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Frail Elderly as Disaster Victims: Emergency Management Strategies

  • Lauren S. Fernandez (a1) (a2), Deana Byard (a1), Chien-Chih Lin (a1), Samuel Benson (a3) and Joseph A. Barbera (a4)...

To identify the vulnerabilities of elderly to disasters, and to develop strategies to address these vulnerabilities.


A relevant literature search of journal articles, government training materials, news reports, and materials from senior organizations was conducted.


The vulnerability of the elderly to disasters is related to their impaired physical mobility, diminished sensory awareness, chronic health conditions, and social and economic limitations that prevent adequate preparation for disasters, and hinder their adaptability during disasters. Frail elderly, those with serious physical, cognitive, economic, and psycho-social problems, are at especially high risk.


This segment of the population is growing rapidly. Therefore, it is important that emergency management recognize the frail elderly as a special needs population, and develop targeted strategies that meet their needs. Several management strategies are presented and recommendations for further action are proposed.

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1. Hobbs, F, Damon, B: 65+ in the United States. Washington, D.C.: U.S. Government Printing Office; April 1996. Identification No.: P23–190. Sponsored by the United States National Institute on Aging's Office of Demography of Aging.
2. Duncker, A, Greenberg, S: Profile of Older Americans: 2000. Sponsored by the Administration on Aging. U.S. Department of Health and Human Services. [accessed 10 October 2001]. Available from:
3. Taber's Cyclopedic Medical Dictionary. 18th ed, Philadelphia: F.A. Davis Company. Frail Elderly; 1993, p756.
4. Contandripoulos, A-P, Kergoat, M-J, Latour, J, Lebel, P, Leduc, N, Roberge, D, et al. Assessment of the Care and Treatment of the Frail Elderly in Geriatric Assessment Units. Health Canada Online. Project #: 6605–4559–602. [accessed: 10 October 2001] Available from:
5. Balducci, L, Extermann, M: Cancer in the elderly. Clinical Geriatrics [serial online] 1998; 6(12). [accessed 10 October 2001] Available from:
6. Administration on Aging. U.S. Department of Health and Human Services: Older Adults and Mental Health: Issues and Opportunities. Jan 2001. [accessed 10 October 2001].
7. Administration on Aging: Number and Percent of Persons Reporting Problems with Two or More Activities of Daily Living (ADLs), By Age, Race, Gender, Poverty, Living Arrangements, Region, and Area of Residence. 1994–1995. Compiled by Westat, Inc. under contract to the U.S. Administration on Aging based on the 1994–1995 National Health Interview Survey on Disability (Phase I), NCHS, CDC, U.S. DHHS. Available from:
8. McNeil, J: Current Population Reports — Americans with Disabilities: 19941995. Census Bureau. Aug 1997 [accessed 10 October 2001] Publication number P70–61:2. Available from:
9. Oriol, W: Psychosocial Issues for Older Adults in Disasters. DHHS Publication No. ESDRB SMA 99–3323. [accessed 10 October 2001] Available from:
10. Imperiale, P: Special needs in emergency planning and preparedness. Networks 1991; 6(2):810.
11. Bolin, R, Klenow, DJ: Response of the elderly to disaster: An age-stratified analysis. Intl J Aging and Human Development 19821983;16(4):283297.
12. Krause, N: Exploring the impact of a natural disaster on the health and psychological well-being of older adults. Journal of Human Stress 1987;13(2):6169.
13. Federal Emergency Management Agency: Disaster-Related Needs of Seniors and Persons with Disabilities. Emergency Management Institute, 1997.
14. Axelrod, C, Killam, P, Gaston, M, Stinson, N: Primary health care and the midwest flood disaster. United States Department of Health and Human Services Public Health Report 1994; 109: 601605.
15. Geehr, EC, Salluzzo, R, Bosco, S, Braaten, J, Wahl, T, Wallenkampf, V: Emergency health impact of a severe storm. American Journal of Emergency Medicine 1989; 7(6): 598604.
16. Morrow, BH: Identifying and mapping community vulnerability. Disasters 1999;23(1):118.
17. National Institute on Aging: Fact Sheet: Hyperthermia — A Hot Weather Hazard for Older People. [accessed 10 October 2001]. Available from: URL:
18. National Institute on Aging: Fact Sheet: Accidental Hypothermia - The Cold Can Be Trouble for Older People. [accessed 10 October 2001]. Available from:
19. Administration on Aging: Disaster Services and the Elderly. Sept 16 1999 [accessed 10 October 2001]. Available from:
20. Reed, M: Disaster preparedness pays off. Journal of Nursing Administration 1998; 28(6):2531.
21. Silverman, M, Weston, M, Llorente, M, Beber, C, Tam, R: Lessons learned from Hurricane Andrew: Recommendations for care of the elderly in longterm care facilities. Southern Medical Journal 1995;88(6):603608.
22. HelpAge International: Older People in Disasters and Humanitarian Crisis: Guidelines for Best Practice. London: HelpAge International Secretariat Communications Team. 2000.
23. Kilijanek, TS, Drabek, TE: Assessing long-term impacts of a natural disaster: A focus on the elderly. The Gerontologist 1979;19(6):555566.
24. Terry, D: U.S. Agents in Chicago track a subtle health hazard: Heat. The New York Times; 04 October 1995; Sect. A:9 (col 1).
25. Gladwin, H, Peacock, WG: Warning and evacuation: A night for hard houses. In: Peacock, WG, Morrow, BH, Gladwin, H (eds.) Hurricane Andrew: Ethnicity, Gender, and the Sociology of Disasters. London: Routledge, 1997.
26. Perry, RW: Aged citizens in the warning phase of disasters: Re-examining the evidence. Intl J Aging and Human Development 1997;44(4):257267.
27. Bolin, R, Klenow, DJ: Older people in disaster: A comparison of black and white victims. Intl. J Aging and Human Development 1988;26(1):2943.
28. Kaniasty, K, Norris, FH: In search of altruistic community: Patterns of social support mobilization following Hurricane Hugo. American Journal of Community Psychology 1995;23(4):447477.
29. Poulshock, SW, Cohen, ES: The elderly in the aftermath of a disaster. The Gerontologist 1975;15(4):357361.
30. Benson, S, Personal interview. 20 July 2002.
31. Administration on Aging: Emergency Prepared Manual for the Aging Network. March 1995 [accessed 10 October 2001] Available from:
32. Administration on Aging: Actions by the Administration on Aging to Strengthen the Disaster Response Capacity to Serve Older People. July 1995 [accessed 10 October 2001]. Available from:
33. Dalaker, J: Poverty in the United States: 2000. Washington, DC: U.S. Government Printing Office. U.S. Census Bureau, Current Population Reports; September 2001 Series P60–214.
34. Hing, E, Bloom, B: Long-Term Care for the Functionally Dependent Elderly, Vital and Health Statistics. National Center for Health Statistics 1990;13(104), DHHS Pub. No. (PHS)90–1765.
35. Department of Health, Education, and Welfare: Planning for the Elderly in Natural Disaster. 1976. Sponsored by the Administration on Aging under grant no. 90A444/01, Washington DC.
36. Lunsford, D: The Triad alliance: Preparing vulnerable populations. Public Management. 82(10):1719.
37. Meals on Wheels of Central Maryland: E-Meals for Disaster Relief. [accessed 10 October 2001] Available from:
38. Norris, FH, Murrell, SA: Prior experience as a moderator of disaster impact on anxiety symptoms in older adults. American Journal of Community Psychology 1988, 16(5):665683.
39. Administration on Aging: Older Population by Age. Chart developed by the U.S. Administration on Aging based on Census Bureau data. [accessed 10 October 2001] Available from:
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Prehospital and Disaster Medicine
  • ISSN: 1049-023X
  • EISSN: 1945-1938
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