One of the primary responsibilities of every fire and EMS department is to understand and best serve the community that supports it. This mission is one of the primary reasons for promoting diversity among department members — to better represent and understand the needs of those served.
But there is one demographic that, with rare exception, will never be included among active firefighters, despite a disproportionate involvement with emergency services agencies. Those are the people in your community who are considered elderly or very old.
On my department, we ran frequent calls involving older people — medical incidents, accidents, service calls, fires. We always did our best even as we complained about repeat callers and tried to be philosophical about seeing so much disability and death.
There were addresses we all knew and dreaded when the tone came in. We made bad jokes sometimes to relieve the stress.
But this was years before we had any real training regarding issues of geriatric health and welfare.
The first training session was set up with staff members from the local senior center. It was a revelation. I can only hope that nowadays such training is standard for all firefighters.
Improved service
There are many things that fire and EMS departments can do to improve quality of care and relationship with their older community members.
They can set up training sessions or informal question-and-answer sessions with local experts such as geriatric social workers, doctors or home health care providers.
They can develop relationships with staff members at care facilities to better understand how emergency services can best work with onsite care providers.
For example, there may be confusion about who will do what if CPR is needed for a resident of such a facility. These are questions that can be asked and answered long before the 911 call is made.
Firefighters and EMS providers can also engage in community education programs for older residents. Such programs might involve fire safety assistance or installation of smoke detectors, for example, or might go further to help people understand what will happen if they call 911.
I remember many people being shocked and dismayed to have firefighters, police officers and paramedics show up with lights and sirens when all they really wanted was a medical transport.
Fortunately, there is more acceptance these days to talk about end-of-life issues. Many older people are well prepared and want their wishes to be honored when that time comes. But they may need to be educated about things such as having DNR orders available for first responders.
Finally, firefighters and EMS providers can do a lot of good for older people just by treating them with respect.
It’s about respect
It’s easy to discount the needs of someone who seems frail or incompetent; it may be tempting to treat all older people as if they are of diminished capacity both mentally and physically. This kind of treatment can be perceived as being very disrespectful even if it is not intended in that way.
So don’t call older people “honey” or “sweetie” just because it is easier than asking for their names. Don’t assume they are OK with you addressing them by their first names either — ask them or another family member for their preferred form of address.
Talk directly to them even if you are not sure they can understand you. Don’t assume they are physically or mentally compromised unless you have clear information that this is the case. Tell them what you are doing and let them participate in the decision-making process.
Early in my fire career, we responded with paramedics to an older woman who had fallen and broken her hip in the entryway of a department store. She was a heavy-set woman in a very awkward position and in a lot of pain.
The paramedic in charge insisted on yelling at the woman when he spoke to her, as if she was hard of hearing. “OK honey,” he yelled, “we’re going to take good care of you.” Then in a low tone of voice he said to the firefighter, “You’d better go get some more people — we’re going to need help lifting her.”
The woman looked him in the eye and said, “Look, I may be fat, but I’m not deaf, OK?”
The paramedic turned purple with embarrassment, as he should have. But it was a lesson for all of us there. Make no assumptions. Treat everyone the way you would want to be treated. Because one of these days, it very well might be you.
This article, originally published in January 2017, has been updated.
