The month of November is just a day away, and traditionally it marks the beginning of the holiday season. There is nothing more traditional in New England than a warm house as the winter snows pile up outside. According to the National Weather Service, the average temperature drops 10 degrees from 57 on the first to an average of 47 degrees by the end of the month, which means that indoor heating season begins in earnest, and unfortunately, as the temperature decreases, the risk of house fires increases as do the fatalities -- dramatically.
Fire deaths from December through February run more than twice as high as those between June and August, reports the National Fire Protection Association, and there is no group more affected by these tragedies than our seniors.
Older adults over the age of 65 are the fastest-growing segment of the American population. More than 1,200 Americans over the age of 65 die as a result of fire each year. Older adults comprise more than 25 percent of fire deaths of all ages, and 30 percent of fire deaths that occur in the home. For those over the age of 75, the death rate is double the national average and for those over 85, the rate is four times the national average. So the next logical question is, why?
Physical and Cognitive Changes
Every adult, as they age, begins to experience changes both physically and cognitively. Aging body organs begin to decline starting at the cellular level. Probably the most drastic loss is to the body's homeostatic systems -- those that control balance and recovery from illnesses and injuries.
"Seniors who suffer burn injuries in home fires face the danger of a fatal outcome more than younger individuals for a number of reasons associated with the aging process," said certified elder law attorney RJ Connelly III. "Aging results in less body water being present, there are issues with skin elasticity, and slower healing, in general, can lead to infection and eventually death." In fact, because seniors often suffer from conditions that cause a lack of sensitivity (like neuropathy) that leads to a reduction of pain sensations, they may not seek medical help until much later and often when others convince them to do so. "Medical providers say that because the elderly put off treatment, fatalities increase 500 percent for those who suffer burns and delay treatment for two to five hours, allowing for infection to get a head start," said Connelly.
Impairments of the sensory systems are also another contributor to fire deaths. Again, age tends to diminish vision, hearing, depth perception, the sense of smell, and balance. This leads to an increased vulnerability in this age group. For example, the inability to detect smoke as rapidly as someone younger leads to more smoke inhalation deaths.
Neurological disorders like dementia have been shown to increase an older adult's vulnerability to being injured or killed in a fire. Alzheimer's disease, which affects one in ten people over the age of 65 and almost half of those over 85, can play a huge role in fire injuries. These disorders cause an altered level of awareness in their victims and as a result, they may not be able to recognize and comprehend the dangers posed by a fire or how to escape the danger.
While depression is not normally a part of the aging process, there is a strong correlation between serious health conditions and this mood disorder. As an example, nearly a quarter of those who suffer a stroke will also be diagnosed with clinical depression within a year. Chronic illnesses like Alzheimer's, Parkinson's, heart disease, cancer, and arthritis have all been associated with the onset of depression. The ongoing pandemic and social isolation have also triggered an increase in depression among seniors. However, this is not a blog about mood disorders, so just how is depression linked to fire and fire deaths in older adults?
It appears there exists a correlation between depression, alcohol use, and smoking. Seniors who are clinically depressed use more alcohol to treat the symptoms and tend to also smoke cigarettes. Add to this, many of these seniors may be socially isolated meaning that no one can warn them of the dangers they are facing. Bottom line -- the risks of fire from smoking increase when combined with alcohol use and depression. Be aware.
"Older adults over the age of 65 receive 35 percent of all prescriptions written in the United States," stated Attorney RJ Connelly. "This age group also takes multiple medications at the same time which can cause issues like impaired judgment and drowsiness, exacerbating the age-related balance issues. The result could be starting a fire while smoking or cooking or not having the ability to detect or escape a fire once it starts." Certain medications have also been shown to interfere in the homeostatic helping mechanisms of the body delaying the healing process for those seniors who suffer burns.
A recent survey for that nearly a quarter of seniors over the age of 65 drink at least one alcoholic beverage a day. Combine this with certain medications used by some seniors and the physical and cognitive abilities of that person have been reduced considerably. Again, the risk of accidentally starting a fire increases, and the chances of successfully escaping are greatly diminished.
Fires caused by smoking are the leading cause of deaths for seniors. If a loved one smokes, stress to them the importance of not smoking in bed. Advise them to never leave smoking materials unattended and that all ashtrays that may be in the house are deep and emptied on a regular basis.
Cooking fires are the number one cause of fire injuries among older adults. Emphasize that they must never leave cooking food unattended. If they need to step away, they should turn off the stove. Keep lids nearby so that if the pan catches fire, they can carefully slide the lid on it and turn off the stove. Mount a fire extinguisher in the kitchen, and check the pressure gauge monthly. Also, remind seniors not to wear loose clothing when cooking: a dangling sleeve can easily catch fire. Keep towels and potholders away from the stove. Clean the exhaust hood and the duct over the stove regularly.
Home Health Care
Again, those who work with seniors know that aging in place is now a common goal of many. The pandemic and the concerns about congregate living increased the popularity of this choice. Along with aging in place comes medical issues that must be treated by home health providers. Medical equipment that is now kept in the home can contribute to fires and fire deaths if appropriate care is not taken.
Home oxygen equipment can cause a fire or quickly exacerbate one if the user is a smoker and the proper precautions are not taken. Further, electronic monitoring equipment has the potential to overload electrical circuits in older homes causing a fire. "The best and safest this to do is have a home assessment done by a licensed contractor who can spot potential safety issues," said Attorney Connelly. "Our office has vetted and licensed providers who can do this work."
On a positive note, medical conditions for those aging in place require a move to the first floor of a home. Such a move improves the senior's ability to escape a fire should one start.
There are sociological issues that also play a role in fire risk and fatalities among seniors. Nearly one in five elderly Americans are considered to live in poverty. Living on a fixed income means that many older adults are forced to keep unsafe older appliances in the home (those with frayed cords and lack safety shut-offs), rely on alternate heating sources like old space heaters, and ignore replacing batteries in smoke and carbon monoxide alarms. In such cases, there are programs available that can assist in making sure these seniors are living as safely as possible.
OSCIL has a number of safety programs available for disabled adults. Click on photo to learn more.
Home Safety Awareness
There are some things that we can do to help seniors, one is doing a basic home inspection and being aware of fire hazards and fire safety.
If you are using space heaters to heat areas of your home, here are some things to be aware of:
Make sure the heaters that you purchase are certified by a nationally recognized testing laboratory.
Before using the heater this year, do a close inspection of the device. Look for broken plugs, loose connections and frayed or worn wire.
Make sure your heater has an automatic shutoff in case it tips over. Older heaters do not have this and should be replaced for your safety. With the new generation of space heaters, they are inexpensive and worth the small expenditure.
Plug the heater directly into the outlet. Do not use extension cords.
Do not use space heaters in damp areas such as the bathroom unless they are specifically made for such use
Never leave a space heater unattended
Allow three feet of space around a heater and make sure there are no flammable items in the area
Never use the oven or stove-top burners as heating sources should the furnace malfunction
Here are some other tips;
Check your smoke detectors and carbon monoxide detectors to make sure they are working. These devices need to be replaced on average every five years. Check the date on your detector.
If you are using oxygen tanks or compressors, have a sign on your door stating that such equipment is in use. It can save the life of a first responder!
Cleaning products and hand sanitizers, which are now present in abundance as the result of the pandemic, can sometimes contain flammable products. Keep them away from heat sources or open flames.
If you have a washer and dryer, make sure the dryer lint catcher is checked on a regular basis as well as the dryer venting system
Develop an emergency escape plan. This is especially important for seniors as leaving a dangerous area may take some time if they have a disability. In some cases, labeling the escape route may be a good idea
Have fire extinguishers present and make sure you know how to use them. However, make sure to understand that if the fire is too big, leave the house.
Check old appliance an extension cords
Make sure the main heating system is in good shape and has had its annual cleaning
If there is a fire, remember this;
Don’t try to fight it. Call 911 or go to a neighbor’s residence and ask for help.
Fires grow rapidly, and you could become overwhelmed quickly
Get out fast and stay out. Do not return to gather property
Once you leave the burning area, close the door behind you to prevent a rapid spread.
If the house is filling with smoke, drop to the ground and crawl out. Put your hand over your mouth
If you are trapped, close all the doors between you and the fire and call 911
If you are in elderly housing, don’t use elevators.
If your clothes are on fire, do the following
Don’t run or use your hands to try and pat out the flames. Running fans the flames and can spread the injury to other parts of your body
Drop to the ground and roll
Cover your face with your hands
If you have burns from a fire or a kitchen accident, do the following:
Run the burn under cool water as soon as possible. This stops further damage from occurring
Put a clean towel or rag on the burn.
Do not apply ointment, grease or butter to the burn
No matter how minor the burn is, seniors may have compromised immune systems and an infection could develop rapidly. Seek medical attention as soon as possible after a burn.