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Older people are among the most vulnerable in major disasters. In their aftermath, it is crucial to institute efforts that will maintain a high level of elders' quality of life (QoL). This paper presents QoL assessments of elderly survivors five years after the Bam earthquake in Iran, and evaluates the determinants. A cross-sectional analysis of 210 randomly-selected survivors was carried out in 2008 using the WHOQOL-BREF questionnaire. A comparison of the results with data on the general population showed that experiencing the earthquake may adversely affect psychological dimensions of QoL even five years after, but paradoxically the earthquake resulted in better social relationships in affected communities than in the general population. Lower QoL associated with female gender, higher age, living alone, severe earthquake-related injury, poor quality of living conditions, increased dependency in the activities of daily living, living in an urban area, and being temporarily housed. Recovery experts and donors should carry out long-term monitoring of health status and QoL in disaster-affected communities, with a focus on psychological wellbeing. Intervention programmes that emphasise post-disaster quality of care and satisfactory housing may lead to better QoL of the victims and may shorten the recovery phase. [ABSTRACT FROM PUBLISHER]

Elders have long been recognised as among the most vulnerable people in disaster events. This paper reports a qualitative study of the self-perceived needs of older people in the aftermath of the Bam earthquake in Iran in 2003. A total of 56 people aged from 65 to 88 years were recruited to the study using purposive sampling, including 29 men and 27 women. Six focus group discussions and ten semi-structured individual interviews were conducted. Each focus group involved six to ten people from the cities of Bam and Baravat and their rural suburbs. Content analysis was used to analyse the transcribed data. The analysis identified four major themes among the informants' concerns: inappropriate service delivery, affronts to dignity, feeling insecure and emotional distress. A disaster-prone country like Iran needs to be appropriately prepared with culturally sensitive plans to meet the needs of those who suffer from their effects, not least older people. Emergency relief managers should note that for many older people in a disaster zone, customary forms of relief are neither required nor appropriate, and that their distinctive immediate and long-term needs should be assessed and met. Relief agencies need to be trained to be age-sensitive and should mainstream older people's rights in the planning and implementation of both the response and recovery phases of assistance. [ABSTRACT FROM AUTHOR]