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Concepts in Disaster Medicine

SWiFT: A Rapid Triage Tool for Vulnerable Older Adults in Disaster Situations

Carmel B. Dyer, MD, Mor Regev, BA, Jason Burnett, MS, Nicolo Festa, MSW and Beth Cloyd, RN, MBA

Address correspondence and reprint requests to Carmel B. Dyer, MD, Director, Division of Geriatric Medicine, University of Texas Medical School at Houston, 6431 Fannin Street, Suite 4.200, Houston, TX 77030 (e-mail: carmel.b.dyer{at}uth.tmc.edu).

Background: In 2005, Hurricane Katrina caused extensive damage to parts of Mississippi, Louisiana, and Alabama, causing many people, including vulnerable older adults, to evacuate to safe surroundings. Approximately 23,000 evacuees—many of them 65 years old or older, frail, and lacking family to advocate for their care—arrived at the Reliant Astrodome Complex in Houston, Texas. There was no method for assessing the immediate and long-term needs of this vulnerable population.

Methods: A 13-item rapid needs assessment tool was piloted on 228 evacuees 65 years old and older by the Seniors Without Families Team (SWiFT), to test the feasibility of triaging vulnerable older adults with medical and mental health needs, financial needs, and/or social needs.

Results: The average age of the individuals triaged was 66.1 ± 12.72 (mean ± standard deviation [SD]) years. Of these, 68% were triaged for medical and or mental health needs, 18% were triaged for financial assistance, and 4% were triaged for social assistance. More than half of the SWiFT-triaged older adults reported having hypertension.

Conclusions: The SWiFT tool is a feasible approach for triaging vulnerable older adults and provides a rapid determination of the level of need or assistance necessary for vulnerable older people during disasters. The tool was only piloted, thus further testing to determine reliability and validity is necessary. Potentially important implications for using such a tool and suggestions for preparing for and responding to disaster situations in which vulnerable older adults are involved are provided.

Key Words: disaster relief • vulnerable older adults • Hurricane Katrina