Module 5 Populations with Special Needs

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Module 5 - Populations with Special Needs
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Learning Objectives

• Identify and describe the characteristic
  reactions of vulnerable groups affected by
  disaster
• Describe effective interventions to assist
  vulnerable groups

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Groups with Special Needs

• Children
• Older persons
• Persons with disabilities (physical/mental
  illness/substance abuse/developmental)
• People with past experience with war or terrorism

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Groups with Special Needs (cont.)

• Ethnic and cultural groups
• Parents with dependent children
• Bereaved spouses or partners
• Economically disadvantaged groups
• Socially disadvantaged groups
• First responders/disaster response personnel

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Groups with Special Needs (cont.)

• Individuals may overlap between groups
• Women Vulnerability
• role of women as primary caregivers (overlap with
  parents, maybe economically disadvantaged)
• Women outlive men and thus may be alone and
  physically compromised as they age (overlap with
  older adults, socially isolated)
• Women may have a history of trauma or abuse
  (overlap with past trauma experience)

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Emotional Stress in Children

• Listen/Observe/Respond
• Changes in behavior, personality, outlook.
• Talk to the child and observe responses.
• Does the child appear upset or confused?
• Compare the childs behavior to other children of
  the same age in the same setting.
• Does the child play appropriately?

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Childrens Typical Responses

• Fear and anxiety
• Childish or regressive behavior
• Difficulty sleeping
• Physical reactions
• Trigger responses
• Difficulty concentrating or thinking

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Reactions Related to Age Groups

• Birth to 2 years
• Irritability, crying, clingy or passive behavior
• Pre-school, 2-6 years
• Intense fear or insecurity
• Play activities may involve aspects of the event
• Re-enactment of the event over and over

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Reactions Related to Age Groups (cont.)

• School age, 6-10 years
• Guilt
• Feelings of failure
• Anger
• Fantasies of playing rescuer
• Intensely preoccupied with the event

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Reactions Related to Age Group (cont.)

• Preadolescence to adolescence, 11-18 years
• Responses resemble adult reactions
• Irritability, rejection of rules and aggressive
  behavior
• Dangerous, risk-taking behavior
• Fearful
• Depressed
• May contemplate or attempt suicide

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Helping a Child

• Help by helping the parents
• Keep familiar routines
• Pamper and care
• Talk about what happened (as appropriate)
• Find opportunities for children to participate in
  decision-making

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When a Specialist is Needed

• Suicidal or homicidal ideation/behavior
• Younger children may say they wish they had never
  been born
• Hopelessness/helplessness
• Unable to stop thinking about the event
• Physical problems
• Alcohol or drug use

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Activity 16 Group Discussion

• Helpers need to be prepared for their own
  emotional reactions when supporting children in
  crisis, and to be aware that their reactions are
  normal.
• Brainstorm and list the normal reactions that
  can helpers may have when working with children
• Many areas of Nebraska have very few mental
  health services for children.
• As a group, brainstorm and list all the mental
  health services for children available in your
  community

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Older Persons

• Especially vulnerable when
• Having co-occurring medical problems
• Having ambulation difficulties
• Living alone
• Lacking help and other resources
• Having to face the shock of losing all that they
  had attained in life
• Home
• Family
• Security

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Older Peoples Typical Reactions

• Increased memories of past
• Wish to connect with past friends
• Increased dependence on family, refusing
  assistance from authorities
• Fear of mortality
• Negative view of the future
• Regression

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Older Peoples Typical Reactions

• Feeling of multiple losses
• Disoriented as routine is interrupted
• Use of denial as a normal defensive reaction
• Immediate fear response, followed by anger and
  frustration
• Concentration and communication difficulties
• Physiological responses

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Helping Older People

• Ensure safety
• Give factual information
• Reassure by providing information about normal
  reactions
• Be supportive and build confidence
• Identify secure attachments and relationships
• Talk about the event
• Be aware of cultural backgrounds

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Helping Older People (cont.)

• Facilitate access to aid and support services
• Ensure that they are not isolated
• Establish Routine
• Provide opportunities for continuity, culture and
  history
• Help them to maintain their sense of community
  and preserve cohesion

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Persons with Disabilities (Physical/Mental
Illness/Substance Abuse/Developmental)

• May need assistance in negotiating the second
  disaster, applying for assistance from aid
  agencies
• May need some accommodations within shelters
• May need assistance in replacing lost
  prescriptions

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Persons with Disabilities

• Always link with existing services for their
  disabilities
• Seek advice if these are evident or suspected
• Suicidal ideation
• Homicidal ideation
• Depression lasts longer than two weeks
• Active hallucinations or delusions
• Rage
• Aggression
• Inability to care for self or carry out
  activities of daily living

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Previous Experience with War/Trauma/Disaster

• Previous, and especially repeated, exposure to
  death and injury may increase a persons risk of
  developing psychological problems after a
  disaster.