Emotional support for older people in a crisis

Emotional stability depends strongly on feeling that you still steer your own life to some extent and on being treated with dignity. For older people who suddenly depend on others in a crisis, exactly this is at stake. Taking decisions away from them without asking increases their sense of helplessness – even when it is well meant.

On top of this come practical obstacles. Without glasses notices can't be read, without a hearing aid announcements are lost, without a walking aid every trip to the toilet becomes a hurdle. Removing such obstacles often reduces anxiety and dependence more than any comforting word.

The WHO guide on psychological first aid names older people as a group that may need special attention. The IASC guidelines also describe protecting particularly vulnerable groups in emergencies. At the same time, older people often bring valuable experience – some have lived through earlier crises or hard times.

Speak respectfully: address the person by name, introduce yourself, make eye contact, speak slowly and clearly. With hearing problems it helps to face the person, avoid background noise and not shout – louder is not necessarily clearer. Never talk to them as to a child.

Ask about practical needs: medication (and whether there is enough), glasses, hearing aid, walking aid, toilet, warmth, food and drink. Repeat important information and write it down in large print if needed – for example the meeting point, time or relatives' phone number.

Involve the person. Let them share decisions and draw on their experience. Offer small tasks if they want them – chopping vegetables, keeping an eye on a child, keeping a list. People who are needed feel less like a burden.

Sudden confusion, disorientation or a marked change in behaviour can be a medical emergency, for example from dehydration, heat or an infection. Older people often feel thirst less strongly and so easily drink too little – especially in heat or under stress. With such changes get medical help; in acute danger call the local emergency number (112 in the EU).

Don't mistake hearing or sight problems for confusion. Someone who doesn't understand a question because they didn't hear it is not confused. First check whether hearing aid and glasses are there and working.

Make sure medication, glasses, hearing aids, walking aids and spare batteries are not left behind during an evacuation. Their absence increases anxiety and dependence. This text gives no nursing or medical advice; questions about medication or care belong with doctors, pharmacies or care services.

Many older people live alone. In a crisis – during a long power cut or a heatwave, for example – they can quickly be cut off if phone and internet fail or they cannot leave their home. Checking in regularly, at the door or by phone, is therefore one of the most effective forms of help.

Help them reach relatives and involve neighbours. A small arrangement in the building (“Who drops in on Mrs M. every day?”) can achieve a lot. Take withdrawal seriously and don't dismiss it as “normal in old age” – it can be a sign of strain, illness or loneliness.

If an older person seems low for a long time, hardly eats any more or talks about not wanting to live any more, they need professional support. In acute danger to themselves or others, immediately call the local emergency number or a local crisis line and do not leave the person alone.

People with dementia are especially vulnerable in crises. Unfamiliar places, noise, many strange faces and changed routines can trigger great restlessness and fear. What helps them is the familiar: known objects, known people, as calm an environment as possible.

Speak in simple, short sentences and give one piece of information at a time. Repeat patiently, even if the same question comes often. Don't argue about what is “right” – reassurance matters more than being right.

Involve carers, relatives and doctors. They know the person, their medication and their habits. During an evacuation, someone who knows the person should stay with them if possible, and their name and relatives' contact details should go with them. Preparedness for older relatives is described in more detail in the family-planning entry.