Sandra Latibeaudiere | Hurricane Melissa exposes vulnerable older adults

Hurricane Melissa’s vastly different human and infrastructural impact between eastern and western Jamaica has continued into the early recovery stages. There is another, far less obvious, disaster divide that is affecting some of the most vulnerable Jamaicans islandwide.

The crisis faced by older adults, whose unique needs, health issues, and inadequate support mechanisms existed long before October 28. The Category 5 hurricane has worsened it considerably, and the gap threatens to open even further during the rebuilding process.

John* is 79 years old and lives alone in Trelawny. He has mobility issues, is blind, and gets some help from the church community with food and washing his clothes. He lost his zinc roof, and his one-room house was flooded. During and after Melissa, the community suffered severe devastation, including damage to the church. In the immediate relief effort, John went unnoticed amid the overwhelming needs of others. It was only because a dedicated volunteer took the initiative to explore less familiar areas that John eventually received the help he needed such as food, clothing, and a tarpaulin.

For John and many seniors, simply accessing services under normal circumstances is a challenge. The chaotic aftermath of Melissa makes these challenges even worse. With limited or no transportation, unreliable communication, or their physical inability to navigate damaged communities, they usually have to wait longer for assistance.

While John’s situation is typically difficult for vulnerable older adults, especially after Melissa, dementia compounds the crisis. A catastrophic disaster like Melissa presents a unique challenge – a physical threat and a cognitive barrier. Cognitive barriers in people with dementia include a gradual loss of memory, reasoning, attention, and language. These changes make everyday tasks, problem-solving, and communication difficult, often leading to confusion, trouble finding words, wandering, restlessness, and challenges with understanding and managing emotions.

Ruby*, a 91-year-old woman with dementia living at home under her daughter’s care, unaware that a Category 5 hurricane was approaching their home in St James. Her confusion and inability to process danger, understand evacuation orders, and recognise storm-related hazards naturally place additional burden on her caregiver, who must make quick decisions to keep them both safe. The daughter recounted: “I felt so overwhelmed, alone and terrified, but I had to act as if everything was fine. if I didn’t, it would cause mommy to become anxious.”

CAREGIVER BURDEN

Studies of caregivers of people with dementia describe caregiver burden as the psychological, physical, financial, and emotional toll associated with this role. They are often called “invisible second patients” because respite is often absent in these circumstances. After Melissa passed, things worsened for them. Their home was destroyed, forcing them into a shelter where routines were disrupted, privacy was limited, and the environment was unfamiliar and noisy — conditions that can be especially distressing for someone living with dementia like Ruby. Unfortunately, Ruby and her daughter are among the over 100 individuals, according to Alvin Gayle, director general of the Office of Disaster Preparedness and Emergency Management ( The Gleaner, December 11) , who continue to reside in temporary shelters in St James.

Dementia is the leading cause of dependency among older adults. A study by Prof Denise Eldemire-Shearer et al in 2015 found that in Jamaica, dementia prevalence among persons 60 years and older was six per cent. It affects both cognitive processes and language abilities, which stem from progressive brain damage. When our brain functions normally, we can filter out unwanted stimuli. A person with dementia has an impaired ability to do this, so they may become overwhelmed by their surroundings. If the environment is very noisy, they might not have even a few minutes to themselves because there is always something happening. Without dementia, we have a higher stress threshold, meaning that we are less likely to break down under pressure. For someone with dementia, they cannot handle as many stresses in daily life before reacting negatively. This may be manifested as crying, shouting, restlessness, or aggressive behaviour.

For individuals living with dementia, maintaining a consistent routine, reducing noise and confusion, and offering reassurance are vital for helping them feel secure and lowering anxiety, agitation, aggression, and wandering. It is crucial to understand that agitation, wandering, and aggressive behaviours often stem from the person’s difficulty in finding the words to express their feelings, needs, and unmet needs (pain, hunger).

LESSONS FROM HURRICANE MELISSA

Hurricane Melissa has become a powerful reminder: disaster preparedness and response must be designed with the most vulnerable in mind. It is not enough to provide care packages — effective support must reflect the specific and often overlapping needs of ageing populations.

To protect older adults, especially those living with cognitive impairments, the systems must prioritise:

• Investing in dementia-friendly shelters — calm, safe, quiet spaces where familiar routines and clear signage can help reduce confusion and distress.

• Caregiver support programmes, giving those who shoulder the emotional and physical burden of care practical help, resources, and respite.

• Accessible evacuation information delivered in formats and simple languages that older adults and cognitively impaired individuals can understand.

• A call for a national older adult registry and monitoring system maintained by the National Council for Senior Citizens. It should include details like parish of residence, living situation (home or care facility), and medical/non-medical needs to ensure that no older adults are left stranded or forgotten amidst the chaos.

• Thoughtfully designed care packages that take into account the health, mobility, and dental limitations of older adults.

These measures are not optional extras; they are essential. If our disaster-preparedness efforts are to protect everyone, they must include the unique challenges faced by older adults and their caregivers. Hurricane Melissa taught us that much. Now, we must act.

*Names changed to protect identity

Sandra Latibeaudiere is a lecturer in the Social Work Unit, University of the West Indies, Mona. Send feedback to sandra.latibeaudiere@uwimona.edu.jm.