Last April the Institute of Medicine released Retooling for an Aging America: Building the Health Care Workforce. This report points out that there are not enough specialists in geriatric medicine.

There is insufficient training, the specialists that do exist are underpaid and Medicare fails to reimburse for the team care that many elderly patients need. This will affect the 78 million baby boomers that are starting to celebrate their 65th birthday.

There is about one geriatric-certified physician for every 2,500 older Americans. There is high turnover of allied health staff, 71% of nurse aides and 90% of home health aides leaving the job within two years. Health care planners believe that they will be unable to handle the baby boomer geriatric, palliative and hospice needs.

Here are three impacts on fire-based ems:

Residents do not want to move and there are enough seniors to make it economically feasible for aging services to come to them. These apartments and housing developments become de facto assisted living and nursing homes without the protection of fire codes, physician oversight, 24/7 skilled caregivers or fire department awareness. (NORC link)

This may mean an exponential increase in 9-1-1 calls for medical assistance to handle situations that are normally handled by skilled nursing center staff.

Philip McCallion, PhD, from the University of Albany provides an excellent presentation on NORC HERE.

San Diego County discovered that 27% of the injured 45 to 64 year olds seen in the emergency department were due to falls. Falls accounted for 57% of the over 65 year old injuries requiring an emergency department visit. For both age groups, 80% of them will suffer another serious fall within a year.

Fire departments may need to re-calibrate their fall prevention training to serve a larger and more active population. The Centers for Disease Control is a start (HERE).

Peter Drucker, in Managing in the Next Society (2002), speculated that current employees could live beyond the century mark, perhaps to 125. There were 50,454 Americans who were 100 or older when the 91 year old Drucker made this speculation.

Actuarial tables, last calibrated in 2004, indicate that a 65 year old man will live, on average, to 82. A 65 year old female will live, on average, to 85. Geriatric science notes that we become fragile between the ages of 75 and 85 and will need nursing care.

Imagine a fire in a non-sprinklered residential high-rise filled with fragile boomers. Oh, wait a minute, Firegeezer has already covered an early morning highrise fire in Memphis this summer (HERE)

Fire officials are crediting smoke detectors for being the major reason there were no fatalities. The resident of the unit where the fire started was roused by the detector leading to a timely call to the FD. Approx. 75 firefighters responded and the fire was extinguished within 12 minutes. The bulk of the force was devoted to evacuations.

Four of the residents had to be taken out of their apartments and transported to the hospital for smoke inhalation. The youngest was a mere 79 yrs.-old. The others were ages 82, 98 and …… 101.

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How long would it take for you to assemble 75 firefighters on the fireground?

How would you set up the EMS sector?

Taken from my blog post on

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