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from Matt Tobia,
Have you ever heard the joke about being nice to your kids because they are going to pick your nursing home? Some people find humor in that,
and it is funny on the surface—but not as amusing
to emergency services personnel. Within those words
there is also a certain irony, an irony that comes from
having spent time in far too many human warehouses.
What are all “those people” doing there? Often, they
are living full and active lives in the safety of a facility
with skilled people dedicated to ensuring dignity,
respect, and compassion. In far too many cases, however, the residents are waiting to die.
Throughout the United States, facilities house tens of
thousands of people who are too feeble or too aged to
care for themselves. These are not the beautiful, well-lit,
and well-managed continuing care communities. These
are one-family dwellings that have been converted into
“assisted living facilities”—places where between four
and 10 individuals are co-located, with the expressed
intent of ensuring end-of-life safety and security. The
problem is that in many states the regulations governing the safety of the individuals are often weak or
absent. Why is this a fire service problem?
Recently, in Baltimore, Maryland, two fires in single-family dwellings claimed five lives ... each. The first
took the lives of children. The second took the lives of
senior citizens. What is the difference? In reality nothing, but in practical terms utilitarian thinkers would
argue that the children’s lives were inherently more
valuable because, as children, there is no way to fully
evaluate (in dollars) what they could have done had
they lived. By contrast, the elderly victims had lived
their lives; their worth as members of our society had
long been empirically calculated. The real difference
is that while both accidental fires could have been
prevented, the fire that claimed the lives of the senior
citizens occurred in a personal board and care home
in a single-family dwelling that looked remarkably like
every other single-family dwelling on the street.
Who speaks for the dead? More importantly, who
speaks for the living? It is not some other agency’s
responsibility—Housing or Social Services. Such agencies are typically grossly understaffed and overextended.
Believe it or not, the reason they are often struggling to
meet their mission is us. That’s right, us. When political
leaders make hard choices to ensure that “public safety”
is maintained, they do so on the backs of agencies
whose mission is triaged as less important. So, it falls
to us as fire service leaders to ensure that we advocate
for those who are least able to advocate for themselves.
In this case, we must work with politicians to pass laws
that strengthen the regulations aimed at keeping at-risk
To do so, we must acknowledge that no fire depart-
ment in this country can ever place enough firefighters
on the front line to prevent all people from dying in
fires. In each of the examples above, the fire depart-
ment arrived in under four minutes, far better than the
national average and absolutely above the reality of most
response profiles in this country. But we simply cannot
get there fast enough. We must also realize that we are
in the most unique position to speak on behalf of those
who cannot speak for themselves. Our uniforms buy
us a level of credibility with decision makers that places
us above other advocates. Our voices are heard more
clearly because of the instant credibility that attends our
positions. We are the experts in firefighting, but our
expertise achieves its greatest value only when we lever-
age it for the safety of those who cannot save themselves.
The next time you respond to one of these personal
care homes, or boarding homes, or “assisted living”
homes, look around. Ask yourself, “If my mother or
father lived here, would she or he be safe? Could they
escape from this place if it caught fire?” If the answer
is no (and far too often it will be), do something about
it. Get involved. At a minimum, engage the owner/
operators in a process whereby you at least provide a
basic safety survey or inspection to reduce potential
sources of fire. Identify these types of homes in your
jurisdiction and ensure that computer-aided dispatch
is updated with premise hazard information relating to the inability of residents to self-rescue. Work
with other agencies in your area to promote model
legislation to provide tax incentives to retroactively
sprinkler properties that provide housing to the elderly
and infirmed. Company officers should identify these
locations to their chiefs and, in turn, chiefs should do
whatever it takes to make them safer.
There is no honor in fighting the fire that could
have been prevented.
Matthew Tobia is an assistant chief with Loudoun County (VA)
Fire and Rescue and is a 29-year veteran of emergency services.
He can be reached at email@example.com.
Hidden in Plain Sight
Personal board and care homes pose
an unmanageable risk for firefighters