This is the 100th article I’ve published.

For a milestone like that, the topic should mean something.

This one does.

If there is a population that Community Risk Reduction consistently underserves — not for lack of caring, but for lack of depth — it is elderly and mobility-challenged residents. We address them. We think about them. We build programs around them.

But we usually stop at fall prevention.

And fall prevention, as important as it is, is only the beginning of what this population needs from a well-designed CRR program.

I want to thank Ret. Chief Ken Kehmna for much of the inspiration of this article. At the 2026 IAFC CRRL Conference, he gave an impactful presentation related to this topic.

The Data Is Stark and Getting Worse

Before discussing what CRR programs are missing, the baseline risk picture needs to be established clearly — because the numbers are more alarming than most departments fully appreciate.

In 2023, individuals ages 85 and over were 3.4 times more likely to die in a fire than the general population, while those adults ages 65 to 74 were 2.2 times more likely to suffer fire-related deaths. The fire death rate for older adults ages 65 to 74 increased 41 percent over the ten-year period ending in 2023. FEMA

 

The presentation data from the IAFC Community Risk Reduction Leadership Conference deepens this picture further. Adults 65 and older represent approximately 13 percent of the U.S. population but account for 32 percent of residential fire deaths — a five-times over-representation relative to their population share. That figure has been trending in the wrong direction for a decade.

The 2025 Los Angeles wildfires put a devastating human face on these statistics. During the Eaton wildfire in January 2025, the average age of those who died was 77. Similarly, during Hurricane Katrina in 2005, 71 percent of the fatalities in Louisiana were individuals over the age of 60, and approximately half were 75 years old or older. These are not anomalies. They are a pattern — and patterns have causes that can be addressed. nih

The presentation data from the IAFC CRRL Conference adds another dimension: the death rate among people with disabilities during disasters is two to four times higher than the general population. Disability and age are the strongest predictors of who dies. This is not widely enough understood in the fire service, and it shapes everything about how CRR programs for this population should be designed.

The Notification Gap Nobody Is Talking About

Ask most fire departments how they reach elderly residents during an emergency and the answer involves alert systems, mass notifications, and social media.

Those systems work well for much of the population.

They work poorly for a significant portion of the elderly population — and that gap is one of the most consequential failures in emergency communication that CRR programs can address.

Consider what actually happens when an emergency alert goes out to an elderly resident living alone.

The phone is on silent. She silenced it at church two weeks ago and never changed it back. The alert goes unheard.

The phone is in another room. He is hard of hearing and does not hear it vibrate. The alert goes unread.

The notification arrives as a text message. She has a smartphone her grandchildren set up for her but rarely checks it and does not understand how emergency alerts work on it. The alert goes unacted upon.

The wireless emergency alert fires. He has removed the battery from the phone because it no longer holds a charge well and he primarily uses it for calls only. The alert never arrives.

The notification system calls the landline. She is in the backyard. Nobody answers. No callback system triggers a secondary attempt.

None of these scenarios involves negligence or failure of the alert system itself. They involve the reality of how elderly residents interact — or fail to interact — with the communication technologies that emergency systems are built around.

Two-thirds of adults 70 years and older have a clinically significant hearing loss, increasing to more than 95 percent among individuals 90 years and older. Hearing loss does not just affect the ability to hear an alarm or a notification — it affects the ability to process spoken emergency instructions, communicate needs to responders, and make rapid decisions under stress. PubMed Central

The presentation data from the CRRL Conference is even more specific about the time dimension of this problem. Research shows that in a fast-moving wildfire, the general population departs approximately 17 minutes from an alert, while elderly and access-and-functional-needs residents depart at approximately 60 minutes — a 43-minute gap. In a fast-moving fire, that gap is often lethal. It is not a gap caused by stubbornness or poor judgment. It is caused by a combination of notification failure, pre-evacuation delay, and the physical and logistical realities of evacuating when mobility is limited.

The Pre-Evacuation Delay Problem

Physical movement speed is only part of the problem. Getting started is where the biggest time penalties accumulate for elderly and mobility-challenged residents.

Before leaving, this population typically must manage tasks that the general population either handles quickly or does not face at all. Medications must be gathered — often from multiple locations, in correct doses, with adequate supply for an unknown duration. Medical equipment must be prepared for transport: oxygen concentrators, CPAP machines, mobility aids, hospital-grade beds. Arrangements must be made for pets, which for many elderly residents living alone represent a critical emotional anchor that significantly affects willingness to evacuate without them.

For residents with cognitive decline — and cognitive impairment affects up to a third of adults 85 and older — the cognitive load of an emergency situation may be overwhelming in ways that further delay or prevent action. Decision-making under stress is difficult for everyone. For someone experiencing early or moderate dementia, an unexpected emergency notification can produce confusion, fear, and paralysis rather than action.

Transportation is another compounding factor. Older adults with disabilities face significant barriers to evacuation. Public transportation options may be limited, inaccessible, or not designed to accommodate individuals with mobility aids, while private transportation may not be available or affordable. The reliance on family or caregivers for transportation can create delays, particularly in situations where these individuals are unavailable or unaware of the urgency. Ucla

The presentation data frames this as a system failure, not an individual failure — and that framing matters for how CRR programs approach it. Zone-based evacuation technology with AFN registry integration is described not as a feature enhancement but as an evidence-based response to a documented, preventable cause of mass fatality. This is not a technology discussion. It is a life-safety discussion.

 

Beyond Fall Prevention: The Risk Categories CRR Programs Are Missing

Fall prevention is important and should remain a component of any CRR program serving elderly populations. But it is one category of risk within a much larger landscape that CRR programs rarely address comprehensively.

Medication management is a significant and under addressed risk factor. Polypharmacy — the use of multiple medications simultaneously, which is common in elderly populations — creates fire risk through sedation, impaired judgment, reduced reaction time, and the physical hazards of medication storage and administration. It also creates emergency preparedness challenges when residents cannot quickly identify and gather essential medications during an evacuation. Fire departments that have built relationships with pharmacists and primary care providers through CRR partnerships have a significant advantage in identifying and addressing this risk.

Medical oxygen use substantially changes the fire risk profile of any home. Homes with supplemental oxygen have elevated ignition risk, accelerated fire behavior, and residents who may be physically unable to move quickly regardless of how much warning they receive. These homes are knowable in advance. They should be known, flagged, and included in pre-incident planning — and yet many departments have no systematic process for identifying them through CRR outreach.

Cognitive impairment deserves specific attention beyond what it receives in most CRR programs. A resident with mild cognitive decline may appear fully capable during a routine home safety visit and be entirely unable to execute an emergency plan under the stress of an actual emergency. CRR programs that rely exclusively on resident self-report to assess cognitive capacity are systematically missing this risk. Partnerships with primary care providers, home health agencies, and social services — the kinds of stakeholder relationships discussed earlier in this series — are the most practical path to identifying residents whose cognitive status creates genuine emergency response challenges.

Social isolation is both a risk factor and an amplifier of every other risk on this list. The majority of those who died in the Los Angeles wildfires were disabled and elderly residents. Many lived alone, with limited social networks and limited connection to the formal and informal support systems that help people navigate emergencies. A resident with no one checking on them during a major emergency is a resident who may not receive the help they need until it is too late. CRR programs that include systematic outreach to socially isolated elderly residents — through senior centers, faith communities, home health agencies, and neighborhood programs — are addressing one of the most consequential risk factors this population faces. Prism

Utility dependence creates emergency vulnerabilities that standard CRR programs rarely account for. Residents who depend on electrically powered medical equipment — oxygen concentrators, ventilators, infusion pumps, power wheelchairs — face life-threatening risk during extended power outages. They may not know how long backup power will last, may not have battery backups, and may not have notified their utility provider of their status. CRR outreach that connects these residents with utility special needs programs and emergency backup planning resources addresses a gap that standard preparedness messaging entirely misses.

Shelter access is a problem that emerges clearly during disaster response but that CRR programs can help address in advance. Residents arriving in hospital gowns, needing oxygen, requiring catheter care, or using wheelchairs often find that general population shelters are not equipped to meet their needs — and that the specialized shelter resources that do exist were not part of their pre-incident planning. CRR outreach that connects mobility-challenged residents with the specialized shelter resources available in their jurisdiction, in advance of any emergency, meaningfully improves the probability that they will get appropriate care when they need it.

The Growing Overlap Problem

The presentation data from the CRRL Conference highlights a geographic trend that dramatically increases the urgency of this issue: elderly populations are growing fastest in high-risk wildfire zones.

Census data from 2010 to 2020 shows that 87 percent of population growth in moderate-to-high wildfire risk areas was among adults 60 and older. The populations most vulnerable to emergency notification failures, evacuation delays, and disaster fatalities are concentrating in the areas facing the highest and fastest-moving hazard threats.

This is not a future problem. It is a current one that is accelerating. CRR programs that have not specifically assessed the intersection of elderly population concentration and hazard exposure in their communities are missing one of the most consequential risk patterns in their jurisdiction.

What CRR Programs Can Actually Do

The breadth of what this population needs can feel overwhelming. It should not produce paralysis — it should produce prioritization, and that prioritization should start with a Community Risk Assessment that specifically examines where elderly and mobility-challenged residents are concentrated, what specific risk factors they face, and what the gaps are between those risk factors and current prevention and response capability.

From that foundation, practical steps follow.

Registries of residents with access and functional needs — including mobility limitations, medical equipment dependence, cognitive impairment, and social isolation — allow departments to pre-position knowledge that makes both prevention and response more effective. Building these registries requires partnerships with social services, home health agencies, utilities, and healthcare providers. It requires intentional outreach to populations that do not self-identify. And it requires ongoing maintenance, because an AFN registry that is two years out of date may be worse than no registry at all.

Communication strategies for this population cannot rely exclusively on smartphone-based alert systems. They must include redundancy: door-to-door welfare checks pre-positioned for high-risk zones, neighbor notification programs, landline callbacks, partnerships with home health aides and visiting nurses who can serve as emergency communication nodes, and direct relationships with facilities serving concentrated elderly populations.

Home safety assessments for this population need to go beyond the standard checklist. They need to incorporate medication storage, medical equipment, egress capabilities given actual mobility, oxygen use, and honest assessment of whether the resident has a realistic evacuation plan given their physical and cognitive capacity. Virtual CRR tools that deliver structured, room-by-room assessments to residents in their homes — and that collect standardized data that can inform both individual risk reduction and community-wide risk intelligence — can extend this capacity significantly beyond what in-person visit programs alone can achieve.

Partnerships with healthcare providers are not optional for a CRR program that genuinely intends to serve this population. Physicians, pharmacists, home health nurses, and social workers have visibility into resident risk factors that fire departments will never independently develop. Building those partnerships, establishing referral pathways in both directions, and creating shared understanding of each partner’s role in risk reduction is some of the highest-value work a CRR program serving an aging community can do.

The Standard We Should Hold Ourselves To

The data is clear. The patterns are documented. The LA fires, Hurricane Katrina, the Camp Fire, and dozens of other disasters have produced the same finding in different communities across different hazard types: elderly and mobility-challenged residents die at rates far exceeding their share of the population, and the factors driving those deaths are knowable, addressable, and frequently not being addressed.

CRR programs that stop at fall prevention are doing something meaningful.

But they are not doing enough.

The population that is most at risk from fire, most at risk from delayed notification, most at risk from evacuation barriers, and most at risk from disasters of every type deserves a CRR response that matches the scale and complexity of the risk they face.

Building that response requires honest assessment of what current programs are and are not reaching, genuine partnership with the organizations and agencies that serve this population daily, and a commitment to treating elderly and mobility-challenged residents not as a checkbox on a prevention program — but as the population whose safety may most directly reflect the quality of our CRR work.

A hundred articles into this conversation, that feels like the right thing to say.

Brent Faulkner, MAM, FO, is the CEO and Founder of Virtual CRR Inc.
A retired Battalion Chief from Anaheim Fire & Rescue, Brent brings 28 years of fire service experience, including leadership in structure fires, wildland operations, hazardous materials response, EMS incidents, and specialized rescue operations. He also served 17 years on a Type 1 Hazardous Materials Response Team.

A defining moment in Brent’s career came while leading Critical Infrastructure Protection (CIP) efforts at a DHS-recognized Terrorism Fusion Center. There, he oversaw initiatives to safeguard critical infrastructure from terrorism, natural disasters, and emerging threats — an experience that shaped his passion for Community Risk Reduction and ultimately led to the creation of Virtual CRR.

Brent holds a Master’s Degree in Management, a Bachelor’s in Occupational Studies, and Associate Degrees in Hazardous Materials Response and Fire Science.