Workshop: people with mental disabilities in disaster and emergency situations The workshop has been held at the University of Innsbruck, Psychology Department on September 30th 2016. Participants came from 4 different organisations and were mainly leading personnel. All experts had more than ten years of experience in the field. In the workshop, we focused on the following topics Input about EUNAD-IP Collection of practice examples and experience exchange Development and discussions of training needs based on the practice examples Summary of workshop results Perceived Challenges in emergency and disaster situations with people with mental disabilities As we saw in the workshop, EMTs and caregivers have similar views about challenges in emergency situations and disasters but a very different emotional situation. Generally speaking, emergency personnel needs good cooperation with caregivers and a lot of information about persons with mental disabilities in order to fulfill their tasks. Caregivers on the other hand are often overwhelmed and anxious because of their enhanced feeling of responsibility and their lack of information and experience about procedures in emergency and disaster situations. People with mental disabilities themselves often have difficulties in understanding the situation and are highly dependent on the reactions and support of their caregivers. Relatives often are overprotective and do not want the mentally disabled person to get information about death. Perceived training needs and ideas for improvement Generally, the expert’s opinion is to consider each of the affected groups of helpers separately because their training needs may differ a lot. There seem to be three areas of “training” Exercises Trainings Checklists Emergency personnel and management may use exercises to gain experience in interaction with people with mental disabilities, but also to get to know caregivers and their needs, as well as to inform themselves about the specific caregiving facilities and their structures and procedures. In trainings,
Use simple language Use Repetition Consider individual needs Use small gestures that may give safety: e.g. Hold the hand of the patient, Use closeness to create safety Stay with the patient Engage on the linguistic, visual, acoustic and cognitive level of patient (simple language) Integrate reference person (relatives, caregiver) in care of patient Create calm and safe environment Create familiar environment Consider optimal patient care Guarantee privacy Build trust Death of a relative: Integrate people with dementia into the grieving process of the whole family Slow, calm and careful action Patient and slow transfer to hospital staff Table 12. Experienced helpful interactions with persons with mental disabilities in emergencies For emergency personnel, a lot of useful information can be found on this website of the University of Hertfordshire: . Especially the following guidelines are of great use: Roleplay and table top exercise instructions In total, we chose 18 case examples for training. These can be found in the Appendix. Roleplay and table top exercise instructions You may use the case examples in the Appendix for roleplays and tabletop exercises. You should do this in several steps. Roleplay: you let participants play out the situations by going into the role of each character. Table top exercise: you give out information about the situation and let participants discuss problems that may arise during the situation and how to best solve them.
First discuss the main events that may happen or already have happened in your facility. Use the following graph as a framework. Event (grouped according to propability) Moderate Impact Severe Impact Critical Impact Medical emergency Accident within facility Accident out of facility Power outage Fire Flooding Etc. All events that have severe to critical impact should be considered regardless of their propability. The following Case examples show how each event needs a lightly different approach. Look at the following examples and then do your own examples according to the list you have developed. Adapt the examples to your kind of facility (housing facility, working facility, hospital etc.). Medical emergency in facility In a working facility for mentally disabled persons a client (46) broke down and was unconscious for a short time. A caregiver immediately alarmed the ambulance and started first aid. When the emergency doctor arrived the patient was able to communicate again. He did not want the doctor to touch him and reacted aggressively. Accident in facility In a working facility for mentally disabled persons a client had an accident with a carving knife (he severed an artery in his arm and was bleeding heavily. The caregiver alarmed the ambulance and started first aid according to what the dispatcher told him to do. The co workers became very distressed because of the blood and the fearful crying of the patient. Swimming Accident During a swimming lesson of a group of 8 persons with mental disabilities a 49 year old client was found in the water wothout vital signs. Two caregivers took him out if the water and immediately startet CPR. After the emergency doctor arrived the person was declared dead. Bus accident A group of 21 persons with mental and physical disabilities and 3 caregivers was on their way to a holiday camp when their bus had an accident. One of the caregivers died. 5 clients were critically