Disaster Assistance

II. Executive Summary

Annually, natural disasters occur through floods, tornadoes, earthquakes, and hurricanes, and some may be serious enough that they are Presidentially declared. This declaration brings to bear the resources of the federal government in order to restore the public facilities of a community and to assist individuals in restoring their lives. Many more disasters occur on a smaller scale that are not of such scope and, therefore, are ineligible for a federal response. This often leaves older persons dependent upon their own individual resources and capabilities which are often inadequate. Some such disasters in recent years have been huge, such as the San Francisco earthquake; the South Carolina hurricane, Hugo; the Florida hurricane, Andrew; the Midwest floods; and, most recently, the Los Angeles Earthquake. Many older persons, often with little or no opportunity to recover on their own, have been seriously impacted by these calamitous events.

Historically, the mission of several national non-profit organizations (American Red Cross, Salvation Army) has been to assist in disaster situations on an immediate response basis. These agencies do an outstanding job of meeting the short term needs of the general population. In many instances these agencies respond to a disaster prior to a Presidential declaration and/or when a disaster is not Presidentially declared. However, neither of these agencies nor the Federal Emergency Management Agency have fully established an operational response capability to serve the special needs of older adult or disabled disaster victims, especially on a long term basis. Further, these agencies have not developed an assistance strategy that would be adaptable to individual or situational circumstances.

This means a coordinated team effort, including all of the expertise and capabilities of the aging network, is necessary if older persons are to be served adequately.

The on-going activities provided on a day by day basis by the aging network serves as preparation for an appropriate disaster response. Currently, many States require Area Agencies on Aging to develop disaster preparedness plans which deal with the process of disaster response. A key element to the disaster response strategy is disaster advocacy and outreach. Typically, agencies will expand or develop new services in order to meet identified needs. One of the services that must be established quickly is called "Disaster Advocate and Outreach Services". Over the years, this service has been identified as the most critical service that can be provided by the aging network for older disaster victims.

Disaster advocates are persons who volunteer or are employed to work on a one-to-one basis with older persons once a Disaster Application Center (DAC) is established or even prior to that time. DACs are locations where representatives of many different programs come together so that disaster victims may apply for disaster services at one location. After a major disaster declaration, FEMA and state officials establish Disaster Application Centers. The DAC brings together in one location many resources that are available to aid individual disaster victims. It is a convenient "one-stop" means for individuals to obtain information and apply for assistance through the various disaster programs, representatives from organizations and agencies such as Red Cross, Aging, Church World Services, Mennonite Disaster Services, etc. are often present in the DAC.

Areas are chosen for DAC sites based on the impact of the disaster incident on individuals, the availability of an adequate facility to serve as a DAC and the accessibility of the facility to the affected population. They may be located in one location for as long as several months while others, called mobile DACs, which serve sparsely populated areas or areas with less impact, may operate for one or two days.

In addition to the DAC, individuals affected by the disaster may obtain information and make application through FEMA's National Teleregistration Center (NTC). The NTC is able to accept applications and provide information within a few hours after a disaster declaration. However, since the referral agencies are not located at the NTC, the disaster victim is not able to take advantage of the "one-stop" concept. While not as yet demonstrated, research seems to indicate that older persons have some reluctance to use this kind of system. If this is the case, this reaction by older persons would be consistent with findings related to delivery of information and referral services. More importantly, there are strong indications that older persons frequently fail to follow through with the necessary processes and procedures (application and denial of SBA loans) to obtain Individual and Family Grants. (In 1994, $12,600 was available and could be supplemented by states. The amount increases annually based on the cost of living.)

The earlier a disaster advocate can begin supportive activities for older disaster victims, the more timely will be the delivery of necessary programmatic and emotional support. Abilities required of disaster advocates include the ability to be good listeners, to relate well, to be quick to assimilate training about disaster services and freedom to commit a period of as much as one year to the effort. Volunteers or persons employed to provide these services range from fully qualified social workers to active older persons living in the proximity. Churches, senior centers, and possibly AARP chapters and retired teacher units are excellent sources for the people necessary for this important service. Because they often can relate more effectively than younger persons, older disaster advocates have been particularly effective in their roles during previous disasters.

Responsibilities of disaster advocates include knowledge of disaster services, victim interviews, needs assessment, ability to provide emotional support, and negotiate and advocate on behalf of the older victim. The disaster advocate facilitates a wide range of assistance that can be provided older victims by the aging network and other State and Federal agencies. A major difficulty in each disaster is the recruitment and training of individuals to fulfill these responsibilities in the short time frames available to responsible organizations in affected areas. Disaster advocates must always have professional supervision and an understanding that when certain levels of individual needs are encountered, there are more highly qualified individuals available to provide guidance or to assume the responsibility for follow-up activities with the victim.

Disaster advocate services are needed after a disaster because older persons often have special needs and characteristics that must be accommodated, if they are to be served proportionally with the level of service provided the general population. Many agencies make the mistake of assuming that older persons are a homogenous group. If that were the case, an assistance strategy adopted in one situation would always be appropriate in another. This is not the case at all. People do not become more alike as they age, they become more dissimilar. Personalities and physical capacities become more distinct among aging individuals. It is important to recognize that there are few blanket statements that can be made that will apply to individual older persons. This is as valid in disasters as it is in other situations. In responding to disasters, there is a definite need to establish and maintain an effort to meet the needs of older persons who require special help as well as make an effort to utilize the strengths and skills of the many older persons who can contribute.

One of the special characteristics that many older persons have in common is delayed response time. In the 1977 Kansas City Plaza flood, approximately 1700 older persons received assistance by coming to the DACs. These centers were established throughout the Kansas City area and were kept open for six weeks. At the end of the six weeks, the numbers of persons coming to the centers had dropped considerably and it was felt that it was time to close them. However, there remained one issue that was debated concerning the closure of these centers. Older persons had not come to the centers in the numbers expected. Projections had been made by the Area Agency on Aging through analysis of the areas that had been affected. With input from the aging network, FEMA made the decision to leave one centrally located center open to serve persons who had not yet visited a center. Subsequently, over one-half of the 1700 older persons would not have been served or even heard from if one center had not been maintained. Without special assistance and intervention by agencies and organizations that serve older adults, many older persons affected by disasters would never receive the entitled services because they responded too slowly.

Older persons frequently experience various degrees of sensory deprivation. This includes reduced ability to see and hear. These difficulties and their bearing on older disaster victims became quite evident during the response to the Omaha, Nebraska tornado of 1975. Older persons crowded into disaster centers along with others of the general population who were seeking assistance. It was discovered that older persons were exiting the center without understanding what had just happened to them. They were simply confused. One of the major factors included the kind of hearing loss that older persons experience which makes it extremely difficult to hear certain tones. When a great deal of background noise is present, as in a disaster center, it becomes almost impossible for a person with that kind of difficulty to understand what is being said. If the older person has difficulty in reading print that is too small, they have for all purposes been cut off from communication with the very people that they depend on for assistance.

Welfare stigma and inexperience with bureaucratic systems are often barriers to older persons in receiving disaster services. If a service in any way looks like charity, a handout, or welfare, it will often be avoided. It is important that older persons understand that the services they apply for in a center are benefits they have earned as taxpayers. Then, in the interaction with agency personnel, older persons must often overcome the fears that accompany a new experience. They may not be assertive enough to take charge of an interview and assure that necessary contact and understanding occur. The interviewer, who probably has never had an orientation to the special considerations involved in serving older persons, may never know that real communication has not occurred.

Many older persons have disabilities, are frail, or have chronic health problems such as arthritis. This means that special efforts related to transportation to centers, availability of wheelchairs, attention to medication, and special outreach efforts must be addressed. The more frail an older person is, the more susceptible he is to a condition known as transfer trauma. This condition was first noted and documented in nursing homes and occur when an older person has to be moved from one living arrangement to another. Statistics show that rates of illness and even death increase significantly. Properly followed procedures by persons knowledgeable of such factors can greatly reduce the negative impact of necessary relocation.

It is a challenging responsibility to meet the needs of older disaster victims. For a person or agency that does not work in the field of aging, it is perhaps an impossible challenge to do the job well. That is why anyone who works with disasters should know about the aging network and have the support of trained individuals who can assure that the older victims receive the special attention necessary to meet their special needs.

In addition to Disaster Advocate and Outreach Services, the aging network must provide gap-filling services. Gap-filling services are those services that are necessary after a disaster because: (1) they are not available and are necessary for older persons; (2) they are not in sufficient quantity to provide services to the older disaster victims who need those services; or (3) will not be available for a long enough period of time to meet the need. Gap filling disaster services are those provided immediately following the disaster which often continue to be necessary during long term recovery. These services may be provided for as long as one year or even two years in catastrophic disaster response. These services are those which are necessary to maintain older disaster victims until they have recovered to the point where they do not need further assistance, to help provide the capacity to address problems that develop as a result of the disaster, and finally, to provide services that will be on-going in nature and that will transition to existing programs. In conclusion, State and Area Agencies on Aging and Native American Tribal Organizations play critical roles in disaster response. State Units on Aging must facilitate the flow of information, provide technical assistance and maintain momentum in service delivery and development of funding. For example, the State Unit on Aging must assure that the Area Agencies on Aging know when DACs are going to be open and their locations so that Area Agency staff can operate a desk for access of services by older victims and can provide disaster advocates to assist older persons as they seek assistance from the participating organizations. The State Unit on Aging must work with Area Agencies on Aging and Native American Tribal Organizations and coordinate information flow so that appropriate state organizations, including the State Emergency Management Agency, and the Administration on Aging have information on the status of older victims and prompt development of necessary applications and updates.

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