Managing Disaster Stress-Related Responses in the Elderly
Although it is normal for those experiencing disasters to have a traumatic stress response, excessive reactions may also occur when a situation overloads the mental ability of the person to act appropriately. These excessive stress responses may cause a person to become very agitated or angry, to seek to find someone to blame, or even to strike out at others physically. Here are some guidelines to avoid such responses in elderly persons including elderly persons with dementia.
1. Preparation and Prevention
Potential causes of excessive responses are over-stimulation, inadequate attention, pain, fear, hunger, and misunderstanding or misinterpreting the events in the environment. Disruptions of routine tend to be exaggerated in times of disaster, and knowing this we can make necessary adjustment to minimize traumatic response.
2. Responding to Stress in Others
Understanding another person’s feelings is necessary before we can respond to them. Often by the time we have truly understood no additional response is necessary. Here are some helpful listening and understanding principles:
- Appreciating that the person under stress may be responding not just to these circumstances, but to the way that the present situation is reminding them of something in the past.
- Speaking in a calm, low-pitched voice.
- Avoiding the use of force or physical restraint whenever necessary. Reassurance and guidance and redirection are always less stress-inducing than force.
- Validating the other’s experience. Focus on the feelings, not only the content of what the person is saying. Sometimes the emotions being expressed are more important than what is being said. Look for the feelings behind the words.
There are also some environmental and behavioral ways to minimize disaster-related stress:
- Try to reduce excess stimulation. Turning down the volume on the television or the radio, or closing the curtains, can often promote calm even in disaster circumstances.
- Demonstrate and teach relaxed breathing strategies
- Listening to familiar music or recordings, or looking at familiar pictures, can often convey a sense of consistency and calm.
- Short exercise breaks, even something as simple as taking a walk around a shelter or doing some mild stretching, can also help prevent excessive reactions to stress.
- Regular verbal and written cueing (“We’re going to the shelter now,” “There has been a tornado, but now we are safe,” “The lights are off because there is no electricity, but we have candles”), without infantilizing or “talking down,” can often help.
- Even in the midst of a shelter or other difficult disaster environment, seeking to provide and maintain a consistent routine (teeth brushing, meal and sleep times) can help minimize stress.
- Use of familiar transitional or “comfort” objects, such as pillows or photographs or even items of clothing, can also minimize stress.
With appropriate prevention and some adjustments in our environment, we can maintain mental health in the face of disasters.