It stands to reason that a person with dementia is at greater risk than healthy adults in a natural disaster, as a result of their older age and cognitive impairment. Depending on the amount of impairment, their support needs may be modestly or dramatically higher both during and after the crisis.
In Geriatric Mental Health Disaster and Emergency Preparedness, edited by John A. Toner, Ph.D., the authors state, “Disasters and emergency situations are difficult for anyone. The sheer unpredictability of a disaster requires problem-solving skills, flexibility and an understanding that many things are out of one’s control. Because (dementia) affects all levels of cognition, including memory, judgement, orientation and abstract thinking, the ability of the person with dementia to understand and cope with a disaster situation is greatly challenged. Complicating matters further, older people with (dementia) are at greater risk for restriction, abuse, neglect and mistreatment, especially at times of crisis. (Fulmer & Garland, 1996).”
During and after a natural disaster or emergency, a person with dementia may:
- not understand what is going on around them,
- become overly agitated and emotional, or lash out verbally or physically
- may be at increased risk of wandering,
- display greater cognitive impairment than normal,
- be clingy or have increased anxiety,
- become tired more easily, and
- be more disoriented.
The authors suggest these helpful tips to help a person cope after a disaster:
- Provide additional reassurance using both words and physical touch, such as placing a hand on the shoulder or arm and saying you are there to help them through this.
- Look for signs of agitation, such as pacing or fidgeting. Be creative and find a physical outlet to help them spend ‘anxious energy.’
- Limit stimulation where possible and ensure they have ample opportunity to rest or sleep.
- Try to maintain as normal a routine and schedule.
- Be prepared to provide extra assistance in activities of daily living.
- If they are not in their normal residence, remind the person that he or she is in the right place.
- Don’t argue if the person is not oriented to reality. Instead, listen and respond to the emotions they expressing.
- Make sure they are getting enough to eat and drink. They may need reminders or cueing.
- Tell others involved that the person he or she is at increased of wandering or getting lost.
Caregivers are at heightened risk of not being as resilient during a disaster as well. Friends and family members should reach out and provide increased support to the primary caregiver during and after a disaster. This includes both practical caregiving assistance and emotional support.
To learn about disaster preparedness for dementia caregivers, read this article by the National Institute on Aging.