Is everyone notified of this designation? Do they document in detail any emergency responses?

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I googled senior at risk and found there is a website with this name, but it seems to refer more to the over-medication of seniors in institutions. Can you tell us more about your situation? Thanks!
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I have proactively registered with Smart911
I Establish a family safety profile with Smart911 to give emergency responders information before they respond. Smart911 is a national database that gives your 9-1-1 dispatchers and first responders critical-care and rescue information The information is entered through the Smart911 website and if you call 9-1-1 from a Smart911 registered and verified phone, Smart911 automatically makes your information available to your 9-1-1 operator and first responders where the service is installed.
Register at and follow the prompts for creating for Smart Safety Profile.
The prompts/questions are terrific for writing a file of life document to place on you refrigerator or place where the members of the med response team can find the document and take it with them to the hospital.
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My husband who has Parkinson's had to be transported by ambulance to the ER. At that time they asked me his size and mine. They listed him as "senior at risk" because he could have been combative and sent to deputies with the ambulance as a precaution. Once at the hospital he was quite argumentative and I was glad they had sent them.
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Uncle Dave -- Thanks for the info on Smart911. It would have been useful a few years ago when I woke up with pneumonia and could barely talk to the 911 operator. I could only whisper "Can't breathe." Fortunately the operator was still able to direct an ambulance to my home.
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I thought the term "senior at risk" was a generic phrase used to identify those seniors/elderly who: live in a situation where they might not get the assistance they need; are more prone to instability due to falls, medications, low blood sugar, etc.; have a known medical condition such as Parkinsons, prior stroke, etc. which means that the paramedics and hospital need to handle that situation in addition to whatever reason it was that medical intervention was requested; or basically, live alone, are somewhat frail, and if they have not been seen for a day or don't answer the phone, police know to intervene.
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My county emergency has a data base for people that may need extra help. My husband being hard of hearing wouldn't hear an announcement to evacuate. (they come around in the firetruck) So, they have to find a way to tell him. If the electric goes out, they need to know who is on oxygen. Arianne, your address should come up on the 911 screen unless using a cell.
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Stephanie Z posted this on
Defining Elder Abuse and Neglect

Care-giving for people with dementia is stressful to say the least. This is true for both family members and professionals working in long term care settings.

Abuse in the home setting

Add a variety of sometimes problematic family relationships and perhaps the personal stressors of the caregiver or other family members and the potential for neglect and abuse can increase. The problem is that most families don?t understand the potential for abuse or the fact that the most loving caregiver can be guilty of neglect. Most reported family situations appear to involve abuse or neglect which is has not been recognized until the person with dementia has a crisis.

Abuse in long term care

Abuse can also occur in a facility. Even the best of facilities occasionally find an employee who is abusive verbally, physically, even sexually, although that is relatively rare. Residents belongings are also at risk from abusive staff. Therefore families must always monitor what is going on with their LO and immediately report anything suspicious.

The Omnibus Reconciliation Act, which was put into law in 1989 and still in effect today, defines the rights of the elderly in long term care settings, including the right to be free from verbal, physical, and financial abuse. This extends to the inappropriate use of chemical and physical restraints (which can only be used in an emergency and for short periods of time)

Medical professionals are mandated to report suspected abuse. (and so are families and other non professionals in many states) Failure to report can result in loss of professional license, fines and even jail time.

Here is information on what to observe when looking for signs of abuse. (These come from the Elder Assessment Instrument which was created for this purpose. This information may be helpful if you suspect abuse of your LO either by a family member or the staff at a long term care facility.)

Observe the general condition of your LO.

Is their clothing clean and are they dressed according to the environment?

Are your LO?s hygiene needs being met? (Bathing, dental care, incontinence care?} Please consider that some people with dementia resist bathing and families need to learn how to address this.

Are their nutritional needs being met? Needs will change according to stage of the disease. The key is to observe for weight, hydration, redness or irritation on boney prominences as inadequate protein can add to the risk of decubitus ulcers. In the later stages of dementia when a person becomes bedridden and has problems swallowing, weight loss is expected but there should be an assessment of swallowing and adjustment of the diet to accommodate their needs (perhaps finger foods or puree foods and thickened liquids)\

Skin integrity ? Are there decubitus ulcers? Were they avoidable? (Ask a professional to assess this) Are there contractures of the arms and legs and fingers? (Unable to straighten out due to lack of range of motion exercises) Contractures are very preventable, when they occur they are painful to the person and are usually permanent.

Possible Abuse Indicators:

Bruising. Occasional bruises and skin tears will happen in the older adult, especially in the later stages of dementia. However bruises in unusual places (like the middle of the back or stomach, inner thigh, upper arms, etc.) and unexplained bruises that occur regularly, are red flags. These MAY be coming from rough handling or even hitting. These need investigation by the staff and if the explanation is not satisfactory, call APS and let them assess it.

Lacerations and fractures can occur with falls. When this happens, or especially if there is no explanation (ie: no one saw it happen) an investigation should be done by the facility. If an adequate explanation is not given, or this happens more than once, or you are not satisfied with the explanation, call APS and let them assess it.

Evidence of sexual abuse:

The following signs may indicate that your loved one is the victim of sexual abuse in a nursing home:

Unexplained difficulty with walking or sitting

Bruising and/or thumbprints on the inner thighs, genital area, buttocks, and/or breasts

Unexplained vaginal and/or anal bleeding

Unexplained sexually transmitted disease or genital infection

Unexplained genital irritation, injury, and/or redness

Torn, stained, or bloody underclothing

Stained or bloody sheets

Fear, stress, anxiety, or a another strong reaction when a particular person approaches to help with bathing, dressing, or toileting

Please note that sexual abuse can even happen if a spouse is coerceing a partner into unwanted sex.

Statements by your LO that indicate abuse may be taking place. Always investigate even if you believe nothing has happened. It doesn?t hurt to be sure.

Possible Neglect Indicators

The presence of the following may indicate neglect:

Decubitus Contractures Dehydration

Untreated diarrhea Impaction Depression Malnutrition Urine Burns (diaper rash)

Who to notify:

If someone is in immediate danger, call 911 or the local police for immediate help.

If the danger is not immediate, but you suspect that abuse has occurred or is occurring, please tell someone. To report elder abuse, contact the Adult Protective Services (APS) agency in the state where the elder resides. You can find the APS reporting number for each state by visiting:

The State Resources section of the National Center on Elder Abuse website

The Eldercare Locator website

or calling 1-800-677-1116.

If the abuse takes place in a long term care facility, let the administration know, call your Ombudsman and Adult Protective Services.
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There are codes that all that start with a 10 _____that police/EMT's use.
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A-2. California Highway Patrol Radio Codes Radio Code Description
104 Message Received
106 Busy
1013 Advise Road Or Weather Conditions
1014 Provide Escort
1020 Location Requested
1021 Telephone _________
1022 Disregard
1023 Standby
1031 Attempted Suicide
1039 Message Or Item Delivered
1097 On Scene
1098 Assignment Completed
1110 Take A Report
1124 Abandoned Vehicle
1125 Traffic Hazard
1126 Disabled Vehicle
1141 Ambulance Required
1142 Paramedics Required
1144 Possible Fatality
1148 Provide Transportation
1166 Defective Traffic Signals
1179 Accident - Ambulance Responding
1180 Accident - Major Injury
1181 Accident - Minor Injury
1182 Accident - Property Damage
1184 Traffic Control
1185 Tow Truck Required Or Requested
1186 Bomb Threat
1187 Bomb Found
1198 Meet

Communication Codes are as follows:

Code 1: Normal Response (no lights or sirens)
Code 3: Emergency Lights & Sirens
Code 4: Disregard
Code 5: En Route
Code 6: Arrived
Code 10: Known Offender
Code 10C: Known Dangerous Offender
Code 10W: Felony Warrant
Code 10X: Stolen Vehicle

A-4. F.D.N.Y. Radio Codes Radio Code Description
10-1 Call Your Quarters or Other Unit
10-2 Return to Quarters
10-3 Call Dispatcher by Telephone
10-4 Acknowledgement
10-5 Repeat Message
10-6 Stand by
10-7 Verify Address/Location
10-8 In-Service by Radio
This signal is also used when the AT/SP is not in service and a unit is leaving quarters.
Code 1 - Used only by a Division or Battalion to indicate it is in-service by radio when leaving a quarters other than its own at which it had been off the air and to which alarms had been routed.
Code 2 - Used by any unit to indicate it is on the air outside its response area. When the unit returns to its response area, the dispatcher must be notified again using 10-8.
10-9 Off the Air
A unit will be out of radio contact. (State the reason: entering tunnel; visiting quarters; at a fire or emergency, etc.) A 10-8 is to be transmitted, with code if necessary, when contact is re-established.
10-10 Unit Location
A request is made for a unit's location. The unit is to acknowledge by giving its present location.
10-11 Radio Test Count
10-12 Preliminary Report
A request by a chief officer or dispatcher for a preliminary report by the first arriving unit. The dispatcher shall relay the report to the responding units.
10-13 Fire Marshall Needs Assistance
Urgent Assist by NYPD.
10-14 Roster Staffed Engine Company
Use by roster staffed Engine Companies when acknowledging a structural response.
10-18 Return All Units, Except 1 Engine and 1 Ladder
Transmitted for a fire or emergency, when in the judgment of the officer in command, conditions indicate that 1 Engine and 1 Ladder company are required. No further assistance is necessary. If the required unit(s) has not arrived, they will be notified by the dispatcher to continue responding to the location. Other responding units shall return to quarters or previous activity. The Battalion Chief need not continue to the scene after a 10-18 has been transmitted unless he deems it necessary. This decision must be based, in part, on the experience level of the officer transmitting the signal. Battalion Chiefs are to notify the dispatcher that they are 10-8 when not continuing in on a 10-18.
10-19 Return All Units, Except for 1 Engine or Ladder
Transmitted for a fire or emergency, when in the judgment of the officer is command, conditions indicate that 1 Engine or 1 Ladder Company is required. No further assistance is necessary. If the required unit(s) has not arrived they will be notified by the dispatcher to continue responding to the location. Other responding units shall return to quarters or other activity. The Battalion Chief need not continue to the scene after a 10-19 has been transmitted unless he deems in necessary. This decision must be based, in part, on the experience level of the officer transmitting the signal. Battalion Chiefs are to notify the dispatcher that they are 10-8 when not continuing in on a 10-19.
10-20 Proceed at Reduced Speed
No warning devices are to be used and all traffic regulations are to be observed.
10-21 Brush Fire
10-22 Outside Rubbish Fire
10-23 Abandon/Derelict Vehicle Fire (ADV)
A fire in a vehicle which has no value other than salvage and no owner can be located.
10-24 Auto Fire
A fire in a vehicle with plates or in any vehicle having a value greater than that of salvage.
10-25 Manhole or Transformer Vault Fire
Code 1 - Fire has extended from the manhole or conduit into a building.
Code 2 - Fire has blown one or more manhole covers, or smoke is issuing from a manhole under pressure.
Code 3 - Smoke is seeping from a manhole.
10-26 Food on Stove
10-27 Compactor Fire
Fire has not extended from compactor or shaft
10-28 Subway or Railroad System - Fire, Emergency or Smoke Condition (Code Required)
Code 1 - NYCTA.
Code 2 - Other than NYCTA.
10-31 Clogged Incinerator
Fire has not extended from shaft.
10-32 Defective Oil Burner
Fire has not extended from fire box.
10-33 Odor of Smoke
A smoke condition caused by a nearby working fire or fires such as barbecues, salamanders, etc.
10-34 Sprinkler System Emergency
Code 1 - Defective sprinkler device or system (defective alarm valve, broken pipe, etc.)
Code 2 - Unwarranted sprinkler alarm. Not defective (surge in pressure, people working on system, etc.)
Code 3 - Sprinkler has been activated by heat source not associated with an accidental fire.
10-35 Alarm System Emergency
Other than a sprinkler system.
Code 1 - Defective alarm device or system.
Code 2 - Unwarranted alarm. Not defective (accidentally activated by cigarette smoke; low battery, etc.)
Code 3 - Recorded alarm.
10-36 Automobile Emergency
Any type of automobile accident or washdown of a fuel spill.
Code 1 - Washdown
Code 2 - No injury or washdown
Code 3 - Injury
Code 4 - Extrication
10-37 Assist Civilian
First Aid or other call for assistance.
Code 1 - Victim deceased
Code 2 - Victim not breathing
Code 3 - Victim injured
10-38 Carbon Monoxide Response
Code 1 - Detector Activation - Defective, low battery, unwarranted.
Code 2 - Co Incident - Readings from 1 - 9 ppm.
Code 3 - Co Emergency - Readings over 9 ppm.
Code 4 - No detector activation during incident or emergency.
10-40 Gas or Electrical Emergency
Code 1 - Gas Emergency. (Gas main leak; gas leak in structure; effective gas appliance; etc.)
Code 2 - Electrical emergency. (Wires down; sparking fixture; short circuit; etc.)
Code 3 - Water condition.
Code 4 - Steam leak.
Note: Do not use 10-40 where the emergency causes a structural fire.
10-41 Suspicious Fire (Code Required)
Fire Marshall investigation is required.
Code 1 - Occupied Structure or Vehicle. A Structure (commercial, residential, public), or vehicle (car, bus or train) which is occupied at the time of the fire. This also includes a vacant apartment in an occupied building, or a store with a dwelling above.
Code 2 - Unoccupied Structure. A structure (commercial, residential, public) normally occupied which is unoccupied at the time of the fire.
Code 3 - Unoccupied Vehicle. A vehicle (car, bus or train) with or without plates which is unoccupied a the time of the fire.
Code 4 - Vacant Structure. A vacant building or building under construction or demolition. (If there are squatters or workmen in structure, transmit a Code 1.)
10-44 Public Ambulance
A request for a public ambulance. Specify the reason.
10-45 D.O.A. or Serious Injury
Transmitted immediately upon the discovery of a fatality or serious injury at a fire or emergency. This shall be followed as soon as possible with the appropriate Code and the number of victims.
Code 1 - Victim Deceased
Code 2 - Victim suffering serious injury. (Apparently life threatening)
Code 3 - Victim suffering serious injury. (Apparently not life threatening.)
Note: Do not transmit this signal for minor injuries.

Police Response
Police assistance is needed for crowd or traffic control, security, apprehension, etc. (specify reason)

Police Response for Harassment
Firefighters are being harassed an police assistance is needed immediately.

Cancellation of Outside Activities
Transmitted when outside activities are to be canceled. When the conditions that caused suspension of outside activities, the following message will be transmitted by radio, voice alarm and teleprinter: "All units shall resume outside activity forthwith."
10-60 Major Emergency Response
Transmitted for a collapse, airplane crash (except airport crash boxes 0037-LaGuardia Airport, and 0269-Kennedy Airport) train derailment, or similar emergency with the potential for multiple casualties. The following will respond. 3 Engines, 2 Ladders, 3 Rescue Companies (including Rescue with the Collapse Unit) 5 Battalion Chiefs, 1 Tactical Service Unit, HazMat, Field Communications Unit, Squad Company 1 with Technical Response Vehicle, 1 Deputy Chief, 1 Safety Battalion.
10-70 Water Relay Required
A notification that the first arriving engine has no positive water source and a water relay is required.
10-75 Notification of a Fire or Emergency
A notification signal transmitted when, in the judgment of the officer in command, conditions indicate a fire or emergency that requires a total response of the following units: 4 Engines, 2 Ladders, 2 Battalion Chiefs, 1 Rescue Company and Squad Company. Officers transmitting a 10-75 shall also state if it is for a fire or emergency and if a building is involved along with the type of building.
10-76 Notification of a Fire in a High-Rise Building
A notification signal transmitted when, in the judgment of the officer in command, conditions indicate a fire in a high-rise building that requires a total response of the following units: 5 engines (1 is CFR), 5 Ladders (1 is fast), 3 Battalion Chiefs, Engine 3 and High Rise Unit, 1 Deputy Chief, Field Communications Unit, 1 Rescue Company, Mask Service Unit, PIO, Command Post Company, 1 Squad company, 1 Tac unit. (restricted use of Citywide frequency, for operation of the High-Rise repeater.)

High-Rise Multiple Dwelling Fire
High-rise multiple dwelling fire (Response of 5 engines, 5 ladders, 3 battalion chiefs, 1 deputy, 1 rescue, 1 squad, the Special Operations battalion chief, a safety coordinator, transmitted by the Incident Commander after size up and the Safety Operating battalion chief.)
10-80 Hazardous Materials Incident
The Initial notification by field units of a hazardous materials incident. Responders are to proceed with caution to avoid entering a restricted area. Code will transmitted by the Incident Commander after size up and evaluations of the incident.
Code 1 - An incident confined to a small area and which does not pose an immediate threat to life or property. Can be controlled by a unit or units up to and including: 3 Engines, 2 Ladders, and 2 Battalion Chiefs.
Code 2 - An incident involving a greater hazard or larger area which posses a potential threat to life or property. Following units will respond: 3 Engines, 2 Ladders, 2 Battalion Chiefs, 1 Deputy Chief, HazMat Company 1, 1 Safety Battalion and Field Communications Unit.
10-84 Units Arrived at Scene
All units shall immediately transmit a 10-84 by Radio or MDT when arriving at the box of the incident. Other signals should not be given with the 10-84 except where the situation is apparent on arrival. This signal must be followed within 5 minutes by a preliminary report including the appropriate radio code signal or additional information by first arriving unit. Fire commanders and Chiefs within their command are to take necessary steps to insure that units are transmitting the 10-84 signal for responses. Chief officers shall transmit a 10-84 upon their arrival at an alarm.
10-85 Fire Marshall Requires Additional Units
Used for additional units (other than NYPD - See 10-13)
10-86 Foam Operation
Transmitted for a fire or emergency requiring any type of foam concentrate in addition to that carried by units on the scene. The following are to respond: 2 Foam Carriers, 1 Satellite Hose Wagon, 1 Foam Coordinator (Batt.Chief).
Code 1 - Maximum amount of Flouroprotein foam required. In addition to units on the 10-86 the remainder of the Foam Carriers and all Bulk Foam Units will respond.
Code 2 - Flouroprotein foam required. In addition to units on 10-86 the remainder of the Foam Carriers will respond.
Code 3 - High Expansion Foam required. The High Expansion Foam Unit will respond. Units on 10-86 will also respond.
Note: On all Special Calls for foam (Foam carrier or High Expansion Foam) the associated Engine Company will respond with both pieces of apparatus and all members.
10-91 Emergency; FD Not Required.
10-92 Malicious False Alarm
Indicates that a false alarm was transmitted with malicious intent.
10-99 Units Will Be Operating for at Least 30 Minutes
An operating unit or all units at an incident will be unavailable for at least 30 minutes. The unit(s) is to state the reason it will not be available.
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I know when my dad called 911 and said he was alone, they came to the house, unbeknownst to my mom that he had even called. they came to my place (down the road) and I explained that we were pretty sure that my father had dementia. thankfully the cop that showed up was also a minister (but not the exact name) in the force so he made a note in his system that any more calls from my parents house would alert them that he had dementia. I am guessing so they know to handle with kid gloves in talking etc. thankfully no more calls were ever made.
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Add into that well beings checks by the police.
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Smart911 is totally unnecessary. If you alert your local PD ahead of time that there is a medical condition at the house, whether it is cardiac, neurologic or paraplegic, they will handle it. The fire department always wants advance notice if oxygen is being used/stored in the house.
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I have had to get 911 emergency help several times.

When it was for myself and I did not have the 911 data base I was rushed away with my wife being cared for at risk.

Now when I call 9-1-1 call takers have very little information to help you – only your phone number and a very general sense of your location.

Before I signed up for smart911 When I was rushed to ER for heart attach my LO was left for the EMRespondersvto figure out what to do with her and our pet cat.

Now both 9-1-1 call takers and first responders know exactly what you want them to in any kind of emergency.
They now have both People and Household Info

My entire household information is available .. Just filling out the questions helped me fill out the file of life in the kitchen, assuming they got time to look for it. The first thing is getting the patient rescued.

Names, physical descriptions, including pets and photos are known before they arrive

Medical Information includes medical details for all of us
enabling responders to have more information before they arrive on scene.

They know in advance who should be contacted , family members, friends or neighbors and their phone numbers
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