Elderly long-term care residents suffer cognitively during disasters

In a summer with unprecedented weather events, from tornados, floods, fires and hurricanes, researchers at the University of Pennsylvania School of Nursing found that physiological changes associated with aging and the presence of chronic illness make older adults more susceptible to illness or injury, even death, during a disaster.

Investigators followed 17 long-term care residents, with a mean age of 86, who were evacuated for five days due to a severe summer storm and were relocated to different facilities with different care providers and physical surroundings. The displaced participants experienced delirium, , hospitalizations, and death, according to research published in the Journal of Gerontological Nursing.

" often have visual and hearing deficits, making it more difficult to interpret their environments and precipitating increased stress," said lead author Pamela Cacchione, PhD, APRN, GNP, BC. "This stress can also exacerbate , further precipitating delirium."

The 17 participants were part of a broader testing the effectiveness of a nursing intervention to improve vision and and decrease incident delirium and other outcomes.

As part of the parent study residents were measured with four different tests. The MMSE is a 30-item mental status test that includes questions on orientation, language, attention and recall. The GDS is a 30-item interview based depression rating scale requiring yes or no responses, the NEECHAM is a 9-item nurse rated scale that includes the participant's vital signs and pulse, which is designed to assess for acute confusion/delirium and the mCAM, another delirium assessment tool which includes tasks to assess attention.

The participants were all screened with the NEECHAM and the mCAM on the day of the severe storm and three times a week for two weeks upon their return to their home facility. The scores were compared with their Week 1 scores.

"This study provided documentation of what clinicians have known for some time, but such anecdotal accounts are seldom described with the clinical instrumentation described here," said Dr. Cacchione. "Unexpected relocation often leads to poor outcomes for nursing home residents."

The study, published in September 2011 issue, found that more than half the residents were negatively affected by evacuation and showed signs of delirium within the two weeks immediately following – two participants were hospitalized and one died.

"Nurses in all care settings, not just LTC sites, should be aware of the potential difficulties older adults may experience as a result of a natural disaster, especially when evacuations and relocations occur," said Dr. Cacchione. "Basic physical care, ongoing assessment of chronic conditions, medication management, the return to familiar surroundings, and the return of valued objects should be facilitated as soon as possible."

Provided by University of Pennsylvania School of Nursing

not rated yet
add to favorites email to friend print save as pdf

Related Stories

Relief on the way for delirium patients

May 27, 2011

Adults with dementia and delirium may soon have a way to combat their delirium, thanks to a $2.4 million, five-year grant from the National Institutes of Health.

Study: delirium presentation predicts mortality

Jul 06, 2009

The way certain patients present in the post-acute hospital setting with delirium, a common, preventable but life-threatening acute confusional state, predicts mortality, according to a study conducted by the Institute for ...

Recommended for you

Study reveals state of crisis in Canadian foster care system

17 hours ago

A new study of foster care in Canada led by a researcher at Western University reveals a shrinking number of foster care providers are available across the country to care for a growing number of children with increasingly ...

Researchers prove the benefits of persimmons for diet

18 hours ago

Alba Mir and Ana Domingo, researchers from the Department of Analytical Chemistry of the University of Valencia, under the supervision of professors Miguel de la Guardia and Maria Luisa Cervera, from the same department, ...

Hand blenders used for cooking can emit persistent chemicals

18 hours ago

Eight out of twelve tested models of hand blenders are leaking chlorinated paraffins when used according to the suppliers' instructions. This is revealed in a report from Stockholm University where researchers analyzed a ...

User comments