Our Aging Population

By Robert J. O’Brien

One of the most significant challenges facing the EMS system is the increasing number of senior citizens in our communities and the increasing number of calls EMS agencies receive from them. In approximately 20 years, there will be more of our citizens in retirement than in the workforce. Unless EMS providers change their outlook on responses to these customers today, the potential exists of a decline in credibility for many organizations.

As a fire service EMS provider, many of your responses to 911 calls are EMS-related, or are for citizen assists (help someone back in bed). Senior citizens comprise, in most communities, the majority of all patient contacts. Keeping this in mind, EMS providers need to understand the special needs of geriatric patients. These patients are fragile and can have a multitude of medical problems, and they tend to need more medical interventions. But most of all, they require our understanding, patience and compassion.

Some patients use our services so frequently they can become a burden on the 911 system; hence the term “frequent flyer” has become a part of our daily vocabulary. When we encounter frequent flyers, or patients with special needs (home health care, grab bars for showers and toilets, etc.), it is paramount that responders know how to locate local referral services for the patient, or at least attempt to direct family members and friends to an agency or organization that can provide additional services once the patient returns from the hospital. This may be a no-brainer for many, but some fire service organizations and ambulance services haven’t prepared their personnel to handle these situations. Subsequently, the patient, the community, and the 911 system lose.

One thing that frustrates responders more than anything is responding daily to retirement communities, residential care facilities, convalescent hospitals, Alzheimer’s facilities, and frequent flyers. Some personnel have a tendency to make derogatory remarks en route to these calls, or vent to their peers upon returning to quarters. Frustration can be related to the level of care being provided to the patient, the way another EMS provider from another service handled the call, or just the patient. If these types of calls bother you, you might be in the wrong line of work, or maybe its time to transfer to another area of the community where the demographics don’t reflect those mentioned here. Whatever you do, I recommend not taking out your frustration on those present at the call. If you do, I guarantee the fire department or ambulance service will receive a citizen complaint. Most complaints are related to bad attitudes on scene, i.e. making derogatory statements to nurses and or healthcare workers insinuating the response was needless; insinuating that a caregiver contributed to the patient’s demise; approaching the scene with a “why are we here again?” attitude; or treating persons on scene like they are ignorant, second class citizens. With many citizen complaints, your organization may lose its credibility.

Keep in mind, one day you will be old and might need the services you’re now providing. A good rule of thumb is to treat every patient, whether they push a shopping cart or drive a Mercedes Benz, the way you would want to be treated”.

Robert J. O’Brien is the EMS division chief for the Fremont (CA) Fire Department and is a 27-year veteran of the fire service. He is past president of the California Fire Chiefs Association EMS Section. O’Brien has an associate of arts degree in fire science, has fire officer certification with the State of California, and graduated from the Executive Fire Officer Program at the National Fire Academy. He graduated from the Stanford-Foothill paramedic program in 1986 and maintains a California paramedic license.

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