Management of the Immune-Compromised Older Adult in a Disaster

Abstract

Senior patients represent a special population who has diminished response to environmental factors. In the event of a disaster, senior populations are more prone to suffer deleterious consequences. Inadequacy of disaster-training or disaster-planning strategies among health care providers, administrators, and general staff of assisted living facilities, nursing homes, and general hospital settings complicates this situation even further.

Senior immune-compromised patients face particular issues. The use of immune-suppressive agents and the need for regular laboratory monitoring are some of the circumstances they have to face on an everyday basis. In view of these special measures these patients may be even at higher risk of complications in a disaster situation than the nonimmune-compromised senior patients.

After a disaster, conditions such as stress, the lack of food or water, extremes of heat or cold, and exposure to infection may contribute to rapid worsening of a chronic illness that was stable before the event. Interruptions in medication regimens can exacerbate underlying conditions and increase the risk of morbidity or mortality. In the immune-suppressed population, this is even more relevant since patients need their medication, may get exposed to environmental threats, and be more susceptible to life-threatening complications.

Elderly immune-compromised patients require special attention during disasters. This population has especial characteristics and is at high risk to develop complications during disaster. Main attention should be focused on infection prevention and awareness and lack of symptoms when patients develop infections. Patients may have life-threatening systemic diseases and appear asymptomatic. Emergency and health staff personnel require training to be aware of this special patient population. Active participation of patients, health and emergency staff, and government officials is needed to design proper strategies to take care of this population in a disaster situation.