Planning for Emergencies
By Eva Mor, PhD

Providers must be proactive in assisting patients and clients with establishing measures and documents that will make emergency situations less difficult to handle effectively.

In 2011 the first baby boomers will turn 65 years old, according to the U.S. Census. This demographic will increase at a rapid pace, reaching 72 million within the next 20 years and doubling the number of adults over the age of 65 as calculated in 2000. As the American population ages, the rate at which the number of elders aged 65 and older grows will accelerate to represent 20% of the total population, according to the U.S. Census.

According to AARP, 80% of older adults have at least one chronic health condition, and 50% of them have at least two, including hypertension, heart disease, diabetes, and arthritis. Many elders live in unsafe environments and are susceptible to injuries from falls or taking medications at inappropriate times or in inappropriate doses. This places a great responsibility on health service providers to educate older adults on the precautions they should take. Professionals have an obligation to help this population and their families and caregivers to put in place emergency plans that will help them prepare for future needs.

Our healthcare is provided through multiple sources and specialists. It is not easy for older adults to navigate the many options that are available or to identify specialized services. The responsibility falls on healthcare professionals to reach out and help them.

Each older adult should have is an emergency plan of action. A fall, a stroke, or a heart attack, for example, can prompt the need for such a plan. It need not be complex; you may want to offer your patients or clients a list similar to the one that follows to help them protect themselves. The list is a shortened form of the one that appears in Making the Golden Years Golden.

Emergency Plan of Action
• Recognize the signs of decline and be ready to step in. As a physician, nurse, geriatric care manager, or social worker you may be the one who notices mental or physical changes in a patient, prompting the need to inform the elder’s relatives that greater oversight will be needed. Among changes you may notice are signs of neglect, confusion, soiled clothing, and/or significant weight loss, which are all indicators of a crisis that must be addressed. If a visiting nurse notices neglect, a foul odor, or an older adult who is still in his or her night clothing at midday, she should recognize that an intervention is necessary.

• Advise your patients of the need to protect themselves legally. They need to put in place legal instruments such as a power of attorney, a living will, and a health proxy. Clients should be advised to choose a health proxy representative who will be available to healthcare providers in the event the patient is unable to voice his or her wishes.

• Advise your patients to be on the alert for scams. Last year Americans were scammed to the tune of $60 billion. According to AARP, one third of this amount was scrupulously obtained from older adults. This number is likely to be much higher since many elders fail to realize they have been scammed or are embarrassed to report the fact that they have been scammed. Advise clients not to accept telemarketing calls and to simply hang up the phone. Also remind patients to never give out personal information such as their Social Security or bank account numbers over the phone.

• Advise patients or their caregivers to keep up-to-date lists of their medications. Recommend that they keep the list current and include each drug’s name, dosage, and mode of usage. Due to patients’ multiple health issues and care frequently provided by several specialists, make physicians aware of medications others are prescribing. Advise patients to take copies of their medication lists to all doctors’ appointments. There are many aids to help elders avoid taking medications twice, remember whether they have taken a medication already, or remind them to take their medications.

• Advise patients to develop a list of emergency contacts in case of an emergency. The list should include the names and contact information of children, other relatives, neighbors or anyone who could be of assistance during an emergency along with the names of all current physicians. The doctors’ information should include name, specialty, phone numbers, and addresses. If home care is provided through an agency, the agency’s contact information should be included on this list.

• Suggest to your patients to develop a list of personal information including Medicare, Social Security, and insurance information. This information should be available for quick retrieval in case of an emergency.

• Advise your patients to accident-proof their home. Seventy-eight percent of injuries among older adults occur at home. Elders need professionals to walk through and point out the safety measures that should be implemented. These include such measures as installing grab bars in the bathroom and removing area rugs. Suggest that they develop habits that will keep them safe such as bringing a glass of water to the bedside to avoid trips to the kitchen in the middle of the night, using a night light to reduce the chance of tripping and falling in the dark, and keeping a telephone in the bathroom and next to the bed.

According to the Agency for Healthcare Research and Quality, 79% of older adults are living in their own home with or without assistance, but most can benefit from assistance. Many elders do not have someone immediately available to step in and put in place a plan for them, so the responsibility falls on us as professionals to assist in developing an emergency plan of action for their own protection.

— Eva Mor, PhD, an epidemiologist and specialist in gerontology and healthcare management, has worked with older adults for more than 23 years. She is the author of the book Making the Golden Years Golden.