THE IMPACT OF HURRICANES IRMA AND MARIA ON THE BEHAVIOR AND MOOD OF PEOPLE WITH ALZHEIMER’S DISEASE IN PUERTO RICO

摘要

People with Alzheimer’s disease (AD) have very particular needs in terms of their pharmacologic and non-pharmacologic treatment. Under normal circumstances, these needs present daunting challenges for caregivers. Under emergency situations, such as natural disasters, these challenges become even more daunting. Hurricanes Irma and Maria caused catastrophic damage in Puerto Rico (PR) in September, 2017. We sought to share our experiences, as clinicians and caregivers, about the changes in behavioral and mood symptoms of people with AD in PR in the aftermath of these hurricanes. The authors systematically gathered observations from their clinics and caregiving centers on the impact of these natural disasters on the behavior of their patients with AD, as informed by their caregivers. A massive power outage impacted the whole island, leaving most of the population without electricity for months, and without telecommunications and road access for weeks. Many basic needs of patients went unmet for weeks or months. Rapid changes in mood, restlessness, increased anxiety, irritability, hostility, disorientation and rapid decline in cognitive function were the symptoms most often seen in patients, more so when they AD had to be evacuated and/or re-located. The effect of hurricanes seen on people with AD and their caregivers highlight the need for better preparation for natural disasters. Caregivers should plan in advance strategies to minimize impact. Detailed planning is the key point, followed by prevention before, during and after the disaster to minimize the behavioral and mood symptoms observed, which were very challenging for caregivers.