Feeding Support Team for Frail, Disabled, or Elderly People during the Early Phase of a Disaster

Abstract

Japan was struck by two catastrophic disasters on March 11, 2011 and on April 16, 2016. The former was the Great East Japan Earthquake (M9.0) and the latter was the Kumamoto Earthquake (M7.0). Most inhabitants in the affected areas of both disasters were forced to live in evacuation centers right after the earthquake. Poor oral hygiene, inactivity, malnourishment, appetite loss, eating problems, and swallowing problems due to lack of support for frail, disabled, or elderly evacuees occur during the early phases after a disaster. Disaster-related sequelae, such as pneumonia and disuse syndrome, may also occur as a result of inappropriate nutritional and physical support. Adequate oral intake and physical activity are important to the quality of life for evacuees. We learned lessons from our experiences of evacuee support after the two disasters, focused on feeding support, which consisted of nutritional and physical care. Our experiences revealed that more rapid intervention is necessary, particularly for frail, disabled, or elderly people. In this study, based on our experiences from the two dreadful disasters in Japan, we propose a new concept of medical assistance after a disaster, the Disaster Feeding Support Team (D-FST). The D-FST is composed of multidisciplinary professionals and provides comprehensive nutritional, physical, and health support. The D-FST also performs interventions for swallowing exercises, activity, health condition, and cognition that are related to eating circumstances. We suggest that D-FSTs are organized nationwide and initiate support activities immediately after the onset of a disaster.

Effect of the 2016 Kumamoto earthquakes on preventable hospital admissions: a retrospective cohort study in Japan

“… 21 Another study reported that too many people were evacuated to the shelters in Kumamoto prefecture and the cramped accommodations left little room to walk between beds. 22 Some of the evacuees in these shelters tried not to move into the shelters. 22 The density of evacuees in shelters may have led to outbreaks of vaccine-preventable ACSCs.…”

“… 22 Some of the evacuees in these shelters tried not to move into the shelters. 22 The density of evacuees in shelters may have led to outbreaks of vaccine-preventable ACSCs. Early intervention can prevent progression of acute ACSCs to more serious conditions.…”

Estimating nutrition intake status of community-dwelling elderly people requiring care in disaster settings: A preliminary cross-sectional survey

“…Disaster rehabilitation (2) and feeding support teams (19) worldwide should better organize efforts to address the large population of elderly survivors with special food intake needs, including those at risk of aspiration solely when consuming regularly distributed emergency foods. Studies have reported the effects of disaster rehabilitation on improvements in physical function, post-traumatic stress disorder, quality of life, and re-employment among disaster victims with various disorders (20).…”

Silent aspiration predicts mortality in older adults with aspiration pneumonia admitted to acute hospitals

“…We also recommend maintenance of activity levels (avoiding hospital‐associated deconditioning) in such patients with poor cough sensitivity, in addition to several drugs, oral care and oral intake. A decline in physical activity might increase the potential risk for decline of expiratory and swallowing muscle strength, resulting in failure to recover from the pneumonia and relapse of the aspiration pneumonia …”

“…A decline in physical activity might increase the potential risk for decline of expiratory and swallowing muscle strength, resulting in failure to recover from the pneumonia 9 and relapse of the aspiration pneumonia. 23 There were some limitations to the study. We excluded patients with consciousness issues.…”