When 911 Isn’t Enough

Minnetonka (MN) Fire fills a gap by identifying high-risk repeat call individuals and providing resources

Connecting with the community helps your department provide support for high-risk individuals. (Photos by Jason Stenvold, Glen Lake Photography.)

Connecting with the community helps your department provide support for high-risk individuals. (Photos by Jason Stenvold, Glen Lake Photography.)

Our emergency response system is designed to provide fast, reliable, knowledgeable help in a time of emergency, crisis, or disaster. These situations include fires, personal injury accidents, technical rescue, and medical emergencies, along with numerous other traumatic situations. But after the immediate need is mitigated and the problem is temporarily solved, our first responders leave the scene and go back to the everyday routine parts of their jobs, checking equipment and preparing for the next call. This often leaves our residents with additional needs that are not met because those needs do not appear to be emergent.

Follow-Up Needs

The quality of life follow-up program here at Minnetonka (MN) Fire is designed to fill this gap by identifying individuals who are at a high risk for repeat calls, meeting with them, and providing resources to minimize the risk and prevent further calls. After every call, the fire officer fills out a report; on this report form, there is a check box that, when marked, indicates the need for a follow-up visit from our Fire and Life Safety Division. The need for the follow-up is decided by the crew and officer on the call and includes indicators such as a fall with no hand rails or walking assistance device in the home, a stovetop fire in which the homeowner did not know to use a lid to smother the fire, or a lift in which the caregiver could not move the individual on his own. These are just of few of the many situations that generate a follow-up visit in my department.

During the follow-up visit, a fire and life safety team member meets with the resident in his home to discuss the 911 call and offer various resources to prevent additional emergencies in the home. These resources vary widely and include fall alert devices and emergency entry box information, along with wall grab bar, hand rail, and floor-to-ceiling grab bar resources with the option to have us do the install if requested.

Other resources available include meal delivery, leaf raking, snow shoveling, and other household chores. Some of our favorite resources offer a free consultation in the home by a private company to evaluate needs and provide requested services.

Individual Support

So, let us review four different individuals whom we have supported with our follow-up program.

“John”: John is an older adult in our community who is going through the natural steps of aging. These include some loss of balance, memory, and hearing; decreased mobility; and a general increase in risks related to falls and fires. He lives with his aging wife in a senior condominium association. John is a financially secure individual who has experienced a happy life by all outside observations. But recently, John had fallen a couple of times in his condo, and this included a struggle to get over the threshold of his shower, which is only about five inches high. He had been using the towel bar as a grab bar, but it was not in a convenient place, and it was certainly not secure for supporting a man’s weight. So, John had now fallen in the bathroom, a place with wet surfaces and hard tiles to catch the fall. John’s wife called 911 to ask for assistance in getting John up and off the floor and to assess any medical needs that he may have because of the fall in the bathroom. Fortunately, this time John was not injured and was able to stay home and get into bed for the night. But, our fire crews immediately recognized another need to prevent further falls for John.

On writing the report, the crew lead marked the “yes” box, which indicated that a follow-up visit was necessary to provide some resources for John with the hope that he would not fall again. Within the week, we knocked on John’s door, and he and his wife welcomed us into their home, which almost always happens. Most people are happy to see that someone cares enough to stop by and offer help. After discussing John’s fall and his mobility in the home and assessing the areas that he was having trouble navigating, we decided that a great solution was to order and install a floor-to-ceiling grab bar. With our help, his wife went online and ordered the one best suited to their needs. These are a fabulous, but not well-known, resource to provide stability to those with limited mobility in their homes. They install in minutes and use a tension bar to hold in place between the floor and ceiling, and they can be used anywhere in the home where the ceiling is horizontal and parallel to the floor. I left John’s wife my card and instructions to call when the bar arrived. She called, and we set up a time to do the install. This was more than a year ago, and John has not had to call 911 since.

“Linda”: Linda is an older female adult who lives alone in her single-family home. Linda enjoys her independence, her home, her gardens, and her outings with many friends. One day, Linda found herself in a situation in which she needed to call 911; she had slipped on a puddle created by a melted ice cube on her kitchen floor and had fallen. After several hours on the floor, Linda was able to make it to a phone to dial 911 and ask for help. Fortunately, Linda was only sore but not injured. She was helped to her feet and cleared to stay at home.

Our crew again indicated on the report that a follow up was necessary. Within a few days, my partner rang Linda’s doorbell and indicated that he was there to follow up on her fall from earlier in the week. Again, she quickly invited him into her home. After discussing the fall and what had happened since, she indicated that she had not been able to plant her garden. She indicated that she received great joy from looking at her beautiful flowers out her kitchen window but, without the garden being planted, she had been a little depressed as she did not think she would get it planted this year because of her fall. To make matters worse, because she has been depressed, she has not been going out for coffee with her friends like she regularly does. Our training and education in this area clearly outline the link between falls and general declines in health and other areas. My partner quickly realized that Linda was beginning a downward spiral that would likely continue, and she might not recover if this spiral was not stopped. Linda was not up and about and walking and leaving her home, which in turn contributed to less mobility, which in the end led to the likelihood of more falls. My partner left her with information about various fall alert devices and set her up with a local organization that offered to plant her flowers for free. She used the free service to get her flowers planted, and we have not received another 911 call from Linda.

“Joe”: Joe was about 60 years old and was a quadriplegic living alone in an apartment building. He had been a quadriplegic for more than 30 years because of an accident in his mid-20s. Joe was about the nicest man you would ever meet, gracious and kind, appreciative and unassuming. We received a few 911 calls to his place every year to help him with mobility, always when a caregiver didn’t show up. Despite his disabilities, Joe navigated his home amazingly and provided for himself on a daily basis.

Several years ago, my partner and I were requested to follow up with Joe after one of his 911 calls to investigate his living conditions. What we found was a home that needed some major repairs for Joe to continue living there. Because of his wheelchair, Joe had worn holes through the linoleum in his kitchen floor, which had created small craters that made navigating his wheelchair in his own home nearly impossible. The corners of many of his walls were destroyed all the way through the drywall, and the bathroom needed major cleaning and some grab bars installed. We expressed our concerns to management on Joe’s behalf to make the necessary repairs and changes. It wasn’t easy, but in the end Joe had a tile floor, basically indestructible for a wheelchair; a new oven; fixed walls and corners with indestructible corner covers; and a completely cleaned up bathroom with new grab bars!

Community risk reduction begins with partnership.

Community risk reduction begins with partnership.

“William”: William was a 99-year-old man, and we had been to his home for a few lift assists over the past several months. A follow up was initiated by the crew on a 911 call made from William’s home. I made the follow-up visit two days later, in the morning. The resident’s granddaughter answered the door; I introduced myself and our program and asked how her grandfather was doing, explaining that our crew had been there over the weekend to help him back into bed. She was quick and polite to answer and said, “He hasn’t gotten up since. We have called hospice, and I do not believe he will get up again. He just doesn’t want to get up anymore.” She was not emotional, perhaps prepared, as he had clearly lived a long life at home. My thought was instantly, “Wow, our crews were with him as he took his last steps and no one even knew that would be the case at the time.” We wrapped up our conversation, as she had no further needs. I left, and she thanked me for coming by, stating that her mother just loves the fire department, as we had been there a few times. This case shows that we are not always able to provide a concrete resource to our residents but just knowing that we are the ones who sometimes, even unknowingly, get to take those last steps with a person is one of the little things that make our jobs as firefighters rewarding.

CAP Program

The idea for this program originated about 10 years ago as we began to receive lots of data on our aging population, and we were looking ahead at what we could do to help reduce the fire and fall risk for this population. The data clearly indicated that, for at least the next 30 years, our older adult population was going to grow substantially, and the need for housing, medical care, and emergency services would grow as well.

Our chief was alerted to the Community Assistance Program (CAP) in Phoenix, Arizona. The program is run through the fire department but is staffed by volunteers to provide immediate follow-up services around the clock to those in need. They are called out on the radio by fire crews to provide assistance at calls, which allows the fire and police personnel to get back into service more quickly. These calls range from drownings to murders to sexual assault and more. A team of three of us went to Phoenix from Minnetonka to learn about this valuable program; this included two fire prevention specialists and a member of our Senior Services Department. We spent three days learning about their programs and how they are conducted, what types of training their volunteers receive, and why they do what they do—it was fascinating! Each of us was able to shadow their volunteers for a shift. One of our team members was on a call in which someone had died. He, along with the CAP team members, stayed with the family to help them call a funeral home, answered questions, and waited until the deceased had been removed from the home. Another call, the one I witnessed, involved a young girl who was a victim of sexual assault and had been brought to the local center for sexual assault victims. We stayed with her throughout the entire process and ensured that she had a safe place to be and would be cared for.

Now, the Phoenix population and demographics vary greatly from ours here in Minnetonka. We are a suburb of Minneapolis with just more than 52,000 residents. The greater Phoenix area, which the CAP program covers, has a population of more than 4.5 million people. So, we took what we learned from their complex program of volunteers, recruitment, training, and programming and adapted it to our needs here. We have been providing our program for seven years now.

Overall, we, as a department, feel that our program is a huge success. It helps prevent fires, falls, and other emergencies. It keeps our crews in the station, which is always safer. And our residents love the special attention and hometown feel of having a smiling fire department member care enough to come back to their homes to check up and make sure things are going well and, if they aren’t, to provide valuable advice, resources, and peace of mind to those in need.

By Sara Ahlquist

Sara Ahlquist is a 10-year veteran of the fire service and is a firefighter with the Minnetonka (MN) Fire Department. She began what was a part time job, and it quickly evolved to duty crew shift work. In 2010, Ahlquist was hired as a public educator to create, promote, deliver, sustain, and grow a public education program for the department, all while maintaining her paid-on-call firefighter status. She has Firefighter I and II, HazMat Operations, OEC, First Responder, and Public Educator I certifications. Ahlquist was the 2016 State of Minnesota Vision 20/20 representative as well as an instructor for the Fire and Life Safety I certification in 2017. She also won the 2011 Minnesota Public Safety Service Award for Merit from the North Memorial Hospital system.