Module 5 - Populations with Special Needs

1. Module 5 - Populations with Special Needs

2. Learning Objectives • Identify and describe the characteristic reactions of vulnerable groups affected by disaster • Describe effective interventions to assist vulnerable groups Populations with Special Needs

3. Groups with Special Needs • Children • Older persons • Persons with disabilities (physical/mental illness/substance abuse/developmental) • People with past experience with war or terrorism Populations with Special Needs

4. 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 Populations with Special Needs

5. 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) Populations with Special Needs

6. 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 child’s behavior to other children of the same age in the same setting. • Does the child play appropriately? Populations with Special Needs

7. Children’s Typical Responses • Fear and anxiety • “Childish” or regressive behavior • Difficulty sleeping • Physical reactions • “Trigger” responses • Difficulty concentrating or thinking Populations with Special Needs

8. 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 Populations with Special Needs

9. 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 Populations with Special Needs

10. 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 Populations with Special Needs

11. 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 Populations with Special Needs

12. 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 Populations with Special Needs

13. 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 Populations with Special Needs

14. 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 Populations with Special Needs

15. Older People’s 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 Populations with Special Needs

16. Older People’s 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 Populations with Special Needs

17. 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 Populations with Special Needs

18. 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 Populations with Special Needs

19. 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 Populations with Special Needs

20. 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 Populations with Special Needs

21. Previous Experience with War/Trauma/Disaster • Previous, and especially repeated, exposure to death and injury may increase a person’s risk of developing psychological problems after a disaster. Populations with Special Needs