The so-called ‘one-in-100-year trauma’ had returned for a second time.
On the evening of Saturday, February 26, after hopes that successive warnings would prove false alarms, Queensland’s Brisbane River swelled beyond capacity, sending waves of brown floodwater across the small town of Oxley, 10 kilometres west of the Brisbane CBD, leaving homes and businesses submerged and caked with sediment.
The home of Tanya Kimber and her 89-year-old mother, Patricia (Pat), was caught up in the deluge, forcing the pair to evacuate to Pat’s son’s house in Mansfield, a 40-minute drive away.
Tanya, who takes responsibility for her mother’s care outside of her full-time work schedule, tells Aged Care News the stress faced by older persons and their carers in times of crisis – especially those with cognitive impairments such as dementia – is unique.
“[As we were evacuating], I was trying to look after my mum who’s got no short term memory,” she says.
“She kept asking… ‘Where are we going? What are we doing?’ She was getting really distressed by the idea of having to move to different places that she’s unfamiliar with, with people that she doesn’t know.
“We were all really stressed out, but having to say to her over and over again what’s happened and what’s going to happen is really, really hard, and it’s hard for her, too, as nothing sticks in her mind.
“So she keeps getting re-traumatised by it, which is really horrible.”
Another flooding event was the last thing Pat needed, after losing her beloved husband only a year earlier.
And although Tanya, as her mother’s carer, tried to maintain a steely resolve in the face of this latest crisis, she couldn’t deny the psychological challenge posed by repeat exposure to the calamity.
“Because we got flooded last time, 11 years ago, [this time, as we were] seeing the floods coming up, we’re sitting in the house, the trauma’s coming back and the anxiety is going through the roof.
“I was basically so full of anxiety that I couldn’t pack.”
Provider says mental health support also important priority
Pat Kimber receives level-four care six times per week through a government subsided Home Care Package, providing care and supervision while Tanya is at work.
Boarding at Pat’s son’s house of course provided much appreciated immediate shelter, however there were a host of issues that came with relocating to a home not specifically fitted-out with the care of an older person in mind.
“My mum is frail and not very mobile, so we have been living in my brother’s house, which is completely unsuitable,” Tanya says.
“She can’t get into the shower. She says it’s hard for her to use the toilet, stairs, everything.”
Michelle Leonard, general manager of My Home Care Group, the company providing Pat’s home care, says that after sending a team to reassess Pat’s new living environment, care was commenced as soon as possible, with continuity of care their top priority.
“These floods have had a devastating effect on these communities, especially our elderly, and they rely on these services for their day to day routine,” she says.
“So trying to keep that routine as normal as possible is vital.”
Acute physical care, including wound care and administering of prescription medications, as well as basic hygiene practices, such as showering and toileting, inevitably comes first.
However, Leonard emphasises the need for providers to also closely attend to their older client’s mental health.
“Some of these people were also affected by the 2011 and 2017 floods, and they’re still fresh in their mind. So, the aftermath is all about making sure that mentally, they’re OK.”
Leonard says that, as aged care providers, their duty of care requires them to re-structure their Home Care Packages to provide social and mental health support where required.
This could include the provision of mental health professions such as psychologists or psychiatrists, but she notes that it could be much simpler; listening to vulnerable clients and their carer’s personal preferences, is vital.
“It is just about that resilience, making sure that [services are] flexible to meet the needs of clients.
“Those needs might be that Patricia and Tanya need to go back to the house, and it might be that they just want to sit out the front and have time to take it all in – and we’re quite happy to provide that support.”
A family sustaining compounded trauma
Pat may not always comprehend the present crisis, but she remembers previous floods – and she has literal scars, too.
Wading through muddy floodwater in 2011, a small scrape on Pat’s leg was compromised, infection fiercely advancing across her delicate, mature skin.
“She ended up with gangrene,” Tanya recalls.
“She was in hospital for six weeks and then in rehab for several weeks. She’s got a big crater in the front of her leg from them just having to cut out dead tissue.”
For Tanya, the toll has been primarily psychological; her home was rebuilt and belongings replaced, but this latest flood has just reignited a trauma barely resolved since the last.
“The flood is the easy bit… It’s the years and years of trauma, and not remembering whether you’ve still got something or not, and worrying about future floods.
“For me, if I see a car that’s the same colour as the flood mud from 2011, I just start getting queasy – and people drive these coloured cars all the time.”
Her parents’ health, she recalls, steadily declined after the last flooding event, marking the inception of her caring duties.
Although there is no way to draw a clear causal link, after enduring years of stress, “fighting with builders” to have their family home rebuilt, Tanya’s father developed dementia.
“My mum has PTSD, and I didn’t recognise what it was,” Tanya recalls.
“She changed completely after the last flood.
“She became very passive. She couldn’t make decisions about anything.
“So we just had to look after her after that.”
A 2015 Cambridge University meta-analysis indicates older adults are 2.11 times more likely to experience post-traumatic stress disorder (PTSD), and 1.73 times more likely to develop adjustment disorder.
Disaster prevention must be prioritised over cure
“There’s no system for catching that,” Tanya says, of the psychological trauma her family sustained after the first flood.
“I’m telling people who’ve been flooded for the first time, you need to find a psychologist and start talking to them now.”
However, Tanya hopes in future, prevention will be prioritised over cure.
“We need the army to come in when floods are coming and get people out beforehand. They need to change the system around and be pre-emptive.”
She questions, furthermore, whether government would consider buying back vulnerable properties, or financially assisting home-owners in the area to renovate their homes to be more flood-resistant – a move out of reach for most low and middle income families.
“It’s an unrealistic thing to go, ‘OK, every house that’s been flooded, [government] should buy it back’, because where’s that money going to come from?
“But… maybe there needs to be incentives for people to move higher up the hill or something, or better incentives to get people to put the houses on stilts.”
Such fiscal support is an underrated, adjacent policy to government subsidised clinical support, as there is a clear link between financial stress and worsening psychological outcomes.
Tanya laments the bizarre fact that whilst displaced residents scramble to find supplementary accommodation, bearing immense stress and feelings of uncertainty along the way, countless holiday homes lay vacant, with their doors open to paying customers only.
“There’s all of these Airbnb houses around sitting empty, because there aren’t any people coming here on holidays … and yet there are people like me and my mother, losing our minds trying to find somewhere to live … and all those older people and their families who’ve got nowhere to go – some living in their cars.
“Like, that’s insane.”
If you know someone in crisis or needs support, please call Lifeline on 13 11 14.