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Geriatric Disaster Preparedness
- Mary Colleen Bhalla, Amos Burgess, Jennifer Frey, William Hardy
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- Journal:
- Prehospital and Disaster Medicine / Volume 30 / Issue 5 / October 2015
- Published online by Cambridge University Press:
- 15 September 2015, pp. 443-446
- Print publication:
- October 2015
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- Article
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Introduction
The elderly population has proven to be vulnerable in times of a disaster. Many have chronic medical problems for which they depend on medications or medical equipment. Some older adults are dependent on caregivers for managing their activities of daily living (ADLs), such as dressing, and their instrumental activities of daily living (IADLs), such as transportation.
ProblemA coordinated effort for disaster preparation in the elderly population is paramount. This study assessed the potential needs and plans of older adults in the face of a local disaster.
MethodsThe setting was a community-based, university-affiliated, urban emergency department (ED) that sees more than 77,000 adult patients per year. A survey on disaster plans and resources needed if evacuated was distributed to 100 community-residing ED patients and visitors aged 65 years and older from January through July 2013. Means and proportions are reported with 95% confidence intervals (CIs).
ResultsData were collected from 13 visitors and 87 patients. The mean age was 76 years, and 54% were female. Thirty-one responded that they had a disaster plan in place (31/100; CI, 22.4-41.4%). Of those 31, 94% (29/31; CI, 78.6-99.2%) had food and water as part of their plan, 62% (19/29; CI, 42.2-78.2%) had a supply of medication, and 35% (12/31; CI, 21.8-57.8%) had an evacuation plan. When asked what supplies the 100 subjects might need if evacuated, 33% (CI, 23.9-43.1%) needed a walker, 15% (CI, 8.6-23.5%) needed a wheelchair, 78% (CI, 68.6-85.7%) needed glasses, 17% (CI, 10.2-25.8%) needed a hearing aid, 16% (CI, 9.4-24.7%) needed a glucometer, 93% (CI, 86.1-97.1%) needed medication, 14% (CI, 7.8-22.4%) needed oxygen, 23% (CI, 15.2-32.5%) needed adult diapers, and 21% (CI, 13.2-30.3%) had medical equipment that required electricity. Many of the subjects also required help with one or more of their ADLS, the most common being dressing (17%; CI, 10.3-26.1%), or their IADLS, the most common being transportation (39%; CI, 29.7-49.7%). Only 42% (CI, 32.3-52.7%) were interested in learning more about disaster preparation.
ConclusionOnly a minority of the older adults in the study population had a disaster plan in place. Most of the respondents would require medications, and many would require medical supplies if evacuated.
,Bhalla MC ,Burgess A ,Frey J .Hardy W Geriatric Disaster Preparedness . Prehosp Disaster Med.2015 ;30 (5 ):443 –446.
Update on Mortality in the Democratic Republic of Congo: Results From a Third Nationwide Survey
- Benjamin Coghlan, Pascal Ngoy, Flavien Mulumba, Colleen Hardy, Valerie Nkamgang Bemo, Tony Stewart, Jennifer Lewis, Richard J. Brennan
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- Journal:
- Disaster Medicine and Public Health Preparedness / Volume 3 / Issue 2 / June 2009
- Published online by Cambridge University Press:
- 08 April 2013, pp. 88-96
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Background: The humanitarian crisis in the Democratic Republic of Congo (DRC) has been among the world’s deadliest in recent decades. We conducted our third nationwide survey to examine trends in mortality rates during a period of changing political, security, and humanitarian conditions.
Methods: We used a 3-stage, household-based cluster sampling technique to compare east and west DRC. Sixteen east health zones and 15 west zones were selected with a probability proportional to population size. Four east zones were purposely selected to allow historical comparisons. The 20 smallest population units were sampled in each zone, 20 households in each unit. The number and distribution of households determined whether they were selected using systematic random or random walk sampling. Respondents were asked about deaths of household members during the recall period: January 2006–April 2007.
Findings: In all, 14,000 households were visited. The national crude mortality rate of 2.2 deaths per 1000 population per month (95% confidence interval [CI] 2.1–2.3) is almost 70% higher than that documented for DRC in the 1984 census (1.3) and is unchanged since 2004. A small but significant decrease in mortality since 2004 in the insecure east (rate ratio: 0.96, P = .026) was offset by increases in the western provinces and a transition area in the center of the country. Nonetheless, the crude mortality rate in the insecure east (2.6) remains significantly higher than in the other regions (2.0 and 2.1, respectively). Deaths from violence have declined since 2004 (rate ratio 0.7, P = .02).
Conclusions: More than 4 years after the official end of war, the crude mortality rate remains elevated across DRC. Slight but significant improvements in mortality in the insecure east coincided temporally with recent progress on security, humanitarian, and political fronts. (Disaster Med Public Health Preparedness. 2009;3:88–96)