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Earlier this year in Toronto, the Division of Aging and Seniors and the Centre for Emergency Preparedness and Response of the Public Health Agency of Canada (PHAC) hosted a special invitational meeting with a group of national and international experts on emergency preparedness and seniors. This group included governments, non-government organizations and seniors.

During the meeting, the Canadian Health Network had an opportunity to speak to several of the participants, and their comments are included in this article.

Everybody is vulnerable in an emergency or disaster, but some people, such as children, seniors and persons with a disability are more vulnerable than others.

Seniors can be particularly at risk during catastrophic events. The good news is that they also bring enormous contributions to emergency preparation and assistance.

The following headlines show how several recent disasters have been particularly hard—in some cases, devastating—for seniors:

Disasters are increasing around the world

Over the last ten years, the world has experienced more frequent and intense disasters—natural and man-made—with devastating effects. A paper from the 2005 World Conference on Disaster Reduction states that the last ten years have seen 478,100 people killed, more than 2.5 billion people affected and about US$ 690 billion in economic losses.

Recent natural disasters include the earthquakes in Indonesia and Pakistan, Hurricane Katrina and the tsunami in South Asia. In Canada, we have also experienced our share of natural disasters, such as the forest fires in British Columbia and the ice storm in Eastern Ontario and Quebec. Other types of disasters include environmental spills, nuclear accidents, power failures, terrorism and health emergencies such as the projected flu pandemic.

Seniors: a diverse group—that's getting bigger

Around the world, our population is aging rapidly. One out of every ten persons is now 60 years or above; by 2050, one out of five will be 60 years or older; and by 2150, one out of three persons will be 60 years or older. In Canada, it is projected that by the year 2031, 23% of the population will be over age 65.

The term seniors covers a large number of people aged 65 and over, with as much variation of abilities, circumstances and level of independence as in the Canadian population as a whole. Individual ability varies a lot and may not have much to do with calendar age. Some people do not function very well at age 60, while others are active and involved at 90.

What can happen to seniors during emergencies?

Despite the growth in the number and proportion of older persons in our society, some seniors face specific challenges that become more difficult during emergency situations:

• Physical challenges


Many seniors have physical disabilities or conditions that affect their mobility and agility. The Division of Aging and Seniors states that by age 85, about one half of Canadians experience at least one disability in relation to sight, hearing, cognition, mobility or manual dexterity.

During an emergency, it may be difficult, or even impossible, for some seniors to evacuate quickly if they use wheelchairs or walkers. Those who have trouble hearing, seeing or understanding may miss emergency instructions. Special measures may be needed to ensure seniors evacuate safely and receive adequate care during this period.


• Living situation


Many seniors live apart from their families. For those who are isolated and lack social networks, an emergency could mean that they could be without help.

For example, if transportation and communications systems break down during an emergency, and regular homecare services suddenly stop, seniors without family or community supports may be left stranded without food or medical care and not knowing how to get help. In this respect, there is an important need to identify and link seniors to emergency health and social services before disasters so that adequate assistance will be available.


• Economic hardship


Seniors with low incomes are particularly at risk. According to a recent report by the National Advisory Council on Aging, a number of Canadian seniors are living on or near the poverty line, particularly those living alone, women over age 80, visible minorities and immigrants. Many of these seniors are dependent on supports such as social assistance, housing, food, prescription medications and drop-in programs.

During an emergency, these types of supports may be unavailable for a period of time and this group of seniors has fewer options for temporary care, such as moving to another community or to a hotel. Seniors may thus be in particular need for emergency health and emergency social services, although we know from past disasters they are often reluctant to access available services and become vulnerable in this way as well.


• Place in society


Research coordinated through HelpAge International shows that, despite international protocols, seniors are given low priority and little attention during emergencies.

"Old people can be invisible. In some cases this invisibility is based on ignorance, lack of information," says Alex Kalache of the World Health Organization (WHO).

Seniors also bring many strengths to emergencies

Not all seniors are vulnerable. Indeed, most seniors bring a wealth of life experience that can help both them and their communities prepare for and respond to emergencies and catastrophic events. They often have an emotional resiliency that comes from having lived through life's ups and downs.

"Seniors can be leaders during disasters," says Kym Martin at the Centre for Emergency Preparedness and Response, Public Health Agency of Canada. "They can provide both leadership and capacity during emergencies."

Her colleague, Dr. Dave Hutton, agrees. "Seniors have a lot of capacities, experience and wisdom as a group within the community."

What seniors can offer

• Skills and time


Many seniors bring a wealth of knowledge and skills that can help communities rebuild and recover after emergencies and disasters. Seniors serve as volunteers with organizations where they might prepare and deliver food, provide transportation services for less able seniors, or even help rebuild homes after events like floods or hurricanes.


• Community networks


The Vanier Institute of the Family states that 19% of seniors participate in formal volunteer work and 23% provide unpaid care to other seniors. Many are involved in local organizations that reach a broad section of the community. Seniors also report a strong sense of belonging to their local communities. Through their networks, seniors can help to distribute food, check on housebound neighbours, and provide transportation to health care and other services.


• Perspective


According to Dianne Scoffield, Emergency Management Program Co-ordinator at the Ontario Ministry of Community and Social Services, "Seniors have experienced so much in life, they are less apt to be alarmist than younger people. For example, some seniors can remember the last pandemic."

Engaging seniors in the planning process

To protect seniors and the broader community from the effects of a catastrophic event, we need to focus on building healthy communities in which seniors play an active role in planning and decision-making.

Dr. Dave Hutton of the Public Health Agency of Canada talks about the importance of including seniors right from the beginning. "If we just come to seniors and say 'it's time to prepare for the next emergency', this is not nearly as effective as if we ask them to be part of the planning process."

Val Alcock believes that communities need to begin by identifying who the seniors are in each neighbourhood, so that they can be reached in case of emergency. For example, where she lives in Nanaimo, B.C. there is a Telephone Visiting Society that not only helps to address loneliness, but also could connect people in case of an emergency.

Most people agree that communicating with a group as diverse as seniors will require a multi-faceted approach. Some seniors use the Internet regularly, while others never touch a computer. An effective approach to engage seniors will not be a one size fits all. Rather, it will reflect the contributions and needs of the seniors who live in a particular community.

Canada is playing a leadership role

Canada is placing increasing emphasis on seniors and emergency preparedness. Working with international partners, this work recognizes that preparing seniors and other vulnerable populations is a key factor to prepare for and respond to disasters and other emergencies.

Alex Kalache of the World Health Organization commends Canada for the role it has played: "More natural disasters and more older people who are more vulnerable mean that we need more policies to protect them. This is where Canada has had the vision... to prevent problems for a population that is vulnerable while respecting the resiliency of seniors."

This spring, the Public Health Agency of Canada, through its Division of Aging and Seniors, was awarded the International Award for 2006 annual award of Help the Aged, a British charity fighting to free disadvantaged older people in the United Kingdom and overseas from poverty, isolation and neglect. The award was presented by the Queen and accepted by Margaret Gillis, Director of the Agency's Division of Aging and Seniors, as part of the celebrations to honour the Queen's 80th birthday. Margaret Gillis notes that "to be effective, we must work with diverse organizations that serve seniors, including from governmental, health, social and voluntary sectors. Working with Canadian and international partners helps us build our understanding and learn from past experiences."

According to Alex Kalache, "The country that champions the aging cause at the dawn of the 21st century will show vision and leadership in public health globally for years to come. I acknowledge gratefully that as far as WHO stands, Canada is firmly playing such a role."