Elderly Japanese at severe risk

Dr. Hisashi is Director of Medical Corporation Junkei-kai in Akita, Japan, which is specialises in the treatment, nursing and caring of the elderly.

Q. The older citizens of Japan seem to have been particularly badly affected by the earthquake and resulting tsunami. Can you please explain why this is so?

Dr. Hisashi: Three out of 47 prefectures in Japan were the most immediately affected and hard-hit by the earthquake and ensuing tsunami turning especially coastal communities into a graveyard of rubble probably killing 27,000 people in the country’s north. Many of the small coastal towns hit hardest had seen an exodus of young people moving to cities for work. Now those towns have been flattened, and as much as half the population in some way may have been killed. To start with, there are three risk factors accounting for the fact that the disasters took an especially harsh toll on the elderly first of which has to do with mobility. In northeast Japan, the median age of residents in many communities is over 5o years some of whom suffer from chronic ailments, live in isolation from families and most of all their reluctance to relocate. Second is the lifestyle of older people who tend to live in more fragile wooden houses. They often prefer to live on the first floor, where they were more easily killed by collapsing buildings. Psychology is another risk factor because warnings were sent out and people told to go to safer places, some elderly decline from leaving their homes with the excuse that they did not want to go to an unfamiliar place.
At the evacuation centers, there are large populations of elderly survivors but some have not been able to withstand the aftershock while others developed post-traumatic stress disorder. Moreover, trapped in the overcrowded camps trying to battle freezing temperatures, lack of sufficient food, medicine and care, makes survival among the elderly difficult. With the unfolding specter of nuclear disaster at the power plants, relocation of the survivors was a necessary step. A few aged persons have been reported dead as they were being moved from one camp to another. At this time no updated official death toll of senior citizens is available as rescue work is still in progress.

Q. What type of assistance is most needed for the frail aged?

Dr. Hisashi: Life at the crowded evacuation camps especially for the frail elderly persons is very challenging and difficult. Medical attention is highly required as there are shortages of food, water, clothing and medication. There are increased cases of hypothermia, serious dehydration and respiratory diseases. Although care and medical services are provided, those who suffer from chronic ailments had their medications washed away by the tsunami. More complicated is the fact that many do not remember what they were taking as medication. In effect they need to be relocated into more comfortable environments that can provide complete care for their health and survival.

Q. Which services are in place to assist?

Dr. Hisashi: Currently, Doctors Without Borders in Japan are assessing the need in the field to better understand which professions or extra field staff are needed. Already in place are doctors, nurses, caregivers, volunteer workers, lawyers (to provide free legal advice), and the Japan Ground Force.

Q. Is there something that those working with older people in other countries can learn from this?

Dr. Hisashi: It is important to note that caregivers working with older people should be well trained on disaster preparedness. Care workers should be very aware and understand the needs of people in their care as well as keep stock of basic supplies like water, medication and food for use during and after a disaster. Moreover, natural disasters reveal the best and worst in people. Courage for the elderly survivors to face the challenges of recovery and start life over probably bereft of friends, family and homes will largely depend on the resilience of people in their care.

Q. Apart from donations of money is there anything else concerned readers can do to assist?

Dr. Hisashi: Internet bloggers and community websites have disseminated wrong information particularly about the nuclear crisis which resulted to panic all over Japan. I would start by pledging that readers should be aware of rumors and not spread wrong information as this has had a negative effect on many people in Japan over the past weeks. At the start of the nuclear crisis, false alarm circled the web that the radiation from the plants was serious than imagined. People panicked, hoarding all they could from foodstuff to gasoline. This made it difficult for basic supplies to reach evacuation centers.