At Gabriel House, the assisted living facility in Fall River where a fire killed nine people Sunday, many of the residents used wheelchairs, walkers or were on oxygen and struggled to escape. The tragedy has renewed long-standing concerns about how older adults and people with disabilities can stay safe during emergencies.
“These are people who were not able to move themselves,” Governor Maura Healey said in a statement following the fire. “They were not mobile themselves. And therefore the work that fire, police and EMS did to get people out is truly amazing.”
Paul Lanzikos, co-founder and coordinator of the volunteer advocacy group Dignity Alliance Massachusetts, said he is “very troubled” by what happened in Fall River, and what it shows about assisted living facilities.
“Today, we’re seeing an increasing number of folks with physical and mobility impairments, as well as significant numbers of folks with cognitive impairments, who are inhabiting assisted living residences, yet the regulations have not kept pace with that.”
Before the fire, work was already underway to improve conditions for longterm care residents. Last year the Legislature created the Assisted Living Residence Commission, which brings together policy makers and industry leaders to make recommendations and improve care across the state. The commission is due to submit a report to the legislature by Aug. 1, but some members, including Lanzikos, hope the commission’s work will be extended to take the fire into account.
The Attorney General’s office is working to create regulations for the first time around consumer protections for assisted living facilities. Sen. Elizabeth Warren has also pushed for more federal oversight.
Dignity Alliance is advocating for more regulations around staffing ratios, which Lanzikos says are too vague now. Current regulations require each facility to have “sufficient” staffing but does mandate a specific ratio.
“We would hope that this tragedy, as bad and as sad as it is, becomes the basis for new regulations here in Massachusetts around life safety and other improvements in assisted living,” Lanzikos said.
Advocates say that families can take steps to make sure their loved ones in assisted living facilities are safe, such as visiting a facility multiple times in both both during the day and at night and talking to staff about safety plans before moving in.
John Ford, an attorney specializing in elder law and a member of Dignity Alliance, has a sister who lives on the third floor of an assisted living facility in Bourne.
“The first question I will ask her is, ‘Have you had a fire drill since you’ve been there?’” Ford said. “I think everybody in the state who has an [assisted living] resident are asking the same questions.”
Fear about other emergencies and climate change
As climate change leads to more intense weather events like wildfires, winter storms, hurricanes and floods, advocates say the problem will only worsen and local governments must do better to include people with disabilities and older adults in their emergency evacuation plans.
Those events highlight the “unique vulnerabilities” of older adults, said Marta Corvelo, president and CEO of Somerville-Cambridge Elder Services. “We just want to make sure that older adults are incorporated into these important discussions because they’re often forgotten. … Their needs are so complex and not one-size-fits-all, which makes it very challenging.”
According to the L.A. Times, one third of the people who died in the Los Angeles wildfires this winter had mobility limitations, and many elderly and disabled residents were “stranded” as evacuations began.
“Unfortunately older adults are still falling to the bottom of the list in terms of individuals that we think of as part of emergency preparedness efforts,” Corvelo said, noting that it can be especially difficult in densely-populated areas like Fall River or Somerville, where many residents live in walkup apartments and high-rises.
Rebecca Morris, a resident of Carlisle, lives alone in an apartment complex for seniors and people with disabilities. She is 71, can’t walk and has several medical conditions that keep her in bed most of the day.
She suggests that people with limited mobility should be proactive and reach out to their local fire department to make sure they are aware of your needs.
“I’m really lucky to live in a town with a fire department that is as good as this one is. … I have lived in other towns and cities and have not had that experience,” she said. “So I think one important thing for people with disabilities is to know where you are, know your local fire department, and make sure they know you.”
Where will they go next?
Public officials and residents’ families have been working to find temporary housing and new placements for residents. The Boston Center for Independent Living has already received an inquiry from a family member displaced in the Fall River fire, said Dan Harris, a BCIL staff member.
Harris said that finding a long-term place to stay after an emergency can be challenging for people with limited mobility.
“We work with folks that are homeless a lot of times and especially if you have some form of physical disability, the shelter system is not accessible,” he said. “If folks have PCAs [personal care attendants] or people that support them with their physical care, those folks are not allowed to go into shelters.”
While many people can rely on friends and family, that may not be an option for this population.
“When you have physical disabilities, when you’re older, it’s more than just finding a kind soul with a couch,” he said.
