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It is difficult for the elderly to secure a living place by themselves within a shelter.While they repeatedly move within the shelter and endure a poor living environment, psychological stress sometimes manifests as physical symptoms. In addition, if elderly evacuees are inactive during the day, their ADL level tends to decrease, which can aggravate chronic disorders.PTSD (post-traumatic stress disorder) sometime develops in the elderly without being noticed, and elderly evacuees may suffer from continuous psychological disturbances such as a sense of helplessness and anxiety about their future without prospects for restoring their lives.
Therefore, it is very important to assess the mental state of elderly evacuees and attempt to maintain and improve their mental health.
Assessment of psychological stress and anxiety about the future
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Mental state (anxiety/fretting, irritation, anger, depressive tendency, etc.. |
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Sleep patterns (insomnia, feeling of sound sleep, difficulty in falling asleep, and waking after the onset of sleep. |
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Physical symptoms (increase in blood pressure, increase in glucose, and gastrointestinal symptoms such as nausea, vomiting, stomachache, hematemesis, and bloody feces due to acute gastric ulcer. |
| 4. |
Living state (such as living environment in the shelter and personal relationships with surrounding people) and anxiety about the future |
Coping methods for psychological stress and anxiety
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Arrange assessment by health care practitioner and clarify the mental state of elderly evacuees |
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Secure places that enable the elderly evacuee to be listened to without any time constraints, and listen attentively |
| 3. |
In elderly with an unstable mental state, arrange a visit to or by a psychiatrist. If a prescription is required ensure that the physician's instructions for medication are noted and medication is properly managed |
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Identify factors associated with aggravation of the mental state, and adjust or intervene with these factors |
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Evaluate the area occupied by the elderly evacuee within the shelter, and consider setting up a private space or a change in place when necessary |
| 6. |
Plan regular visits by mental health specialists and carry out mental support programs |
Assessment of sense of helplessness and symptoms of PTSD
* More assessment should be performed in addition to assessment of psychological stress and anxiety about the future. Assess the elderly evacuees for
| 1. |
Mental activity and ADL in shelter life |
| 2. |
Symptoms of PTSD (such as continuous crying when remembering the time of the disaster, insomnia and despondency. |
| 3. |
Troubles and stress in personal relationships within the shelter |
Coping methods for sense of helplessness and symptoms of PTSD
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1. When there are symptoms of PTSD, arrange for immediate visits to or by a psychiatrist or mental care specialist (such as a clinical psychologist, mental health nurse and counselor. |
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Communicate as much as possible, and strive to build up a feeling of mutual trust |
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Plan for group discussions where the elderly can talk to one another about life in the shelter in the presence of mental care specialists |
| 4. |
Arrange for the establishment of a place of counseling by mental care specialists in the shelter |
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Mental health
