Vulnerable Residents Safety at Any Age

Vulnerable Residents

Multifamily residential buildings provide both privacy and community. Privacy, because a recluse in New York City can have almost anything delivered to his door and thus never have to leave the sanctuary of his apartment; and community, because a single retiree in an active adult community in Palm Beach can enjoy the company of his or her peers, as well as the benefits of supportive services and social activities. Population density is what makes co-ops, HOAs and condos ideal living spaces for anyone—including, and perhaps especially, the most vulnerable residents.

Whether we’re talking day-to-day safety or emergency planning, most buildings and HOAs have something on the books to address both standard operating procedures and things like alerts and evacuations. And that’s great if you’re a relatively young, able-bodied resident—but what if you, or a loved one or neighbor, are elderly, or live with a mental or physical handicap, or are a kid with working parents who takes care of younger siblings? Who looks out for the safety of these folks, and makes sure they’re accounted for should a fire, power outage, or other emergency arise? How can boards, managing agents, and residents promote the safety and security of the more vulnerable members of their community, both day-to-day and in emergency situations? What happens during a major weather event? Or an electrical blackout, when power goes off for 24 hours or more?

First, let’s examine who the “vulnerable residents” really are. According to Allan Fraser, senior building code specialist at the National Fire Protection Association based in Quincy, Massachusetts, generally speaking, there are five categories of disability: lack of mobility, impaired vision, deafness or impaired hearing, speech disorders or inabilities, and cognitive disabilities. Each of these categories represents a different challenge when it comes to managing emergency situations. 

Mobility

“Folks with mobility disabilities use one or more devices—things like canes, crutches, manually-operated wheelchairs, scooters—whatever they need to maneuver through their environment,” Fraser explains. Anyone who has difficulty walking—or indeed, is even extremely uncoordinated—is considered disabled in this way for our purposes. “A mobility disability can be an issue with any part of a body. Maybe you can’t open doors, or you can’t go down stairs, you can’t press keypads, whatever that might be.”

An important consideration here is that not all mobility issues are obvious to the eye. Fraser himself mentions this when he gives lectures on the subject. “I played hockey in high school and college and have had operations on both knees,” he says. “So if I had to run down 10 or 12 flights of stairs in a hotel, I couldn’t run. It might take me too long—and you can’t see that. I also happen to be Type II diabetic as I’ve gotten older, and what else you can’t see is I had heart surgery in 2007 and I’ve got two stents in my heart.” In his case—and there are many, many more like him—someone who looks perfectly able to walk down 70 flights of stairs may have extreme difficulty doing so.

Vision

“When you get into blindness or low vision, that includes people with partial or total vision loss,” Fraser says. “Some people with this disability can distinguish light and dark, sharply contrasting colors, and very large print, but can’t read small print and have trouble negotiating dimly lit spaces, or tolerating hard glare.”

In World War I, groups of soldiers blinded by chemical weapons made it to relative safety by putting their hands on the shoulders of the man in front of them. Like snakes, they slowly made their way to where they needed to be. That is an extreme example of course, but for the visually impaired, the way to move in an emergency remains the same.

“Many people who are blind depend on their sense of touch and their sense of hearing to perceive their environment, what’s around them,” Fraser says. “There’s a risk that a person with a visual impairment could miss a visual cue such as a new obstruction that occurred during the event that could affect egress, so if something falls off a wall of a building or gets moved because of an earthquake, they’re not going to see it.”

Less dramatically, there’s also the possibility that a visually challenged resident will not be able to read certain handouts. “If you’re handing out information, it needs to be in multiple formats. So you can’t hand someone an 8 ½” x 11” piece of paper with 12-point font on it and say, ‘Well now I gave this to all the residents.’ It needs to be available in large print, and probably in Braille.”

Hearing

This category includes the deaf, and also those with partial hearing. The latter often use a combination of lip-reading and hearing aids to understand spoken communication; both of these are often disrupted during emergencies.

“If you’ve got fire alarms going off, you’ve got sirens going off, it can seriously affect whatever hearing they have,” Fraser says. “People who are deaf or hard of hearing must rely on reading for information, and must be able to clearly see the face of the person who’s speaking if they’re lip-reading. Those who use sign language—and, by the way, American Sign Language is the third most common language in this country, behind English and Spanish!—so people who are hard of hearing or deaf may have difficulty understanding oral communication or receiving notifications by equipment that is exclusively auditory, such as telephones, fire alarms, or public distress systems.”

Let’s say the building is being evacuated because of an earthquake. If the super gestures to his left and says, “Don’t go that way,” how will this be interpreted by a deaf person? “People who are more visual than they are auditory, that’s the way they’re likely going to go, even though I said don’t go that way,” Fraser says. The messages have to be phrased to avoid negatives.

Speech and Cognitive Impairments

Obviously, a speech disability would not hamper a person’s ability to shimmy out a fire escape, or quickly descend ten flights of stairs. But a speech impairment is still relevant to this discussion. 

“One example that’s very clear is telephones in an elevator,” Fraser says. “Say the elevator gets jammed, the person gets stuck, they pick up that phone and can’t tell anybody what’s going on. So that can be an issue.”

Cognitive impairments, Fraser explains, can be caused by a wide range of conditions, including but not limited to: developmental disabilities, multiple sclerosis, depression, alcoholism, Alzheimer’s, Parkinson’s, traumatic brain injury, chronic fatigue, stroke, and some psychiatric conditions. “All result in the decrease in ability to process and understand information,” he says. “They impair a person from accessing building features due to the inability to process and understand the information necessary to use those features.”

Helping Out 

So how to plan for everyone in your building—regardless of age or physical limitation? 

“One of the things I say that should be done is emergency contacts,” says Susan Birenbaum, founder of  Humanittude, a national organization that deals with issues for seniors. “Every building should have a list of emergency contacts for individuals – and on this list should be an indicator of whether people need emergency assistance. Whether there’s a need for a wheelchair, or if they have young children or older adults, or children with special needs. Everyone should be aware of this, and everyone should have this list.”

As for what to do with this information, management and legal pros caution that identifying who might need additional help doesn’t mean that an association manager or building staff member bears direct responsibility for physically rescuing or otherwise rendering aid in a time of crisis. Boards and HOAs can take the lead in having emergency contact lists, making sure vulnerable residents are accounted for during an emergency, and so on, but Steven J. Weil, Ph.D., EA, LCAM, president of Royale Management Services, Inc., in Fort Lauderdale, says there’s a fine line between attempting to provide services, and providing information about services. “As residents get older, if necessary, they should seek additional services which are often provided by the city or county, or through other local outside agencies. While managers should be able to direct those needing help to local services, it is not their job, nor is it up to the association to provide special help. To do so would only create liability for the manager and the association.” 

Crisis management pros advise individuals with conditions that might complicate their evacuation or put them at increased risk during an emergency to make a personal emergency plan that could include picking a ‘buddy’ who will help you as you help them (recall the World War I soldiers).  “Don’t go through an emergency alone,” says one expert. “Ask at least two people to be in your emergency support network — family members, friends, neighbors, caregivers, coworkers, or members of community groups. Remember, you can help and provide comfort to each other in emergencies.” 

Second, write down instructions. “Prewritten cards or text messages can help you share information with your support network or emergency responders during a stressful or uncomfortable situation. You may not have much time to get your message across,” according to the pros. “Phrases can include: I may have difficulty understanding what you are telling me. Please speak slowly and use simple language or pictures. I use a device to communicate. I am deaf and use American Sign Language. Please write down directions. I speak [insert language below].”

Sam Verghese, who until this past September was secretary of the Florida Department of Elder Affairs, also stresses individual responsibility. In the event of a disaster Verghese encourages seniors to pay special attention to personal medical needs. Modern technology makes it possible to have notice of tropical storms and hurricanes well in advance of the actual event. 

He suggests residents prepare a medication list, and obtain a generous supply of all medications as part of an individual emergency kit. When the state is under an executive order or declared emergency it is possible to receive an extra 30-day supply of medications with no price increase. Speak with a pharmacist or a health care provider immediately if you or someone in your care may need extra medication during a storm or evacuation. Other support and supply items like extra batteries for hearing aids and medical devices, extra eyeglasses, and non-prescription drugs should also be included in an emergency kit.

“The former chair of our disability committee,” Fraser recalls, “used a wheelchair more than half his life, and he always said, ‘All people, regardless of their circumstances, have some obligation to be prepared to take action during an emergency and to assume responsibility for their own safety.’ The right way is to go out and train people before a disaster occurs.”

Boards should be aware of the legal limitations in regard how they should provide help. “The Americans with Disabilities Act (ADA) requires that reasonable accommodations be made for individuals with disabilities to live, it does not make an association or manager into caregivers, or require the association to pay for those accommodations,” says Weil.

The role of management and the board in emergency situations needs to be clear. “We should address the even more important question of just how much an association and its management should provide to those residents in need of special assistance, and whether providing this assistance creates an ongoing obligation as well as legal liability should the association, or manager, be unable to provide the assistance when needed,” says Weil.

Emergency Resources

Experts advise that associations should check community resources and provide a list to all residents to address this specific part of a disaster plan. The South Florida area has a rich reserve of helping agencies.

“The First Call for Help is 211 provides professional information and referral specialists to work with callers to assess their needs, determine their options, provide appropriate programs or services, give support, intervene in crisis situations, and advocate for the caller as needed,” says Weil. He also recommends the Florida Department of Elder Affairs for various programs and services.

Weil also references the non-profit Aging and Disability Resource Center of Broward County as a “one-stop” resource for information on services for seniors, persons with severe and persistent mental illness ages 18 and older, as well as information and support for families and caregivers. Another non-profit resource is the File of Life. This group distributes wallet cards and refrigerator magnets designed to assist firefighters and medical personnel in quickly assessing an individual’s vital health information. Other services such as Life Alert, transportation and companion services, and local Meals on Wheels programs are excellent resources.                  

Greg Olear is a freelance writer and novelist and a frequent contributor to The South Florida Cooperator. 

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