Older People In Emergencies

Older people have often been overlooked in disasters and conflicts, and their concerns have rarely been addressed by emergency programs or planners. This analysis seeks to highlight factors that particularly affect older people in emergencies, especially health-related concerns, propose a strategy to raise awareness about older people in emergencies and recommend policies and practices to address these considerations. Until recently, older people's needs in disasters and conflicts were addressed only by broader adult health and humanitarian programs. This has changed as several recent emergencies highlighted this population's vulnerabilities. Of the 14 800 deaths in France during the 2003 heat wave, 70% were of people over 75 years. Of the estimated 1330 people who died in the wake of Hurricane Katrina, most were older persons. In Louisiana, 71% of those who died were older than 60 years; 47% of this group were over 77 years old. Worldwide, the UNHCR has estimated that older persons make up 8.5% of the overall refugee population, and in some cases comprise more than 30% of caseloads. In 2005, approximately 2.7 million people over the age of 60 were living as refugees or internally displaced persons. Globally, the proportion of older people is growing faster than any other age group. In 2000 one in ten, or about 600 million, people were 60 years or older. By 2025, this figure is expected to reach 1.2 billion people, and in 2050 around 1.9 billion. In developing countries, where 80% of older people live, the proportion of those over 60 years old in 2025 will increase from 7% to 12%. The increasing population of older people has drawn attention to the need to revise humanitarian policies to adequately serve this group s basic living and health requirements. From a health perspective, it is important to recognize the needs of older persons and to develop appropriate policies to promote emergency health care. Yet it is equally critical to assess and prepare for demographic and health trends that determine the shape of future emergencies. By 2050, the prevalence of disability in some developing countries is projected to rise by 400% as the population ages. At the same time, it is important to observe that the older population as a whole is neither helpless nor dependent. Most older people are capable of coping and adapting, despite increasing poor health and frailty as they age. Older people contribute immeasurably to their families and communities in various roles, and commonly sacrifice their well being to help their children and grandchildren. In Africa, the HIV/AIDS epidemic has seen older persons assume responsibility for raising many thousands of orphaned grandchildren and other children in need. Finally, older people contribute to their communities their decades of accumulated experience, knowledge and understanding. This insight makes them an essential resource and potential partner in developing emergency preparedness and response programmes.

Disaster Public Health and Older People introduces professionals, students and fieldworkers to the science and art of promoting health and well-being among older people in the context of humanitarian emergencies, with a particular focus on low- and middle-income country settings. Older people face specific vulnerabilities in physical, mental and social well-being during disasters. They are likely to experience socio-economic marginalisation, isolation, inaccessible information and a lack of relevant post-emergency support services. Meanwhile, although older people can also significantly contribute to disaster preparedness, response and recovery, their capacities are often under-utilised. Drawing on a range of global case studies, this book provides readers with a theoretical underpinning, while suggesting actions at the individual, community and national levels to reduce the health risks to older people posed by the increasing frequency and intensity of disaster, in particular those resulting from natural hazards. Topics covered range from the health impact of disasters on older people and response to their post-disaster health needs, to disaster preparedness, disease prevention, healthy ageing, global policy developments and the contributions of older people in disaster contexts. This book draws on lessons learnt from previous disasters and targets students and professionals working in disaster medicine, disaster public health, humanitarian studies, gerontology and geriatrics.

This issue of Emergency Medicine Clinics, guest edited by Drs. Robert Anderson, Phil Magidson and Danya Khoujah, focuses on Emergencies in the Older Adult. This is one of four issues each year selected by the series consulting editor, Dr. Amal Mattu. Articles in this issue include, but are not limited to: Trends in Geriatric Emergency Medicine, Pharmacologic Considerations in Older Adults, Geriatric Trauma, Resuscitation of Older Adults, Acute Brain Failure, Chronic Brain Failure, Cardiopulmonary Emergencies, ACS in Older Adults, Abdominal Emergencies, Genitourinary Emergencies, Infections in Older Adults and Elder Abuse.

Over the past two decades there has been a marked change in global age demographics, with the number of over-60s increasing by 82% and the number of centenarians by 715%. This new-found longevity is testament to the success of recent advances in medicine, but poses significant challenges to multiple areas of health care concerning older patients. Building upon its predecessor's reputation as the definitive resource on the subject, this new edition of the Oxford Textbook of Geriatric Medicine offers a comprehensive and multinational examination of the field. Fully revised to reflect the current state of geriatric medicine, it examines the medical and scientific basis of clinical issues, as well as the ethical, legal, and socio-economic concerns for healthcare policy and systems. Over 170 chapters are broken up into 16 key sections, covering topics ranging from policy and key concepts through to infection, cancer, palliative medicine, and healthy ageing. New material includes focus on the evolving concepts of malnutrition, sarcopenia, frailty, and related geriatric syndromes and integration of geriatric principles from public health, primary and specialized care, and transitional stages from home to emergency, medicine and surgery, rehabilitation, and long term care. The Oxford Textbook of Geriatric Medicine brings together specialists from across the globe to provide every physician involved in the care of older patients with a comprehensive resource on all the clinical problems they are likely to encounter, as well as on related psychological, philosophical, and social issues.

Geriatric Emergencies is a practical guide to the common conditions affecting older patients who present in an emergency to hospital or primary care. Beginning with the essentials of history taking and clinical examination, the book covers a comprehensive range of emergencies, emphasizing the different management approaches which may be required in older patients. Common geriatric presentations such as falls, delirium and stroke, are explored in detail in addition to more diverse topics such as abdominal pain, major trauma and head injury. Ethical considerations such as advanced care planning, palliative care and capacity assessment are discussed with practical tips on communicating with patients and their relatives. Geriatric Emergencies provides concise up-to-date guidance to the emergency management of the older patient. It is a recommended resource for all health professionals working in the acute environment, in which a large proportion of patients are aged over 65.

The development of this report is a concrete WHO response to the 2002 United Nations Madrid International Plan of Action on Ageing (MIPAA) which recommended greater recognition and enhancement of the positive contributions made by older persons during emergency situations. In collaboration with the Public Health Agency of Canada and Help the Aged (UK), the World Health Organization commissioned case studies in 2006-2007 to examine how older persons fared in conflict-related and naturally caused emergencies in both developed and developing countries - war, drought, heat wave, floods, hurricanes, earthquakes, tsunami, ice storm, wild fires and a nuclear power plant explosion. The report contributes a wealth of real-life experiences to inform policy and practice makers about the needs and contributions that older people face during emergency and reconstruction phases.