1. Addressing Fire Safety & Emergency Disaster Planning Needs of Older Adults in Northern Manhattan Presented by Douglas Drax, Fire Safety Supervisor, FEMA Grant Elizabeth Alvarado, SW Director Isabella Home & Community Based Services 2010 Emergency Preparedness Annual Meeting June 10, 2010, Castleton, NY Isabella Geriatric Center, Inc. FEMA Grant in conjunction with the Columbia University College of Dental Medicine

2. Isabella Geriatric Center Founded in 1875, Isabella Geriatric Center has been located in Northern Manhattan serving the elderly with low- and middle income section of NYC. It’s on-campus programs include:  A 705-bed nursing facility with programs for restorative rehabilitation, dementia and ventilator care  77 apartments of affordable independent senior housing with daily care services and transportation  A medical model adult day care program for 40 community participants  An on-site medical clinic for nursing home residents

3. Isabella Geriatric Center Isabella’s off-campus, community-based programs include:  A 450-client long-term home health care program and a licensed home care agency which provides training to paraprofessional staff.  A storefront Senior Resource Center whose goal is to help independent seniors and their caregivers with concerns such as benefits; nearly 4,000 clients annually receive free services  Two Naturally Occurring Retirement Community (NORC) programs which reached nearly 1,000 clients in 2009

4. Isabella Geriatric Center’s Upper Manhattan Partnership For Senior Independence (UMPSI)  In 2008, DFTA awarded Isabella as lead agency with 8 other community agencies to provide case management services to more than 1,000 largely homebound persons aged 60 or older in the Northern Manhattan neighborhoods of Washington Heights, Inwood, and Central and West Harlem.  UMPSI is responsible for leading this FEMA-sponsored effort. It is this vulnerable population upon which its Fire Prevention and Emergency & Disaster Planning efforts have been focused.

5. Goal of FEMA Funded Grant: In collaboration between Isabella Geriatric Center(Isabella), Columbia University College of Dental Medicine (CDM) and the Upper Manhattan Partnership for Senior Independence (UMPSI) The Main Goal of the FEMA Funded Project: to diminish potential barriers to accessibility, safety, security and usability of home environments for older people with a focus on fire safety efforts.

6. Why Focus on Fire Safety and Disaster Planning for Seniors More than 1200 American over the age of 65 die as a result of a fire each year. Older adults comprise over 25% of fire deaths of all ages, and 30% of fire deaths that occurs in the homes Residential fires injures an average of 3,000 older adults each year.

7. Our population of Frail Elderly within UMPSI: Older adults, especially those who are largely homebound, are at risk for fire related injury and death because they may: – Experience difficulty ambulating – Have cognitive dysfunction or be forgetful especially in regards to smoking &cooking within the household – Have hearing, smell and vision impairments and use medical devices (e.g. oxygen tanks) that may become a fire hazard

8. Process 1. Fire Safety Team member contacts UMPSI member by phone to elicit consent for a home visit. 2. At the home visit, team members: – assess and document potential fire hazards in the home & emergency disaster planning coding – may include contacting Fire Dept – “CIDS” – develop an Emergency Escape plan for the client – replace fire/CO detector batteries with 10-year lithium versions whenever possible 3. Data are entered into database and reported to the Ombudsperson

9. Home Assessment The fire safety team assesses: – Fire alarms – CO monitors – Batteries (10-year Lithium batteries installed) – Medical devices – Ability to ambulate – Clutter/Safe Steps/Lighting – Fire Escapes – Emergency Escape Plan

10. Role of the Ombudsperson Provide Leadership to the Fire Safety Team Liaison with NYC Fire Department – Determine if client needs to be put on the Critical Information Dispatch System (CIDS) Report – Colliers mansion (a dwelling filled with filth, trash and general refuse, typically as a result of hoarding) Ensure fire alarms, CO detectors and batteries are correctly installed Educates community

11. Results Demographics (N=200) Average Age: 81 years old Age Range: 42 – 102 years old Gender: 74.2% Female 25.6% Male

12. Personal Risk (N = 200)

13. Fire Safety Home Assessment (N = 200)

14. Lessons learned…  Most households do not have working or viable smoke or carbon monoxide (CO) detectors  Are not knowledgeable about Fire Safety & Emergency Disaster  Do not understand their tenant rights

15. Conclusions Homebound seniors aging-in-place are at high risk for fire related emergencies & lack of knowledge on emergency disaster planning: – A high proportion (over 80%) have elevated personal risk and may have difficulty escaping a fire – While most senior homes have functional fire alarms, batteries are typically non-functional – Only a very small proportion of seniors have functional fire extinguishers

16. Conclusions Seniors may have difficulty testing and installing batteries in fire alarms. – Installing ten-year lithium batteries is recommended Fire safety is an important, but often overlooked service, which can easily be incorporated into regular home care practice through good planning and better staff training and community education