Management of the Immune-Compromised Older Adult in a Disaster

  • Marco Ruiz
  • Thomas Reske


Senior patients represent a special population who has diminished response to environmental factors. In the event of a disaster, senior populations are more prone to suffer deleterious consequences. Inadequacy of disaster-training or disaster-planning strategies among health care providers, administrators, and general staff of assisted living facilities, nursing homes, and general hospital settings complicates this situation even further.

Senior immune-compromised patients face particular issues. The use of immune-suppressive agents and the need for regular laboratory monitoring are some of the circumstances they have to face on an everyday basis. In view of these special measures these patients may be even at higher risk of complications in a disaster situation than the nonimmune-compromised senior patients.

After a disaster, conditions such as stress, the lack of food or water, extremes of heat or cold, and exposure to infection may contribute to rapid worsening of a chronic illness that was stable before the event. Interruptions in medication regimens can exacerbate underlying conditions and increase the risk of morbidity or mortality. In the immune-suppressed population, this is even more relevant since patients need their medication, may get exposed to environmental threats, and be more susceptible to life-threatening complications.

Elderly immune-compromised patients require special attention during disasters. This population has especial characteristics and is at high risk to develop complications during disaster. Main attention should be focused on infection prevention and awareness and lack of symptoms when patients develop infections. Patients may have life-threatening systemic diseases and appear asymptomatic. Emergency and health staff personnel require training to be aware of this special patient population. Active participation of patients, health and emergency staff, and government officials is needed to design proper strategies to take care of this population in a disaster situation.


Senior Immune-compromised Disaster Preparedness Prevention 


  1. 1.
    Roush RE, Tyson SK. Geriatric emergency preparedness and response workshops: an evaluation of knowledge, attitudes, intentions, and self-efficacy of participants. Disaster Med Public Health Prep. 2012;6(4):385–92. doi: 10.1001/dmp.2012.63.PubMedCrossRefGoogle Scholar
  2. 2.
    Cloyd E, Dyer CB. Catastrophic events and older adults. Crit Care Nurs Clin North Am. 2010;22(4):501–13. doi: 10.1016/j.ccell.2010.10.003.PubMedCrossRefGoogle Scholar
  3. 3.
    Loke AY, Lai CK, Fung OW. At-home disaster preparedness of elderly people in Hong Kong. Geriatr Gerontol Int. 2012;12(3):524–31. doi: 10.1111/j.1447-0594.2011.00778.x.PubMedCrossRefGoogle Scholar
  4. 4.
    Daugherty JD, Eiring H, Blake S, Howard D. Disaster preparedness in home health and personal-care agencies: are they ready? Gerontology. 2012;58(4):322–30. doi: 10.1159/000336032. Epub 2012 Apr 6.PubMedCrossRefGoogle Scholar
  5. 5.
    Laditka SB, Laditka JN, Cornman CB, Davis CB, Chandlee MJ. Disaster preparedness for vulnerable persons receiving in-home, long-term care in South Carolina. Prehosp Disaster Med. 2008;23(2):133–42; discussion 143.Google Scholar
  6. 6.
    Ruiz M, Reske T, Cefalu C, Estrada J. Management of elderly and frail elderly cancer patients: the importance of comprehensive geriatrics assessment and the need for guidelines. Am J Med Sci. 2013;346(1):66–9. doi:10.1097/MAJ.0b013e31826d59aa.Review.Google Scholar
  7. 7.
    Dosa DM, Grossman N, Wetle T, Mor V. To evacuate or not to evacuate: lessons learned from Louisiana nursing home administrators following Hurricanes Katrina and Rita. J Am Med Dir Assoc. 2007;8(3):142–9.PubMedCrossRefGoogle Scholar
  8. 8.
    Aldrich N, Benson WF. Disaster preparedness and the chronic disease needs of vulnerable older adults. Prev Chronic Dis. 2008;5(1). Accessed 12 Dec 2013.
  9. 9.
    Aldrich N, Benson WF. Disaster preparedness and the chronic disease needs of vulnerable older adults. Prev Chronic Dis. 2008;5(1):A27.PubMedCentralPubMedGoogle Scholar
  10. 10.
    Caillouet LP, Paul PJ, Sabatier SM, Caillouet KA. Eye of the storm: analysis of shelter treatment records of evacuees to Acadiana from Hurricanes Katrina and Rita. Am J Disaster Med. 2012;7(4):253–71. doi: 10.5055/ajdm.2012.0099.PubMedCrossRefGoogle Scholar
  11. 11.
    Dosa DM, Hyer K, Brown LM, Artenstein AW, Polivka-West L, Mor V. The controversy inherent in managing frail nursing home residents during complex hurricane emergencies. J Am Med Dir Assoc. 2008;9(8):599–604. doi: 10.1016/j.jamda.2008.05.007.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Louisiana State University Health Science Center New OrleansNew OrleansUSA

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