for At-Risk Individuals, Behavioral Health, and Community Resilience

Office of the Assistant Secretary for Preparedness and ResponseU.S. Department of Health and Human Services

• Introduction

• Office of the Assistant Secretary for Preparedness and

Agenda

Response

• Overview of At-Risk Individuals

• C-MIST Framework

• Resources

ASPR: Resilient People. Healthy Communities. A Nation Prepared. 1

8/29/2012

2

• ASPR was created under the Pandemic and All-Hazards Preparedness Act in the wake of Hurricane Katrina to lead the nation in preventing, preparing for, and responding to the adverse health effects of public health emergencies and di

Office of the Assistant Secretary for Preparedness and Response (ASPR)

disasters.

ASPR focuses on:

• Preparedness planning, response, and recovery

• Building federal emergency medical operational capabilities

• Supporting advanced research and development of medical countermeasures

• Grants to strengthen the capabilities of hospitals and health care systems in public health and medical emergencies and disasters

ASPR: Resilient People. Healthy Communities. A Nation Prepared.

public health and medical emergencies and disasters

• The office provides federal support, including medical professionals through ASPR’s National Disaster Medical System, to augment state and local capabilities during an emergency or disaster

2

• Key Responsibilities:

─Policy guidance

Division for At-Risk Individuals, Behavioral Health, and Community Resilience (ABC)

Policy guidance

─Providing expertise & technical assistance

─Interagency coordination

• Website: www.phe.gov/abc


8/29/2012

3

• In addition to those individuals specifically recognized as “at-risk” in the Pandemic and All-Hazards Preparedness Act (i.e., hild i iti d t ) i di id l h

At-Risk Individuals

children, senior citizens, and pregnant women), individuals who may need additional response assistance include those who have disabilities; live in institutionalized settings; are from diverse cultures; have limited English proficiency or are non-English speaking; are transportation disadvantaged; have chronic medical disorders; and have pharmacological dependency.


• During Katrina, 70% of the 1330 persons who died in the storm or its aftermath were over the age of 60, and Louisiana reported th t 350 000 th f 65 h d t b t d

Why are we having this discussion?

that 350,000 persons over the age of 65 had to be evacuated.

• The population over the age of 65 reached 40 million in 2010 and the number will grow nearly 15% by 2015, with only 5% or 1.7 million living in nursing homes.

• There are many older adults who live in community settings, with a substantial number of frail older adults who have chronic


health problems and disabilities living in their homes.

5

8/29/2012

4

• They are more likely to have impaired physical mobility, chronic health conditions, and social and economic limitations that interfere with their ability to prepare for a disaster and respond

Why are older adults more vulnerable?

interfere with their ability to prepare for a disaster and respond and adapt during such events.

• Older persons might have trouble understanding information and following directions.

• Those who use wheel chairs, canes, or walkers cannot use stairs.

• Older adults who no longer drive or do not own a car face diffi l i i d i


difficulties evacuating during an emergency.

6

• Communication

• Medical Care

C-MIST Framework

Medical Care

• Independence

• Supervision

• Transportation


8/29/2012

5

• Scalable, comprehensive, and adaptable to jurisdictional needs.

C-MIST Strengths

• Allows for more comprehensive planning around broad-based functional needs as opposed to labels or specific categories of at-risk individuals.

• Allows for specific planning and resource allocation based on a community’s functional needs.


y

8

Individuals who have limitations that interfere with the receipt of and response to information will need that

C-MIST: Communication

p pinformation provided in methods they can understand and use. They may not be able to hear verbal announcements, see directional signs, or understand how to get assistance due to hearing, vision, speech, cognitive, or intellectual limitations, and/or limited

li h fi i


English proficiency.

8/29/2012

6

• Develop a communication plan with family members and support network (caregivers, neighbors).

Communication

• Choose an out-of-town contact person, carry family contact information in your wallet, and keep emergency numbers near all of your phones.


Individuals who are not self-sufficient or who do not have adequate support from caregivers,

C-MIST: Medical Care

family, or friends may need assistance with: managing unstable, terminal, or contagious conditions that require observation and ongoing treatment; managing intravenous therapy, tube feeding, and vital signs; receiving dialysis, oxygen, and suction d i i i i d d


administration; managing wounds; and operating power-dependent equipment to sustain life. These individuals require the support of trained medical professionals.

8/29/2012

7

• Older adults many take four to eight or more prescription medications daily. Plan to have medications (with up to a seven-day supply) and medical items

Medical Care

day supply) and medical items.

• Copies of personal documents (e.g., medication list and pertinent medical information, insurance policies).

• Older adults who use ventilators should make sure to have a


back up generator or sign up with utility company for additional support.

12

Individuals requiring support to be independent in daily activities may lose this support during an emergency or a disaster

C-MIST: Independence

support during an emergency or a disaster. Such support may include consumable medical supplies (diapers, formula, bandages, ostomy supplies, etc.), durable medical equipment (wheelchairs, walkers, scooters, etc.), service animals, and/or attendants or caregivers. Supplying needed


g pp y gsupport to these individuals will enable them to maintain their pre-disaster level of independence.

8/29/2012

8

• Prepare a disaster supplies kit including:

─Canned goods, water, flash light, toilet paper,

Independence

Canned goods, water, flash light, toilet paper, plastic bags, and a battery operated radio.

• Keep durable medical equipment support items like wheelchairs, canes, walkers in an accessible location.

• Cash and coins (ATMs may not be available).

• http://www redcross org/preparedness/cdc english/kit


• http://www.redcross.org/preparedness/cdc_english/kit.asp

14

Before, during, and after an emergency, individuals may lose the support of caregivers, family, or friends or may

C-MIST: Supervision

be unable to cope in a new environment (particularly if they have dementia, Alzheimer’s disease, or psychiatric conditions such as schizophrenia or intense anxiety). If separated from their caregivers, young children may be unable to identify themselves; and when in danger, they

l k th iti bilit t th it ti d


may lack the cognitive ability to assess the situation and react appropriately.

8/29/2012

9

• Evacuation and relocation to general population shelters can be physically and emotionally difficult for older adults

Supervision

older adults.

• Find out what provisions are available in your neighborhood, especially for those individuals who require an uninterrupted source of power.


Individuals who cannot drive or who do not have a vehicle may require transportation support for successful

C-MIST: Transportation

transportation support for successful evacuation. This support may include accessible vehicles (e.g., lift-equipped or vehicles suitable for transporting individuals who use oxygen) or information about how and where to access mass transportation during an


access mass transportation during an evacuation.

8/29/2012

10

• Plan the best and quickest escape routes out of your home and evacuation routes out of your neighborhood.

Transportation

• Develop and plan for transportation during an evacuation. Identify resources with in your neighborhood or community for transportation during a public health emergency or disaster.


p g y

18

An individual with early stage Alzheimer’s disease, living independently with the help of part-time care, could easily

Personal Preparedness

p ydecompensate without access to in-home services. During a natural disaster this individual’s care giver may be unable to visit the home, leaving the individual to become fearful, agitated, and confused.

Her functional needs would be maintaining


Her functional needs would be maintaining independence and possibly supervision (if she decompensates).

8/29/2012

11

An elderly Japanese man who does not speak English experiences an earthquake and finds himself in a precarious situation as his

Personal Preparedness

himself in a precarious situation, as his caregiver has not arrived and he needs dialysis treatment.

His functional needs would be access to medical care, supervision, and communication(his lack of English may keep him from hearing about where and how to access


services).

Without addressing these functional needs, he cannot get healthcare services.

• Avoids potential privacy issues by addressing functional needs rather than medical diagnoses.

Overall Benefits of C-MIST

• Enhances emergency planners’ and responders’ knowledge of specific needs that may impact access to and delivery of services.


8/29/2012

12

Resources

Identifying Vulnerable Older Adults and Legal Options for Increasing Their Protection During All-Hazards Emergencies: http://www.cdc.gov/aging/emergency/


AoA Resources for Emergency Preparedness & Response

http://aoa.gov/AoARoot/Preparedness/index.aspx


8/29/2012

13

Public Health and Medical Emergency Support

http://www.phe.gov


http://www.ready.gov/

Prepare, Plan, and Stay Informed


8/29/2012

14

Moira M. Shea, MPASenior Program AnalystDi i i f At Ri k I di id l B h i l H lth d

Contact Information

Division for At-Risk Individuals, Behavioral Health, and Community ResilienceOffice of the Assistant Secretary for Preparedness and ResponseU.S. Department of Health and Human Services


Email: [email protected]

Phone: 202-245-0733

26

effective preparedness and response for older adults and ... 20_09 shea.pdf · effective...

Documents