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Saturday, February 21, 2009

The Fate of the Elderly during a Crisis

By Joseph Parish

We often wonder what will be our reactions during some type of major disaster or crisis. Will we behave as we expect ourselves to? Will we do everything by the book as we had planned? Will we be able to provide for our loved ones properly? There are more questions then we have answers for. Under the expected circumstances all we can do is guess as to what our actions will be.

One area in particular that may present a problem is the fate of our elderly friends and family members. Being an elderly person presents somewhat of a grim future for them as it is. Add to that situation the critical actions that are often associated with any sort of emergency and our elderly folks are simply at grave risk.

During the preparation stage of any sort of emergency condition the rules provide only a rough set of standards and guidelines for anyone and this aptly applies to the healthcare system as well. It is not unusual that during a crisis the governor of any state can suspend various statutes or regulations relating to our hospitals and health care facilities. After all during emergencies the health backup systems are extremely taxed to their limits.

Quality care will usually be at a premium as there simply will not be sufficient personnel to adequately take care of the injured and ill. It is not unusual for the governor of the various states to take those retired or unlicensed volunteers and extend emergency credentials to them so that they may provide the necessary and needed care.

Many alternate care sites will be setup and functioning. These types of sites will be placed in school gymnasiums, sports centers as well as in ordinary parking lots. These particular sites will be equipped for handling various ill and injured patients.

Since most medical equipment will be rationed you should not expect to see much in the way of electronic medical equipment at the temporary sites. The patients who have a critical need for such treatment and here is the key words, “who are likely to survive” will be the ones that are treated prior to those who may be extremely sick or injured to the extent that they may not survive. This was one of the key points for which my FEMA classes stressed.

In view of this shortage of equipment, supplies and practitioners we should be fully prepared to accept that some of the older and sicker of the patients will simply be permitted to die so as the lives of patients that are more likely to survive may receive the available care. This scenario is more then likely to be seen during massive disasters, any sort of biological terror attacks or during an influenza pandemic.

Of course, we fully realize that this is simply not the manner for which nurses and doctors conduct their affairs, however, it is certain to become a part of the various statewide planning.

This new program has even been given an official name. It is known as the "surge capacity guidelines". These guidelines have been released by several state Departments of Public Health. The guidelines actually provide a scenario where patients can be herded into emergency public locations for care or at places where animal doctors could tend to their wounds or repair their broken bones.

The state of California has a 1,900 page document which outlines the various practical and ethical principles for the local and county health personnel, hospital administrators and emergency responders. It will certainly be difficult for those people who are used to saving lives to actually forsake those patients who require their help. In addition the California plan sets guidelines for which the responsibilities for the patient’s protection can be waived in the event that the governor declares an emergency. Additional changes to business as usual would be where the hospitals would not have to report births of newborns, deaths of patients, any sort of infectious disease outbreaks, any acts of medication errors or suspected child or elderly abuse. Keep in mind that any rules that currently protects a patient’s privacy will be simply tossed out the window.

Although this may appear to be tough to think about it actually is the only effective way that the system can handle the massive problems that will be associated with any sort of major disaster. In view of all this perhaps if you have anyone in a hospital or a nursing home you might wish to reconsider putting your priority on getting them out of their as your first item of business.

Copyright @ 2009 Joseph Parish


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