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When the family's equilibrium is upset by stress, it may be pushed off balance temporarily, and the family shows signs of not being able to fulfill its usual functions
When the family's equilibrium is upset by stress, it may be pushed off balance temporarily, and the family shows signs of not being able to fulfill its usual functions. Time and informed interventions help in re-establishing the family and its developmental role.

OTHER SPECIAL RISK GROUPS IN DISASTERS

There are many feelings and reactions people share in common response to the direct and indirect effects of disasters. However, certain groups are more at risk for some reactions than others.

Common Needs And Reactions

1. Concern for basic survival

2. Grief over loss of loved ones or loss of prized possessions

    3. Separation anxiety centered on self and also expressed as fear for safety of significant others

    4. Regressive behaviors, e.g. reappearance of thumbsucking among children

    5. Relocation and isolation anxieties

    6. Need to express feelings about experiences during the disaster

    7. Need to feel one is a part of the community and its rehabilitation efforts

    8. Altruism and desire to help others

    Middle Age

    On the face of it, middle-aged persons seem to be an unlikely special group with specific problems. However, they are, and it is helpful to be alert to these, especially for the possibility of emotional problems arising in later, rather than immediate, post-disaster periods. Consider the family which loses its home and most possessions in a flood. Forced to rebuild, they must do so with far more cost and highly inflated financial expenses. Retirement with the mortgage paid off is now out of the question, and prospects of an old age with adequate pension and comfortable living may have vanished. It takes a while for these conditions and the realizations of a reappraised future to sink in. They may and do, however, have any number of effects such as psychosomatic problems, relationship difficulties, and occupational dissatisfactions.

    Feeling and Behavior Symptoms

    • Psychosomatic problems, ulcers, diabetes, heart trouble

    • Withdrawal, anger, suspicion, irritability, apathy

    • Loss of appetite, sleep problems, loss of interest in everyday activities

    Treatment Options

    • Arrange for medical care for physical symptoms

    • Persuade victims to talk with family physician, clergyman, friends, or to accept professional help

    • Help find medical and financial assistance

    • Keep channels of communication open with members of the family

    • Help family to recognize physical signs of depression and need for professional counseling

     

    Elderly

    The elderly represent their families' memories, their special link with culture and religion. They are members of the community who are able to define their own needs and ask for the services needed to meet them. Most elderly people show strength and courage in disasters. Their life experience has enabled them to acquire the ability to recover. Their physical, emotional, cognitive and behavioral reactions are similar to those of younger adults.

    The reactions of elderly people to disaster may include expressing their worries about the future and the loss of their physical health, their role in the family, social contacts, and financial security.

    With age, we observe greater vulnerability in persons who are alone (unmarried, widows and widowers, divorced) as well as extreme sensitivity to emotional losses and socioeconomic and cultural changes.

    Lacking sufficient validation and emotional links with other generations in the community, elderly people become vulnerable to the whole range of physical, psychological and social tensions.

    Older Adults

    Senior citizens of concern here are non-institutionalized persons whose life sphere has become circumscribed due to aging, primarily, rather than to specific multiple disabilities. These older persons typically do not have highly active schedules during the day. They spend their time mostly with others of similar age and circumstances in daily routines which have become comfortable. Others are confined to house or apartment, frequently alone. When these familiar routines are disrupted by the disaster, and particularly when residential loss and relocation occur, it would be expected that the senior citizen might exhibit some symptoms.

    Feeling and Behavior Symptoms

    • Depression, Withdrawal

    • Apathy

    • Agitation, anger

    • Irritability, suspicion

    • Disorientation

    • Confusion

    • Memory loss

    • Accelerated physical decline

    • Increase in number of somatic complaints

    Treatment Options

    • Provide strong and persistent verbal reassurance

    • Assist with recovery of physical possessions; make frequent home visist, arrange for companions

    • Give special attention to suitable residential relocation, e.g., familiar surroundings and acquaintances

    • Help in re-establishing familial and social contacts

    • Assist in obtaining medical and financial assistance

    • Help re-establish medication regime

    • Provide escort and transportation services

    An important issue is the despair accompanying loss of property and objects, which is a loss of ties with the past. Often, because loss of life has occurred among neighbors or friends, mourning the loss of sentimental objects and loss of property seems "inappropriate". However, these can and do constitute significant psychological loss.

    Socioeconomic Classes

    Socioeconomic circumstances are important influences on attitudes and reactions of people in stress situations. More importantly, these factors have a strong effect on the readiness with which individuals will seek or accept help voluntarily for emotional distress. For example, persons in lower economic circumstances are generally more inclined to seek medical rather than psychological treatment. This re-emphasizes the importance of "outreach" efforts in disaster relief work. Otherwise, these people will not be reached and may not get the help they need. By contrast, people in intermediate and upper income economic circumstances are more aware of and less likely to resist accepting all kinds of help when needed. These social groups would also be expected to be more likely to understand the possibilities of long-range benefits from early use of the services offered, i.e., heading off future problems by dealing with them now. Upper income people might be less inclined, however, to welcome outreach and "free" services as compared with lower and middle income groups.

    Cultural and Racial Differences

    Reports from disaster relief workers in recent years have emphasized the importance of social and cultural differences, especially of races, language, economic levels, class, and ethnicity. There are also reports of socially isolated groups who display what amounts to subcultural differences of attitudes and daily life patterns as a result of geographical isolation and dependence on a single occupational source, for example, small mining towns. For these groups it is essential that outreach efforts be channeled through representatives or facilities within the subculture area. Differences of language and custom, if ignored, will lead to frustration and failure by those attempting to render services.

    Feelings and Behavior Symptoms

    • Depression

    • Apathy

    • Feelings of helplessness and hopelessness

    • Resignation (to God’s will)

    • Suspicious of help offered by "outsiders"

    • Ignoring or rejecting available sources of "outside" help

    • Tendency to close ranks and accept assistance only from family and close friends

    Treatment Options

    • Channel all assistance through local religious and community sources

    • Place emphasis on informational and educational assistance

    • Outreach all services with the exception of those requiring special facilities such as hospitals and clinics

    Institutionalized Persons

    Individuals who are in institutions during a disaster are susceptible to frustration, anxiety, and panic as a consequence of their limited mobility and helpless dependence on their caretakers. The circumstances will vary widely depending on the type of institution. However, there are some common reactions which might be expected to occur in general medical hospitals, mental hospitals, adult and juvenile correctional agencies, and convalescent facilities.

    Feelings and Behavior Symptoms

    • Fear

    • Frustration

    • Anxiety

    • Helplessness

    • Anger

    • Panic

    • "Escape"

    Treatment Options

    • Assist in relocation to safe housing

    • Provide reassurance and information regarding disaster status

    • Assist in making contact with loved ones and friends

    • Encourage involvement in housekeeping and rehabilitation duties

    • Provide opportunities for group discussions of fears and anxiety

    People in Emotional Crises

    When a person is experiencing an emotional crisis, it is usually apparent even to the casual observer. In a disaster it might be expected that the direct and indirect effects of the catastrophe might produce severe emotional crises for some people. Precipitating causes could be death or separation from loved ones, sudden loss of contact with

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