Koç University Faculty of Nursing
Member of 65+ Elderly Rights Association
“In our culture, the most common prayer of the elderly is not to become a frail and dependent person. Therefore, ensuring that they remain as independent and functional as possible will help them recover from the trauma faster.”
“They can be resistant to accepting help. Sometimes this may be because they see it as a donation/charity and consider it as helplessness, sometimes because they are afraid of getting in the way of others who need it more.”
“The elderly may find it difficult to accept that they are distressed and may have mental problems.”
The priority for those who experienced the earthquake is to meet their basic needs. For the elderly, basic needs start with physical comfort and continue with maintaining social ties that make them feel safe.
In elderly people with deficiencies and impairments in daily life activities, physical problems and diseases will occur more quickly than in young people. For example, dehydration, lack of sleep and inadequate nutrition can lead to increased physical fatigue, cognitive changes and cognitive fluctuations in the elderly, and these changes may go unnoticed. In addition, many elderly people take medication for chronic conditions. It is important to ensure that these are provided and monitored quickly in order to prevent further damage.
Elderly people also frequently use supportive tools (e.g. glasses, canes, walkers, hearing aids) in their daily lives due to visual, hearing and mobility limitations, and the lack of these after a disaster increases the negative effects of all the deficiencies in their daily lives. The biggest impact of limitations in sensory organs is on communication.
Those who will work with elderly people should be prepared to make this communication through different means (visual, auditory, written simplified texts and different resources, on-site service provision, etc.). Their messages about the procedures/activities and support should be clear and unambiguous. It is important that messages can be presented in a variety of ways and that the same people provide the service and support, in order to create a sense of trust and safety. Consistent messages from the same people are particularly important for older people with cognitive impairments.
Each older person’s support needs may be different
When making evaluations about 65+ people, the individual-specific characteristics and differences in needs brought about by the aging process should be taken into consideration.
In order to make this assessment in a healthy way, it would be correct to divide 65+ individuals into three groups according to their functionality.
– Those with limited capacity to assess the situation due to cognitive impairment.
– Those who lead a more passive, passive life.
– Active, productive, engaged in daily life.
- The 65+ age group with limited capacity to assess the situation due to cognitive impairment:
Although they may not be able to interpret exactly what is happening, older people in this group, who are cared for at home or in institutions, may experience symptoms such as agitation or apathy due to the disturbed physical environment and disruption of routines and the lack of regular support previously provided. They will need constant support and monitoring. It is important that family members or other relatives living together in tents and containers are also informed and supported.
- The 65+ age group who lead a more passive, relatively inactive life:
Individuals living at home with the support of family members or an assistant may have lost this support. They may feel helpless and desperate. They may feel survivor’s guilt. It is recommended to help them with activities of daily living, to keep them in social groups, and to support them with tasks they can do independently (any tasks they can contribute to, such as monitoring children, supervising the tent). It is important to ensure that these individuals feel that their existence is important/valuable. They should be supported to make their own decisions (in all matters), i.e. they should be encouraged to remain optimally functional.
- Active, productive, engaged 65+ age group:
This group can continue to contribute to life as they did before the disaster when they are provided with basic support in general daily life issues. Encouraging them to make their own decisions, keeping them active, making use of their past experiences will make them feel valued and safe.
The elderly may be reluctant and resistant to accept help
In our culture, the most common prayer of the elderly is not to become a frail and dependent person. They may see the help as being dependent on someone else and therefore may be resistant to accept it. Some elderly people may feel guilty that by receiving the help they are being given, they are getting in the way of others who need it more. For these reasons, they may not communicate their wishes and needs. Ensuring that they remain as independent and functional as possible will help them recover from the trauma faster.
Research shows that people over the age of 50 are severely lacking in their preparedness for natural disasters. Less than 25% of this age group have any kind of emergency plan. Access to transportation or a car in case of a natural disaster was also reported as one of the areas of difficulty. They may also lack information about their social rights after a disaster.
Another issue is the mental health. The elderly may not want to accept that they are distressed and may have mental illnesses. Since such disorders also may lead to stigmatization, this may trigger avoidance. It may prevent seeking treatment.
When engaging with the elderly in a disaster area
– Listen to their stories, experiences and problems without interrupting them
– Talk about how similar problems were solved in the past
– Provide guidance on available services and sources of support
– Do not use medical and professional language
– Make clear statements
– Talk to people who you notice are reluctant to get help, emphasize that independent life does not mean life without support
– Encourage them to stay in touch with their community (daytime gathering spaces, activities, etc., communication with those far away)
– Observe for traumatic stress and abnormal emotional symptoms.
– Provide information about psychological reactions following traumatic events.
Common reactions of the elderly after a disaster*
If you observe one or more of the following reactions in your elderly family members or relatives, do not forget to seek help from your local psycho-social support team.
Observed or self-reported emotional reactions:
– Anxiety, fear
– A state of deep sadness
– Anger
– Feelings of guilt even if there is nothing you can do about the disaster
– A sense of heroic power to intervene
– A state of not caring about anything or anyone, detachment
– numbness, inability to feel sadness or joy
Physical complaints
– Abdominal pain or diarrhea
– Headaches or body aches without a concrete cause
– Loss of appetite or increased appetite
– Unexplained bouts of sweating or chills
– Tremors and muscle twitches
– Easily startled, startled
Behavioral problems:
– Sleep disorders, difficulty falling asleep, staying asleep or excessive sleepiness
– Increase or decrease in energy and activity level, living in two extremes
– Feelings of grief and crying
– Use of alcohol, tobacco, drugs or tranquilizers to cope with sadness and forget
– Outbursts of anger
– Difficulty accepting offers of help and helping others
– Isolating oneself and wanting to spend most of the time alone
Cognitive changes
– Memory difficulties
– Difficulty focusing and thinking clearly
– Confusion
– Don’t be too anxious
– Decision-making difficulties
– Difficulty talking about what is happening and listening to others talk
—————————–
*This section is adapted from the brochure “Helping Older Adults After Disasters: A Guide to Providing Support” published by the Substance Abuse and Mental Health Services Administration in 2019.