title: Multi-disciplinary Care for the Elderly in Disasters: An Integrative Review.
abstract: BACKGROUND
  Older adults are disproportionately affected by disaster. Frail elders, individuals with chronic diseases, conditions, or disabilities, and those who live in long-term care facilities are especially vulnerable. Purpose The purpose of this integrative review of the literature was to describe the system-wide knowledge and skills that multi-disciplinary health care providers need to provide appropriate care for the elderly during domestic-humanitarian and disaster-relief efforts. Data sources A systematic search protocol was developed in conjunction with a research librarian. Searches of PubMed, CINAHL, and PsycINFO were conducted using terms such as Disaster, Geological Processes, Aged, Disaster Planning, and Vulnerable Populations. Forty-six articles met criteria for inclusion in the review.
  
  
  CONCLUSIONS
  Policies and guidance regarding evacuating versus sheltering in place are lacking. Tenets of elderly-focused disaster planning/preparation and clarification of legal and ethical standards of care and liability issues are needed. Functional capacity, capabilities, or impairments, rather than age, should be considered in disaster preparation. Older adults should be included in disaster planning as population-specific experts. Implications for Practice A multifaceted approach to population-specific disaster planning and curriculum development should include consideration of the biophysical and psychosocial aspects of care, ethical and legal issues, logistics, and resources.
authors.affiliation: 1The Uniformed Services University of the Health Sciences,Daniel K. Inouye Graduate School of Nursing,Bethesda,MarylandUSA.
authors.forename: Heather L
authors.initials: HL
authors.lastname: Johnson
authors.affiliation: 1The Uniformed Services University of the Health Sciences,Daniel K. Inouye Graduate School of Nursing,Bethesda,MarylandUSA.
authors.forename: Catherine G
authors.initials: CG
authors.lastname: Ling
authors.affiliation: 2The Uniformed Services University of the Health Sciences,F. Edward Hébert School of Medicine,Department of Preventive Medicine and Biometrics,Bethesda,MarylandUSA.
authors.forename: Elexis C
authors.initials: EC
authors.lastname: McBee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000533:Altruism; D004189:Disaster Planning; D004190:Disasters; D006282:Health Personnel / Q000592:standards*; D006301:Health Services Needs and Demand; D006801:Humans; D012066:Relief Work; D035862:Vulnerable Populations; D014947:Wounds and Injuries / Q000628:therapy
keywords: ADL activities of daily living; CINAHL Cumulative Index to Nursing and Allied Health Literature; DNR do not resuscitate; ESRD end stage renal disease; USUHS Uniformed Services University of the Health Sciences; vulnerable populations