Most house fires are preventable (QLD Gov 2020). Do you know how to stay safe while caring for clients in their homes?
In order to prevent harm, serious injury or death from fire, healthcare staff must be able to identify and address fire hazards or risks in clients’ homes. Furthermore, clients should be adequately educated on how to minimise fire hazards and respond to an emergency situation.
If a client is appearing to have difficulty keeping their home environment safe, this may indicate that the client is not suitable to remain at home and alternative arrangements may need to be considered.
Why are Older Adults and People Living with Disabilities at Greater Risk?
Older adults and people living with disabilities are at increased risk of mortality or injury from house fires, with older adults over 65 accounting for almost half of house fire fatalities (SA MFS 2020; Fire and Rescue NSW 2019).
There are a variety of reasons why older adults and people living with disabilities are more vulnerable to fire threats, including:
Lack of understanding in regard to their own level of risk;
Being less physically or mentally able to withstand fires and related hazards;
Sensory impairment (reduced vision or hearing);
Social isolation; and
Cognitive or physical impairment.
Basic Principles of Fire
An essential component of fire safety and risk assessment is basic knowledge about how fires start and spread, and how they can be extinguished.
There are three main reasons (excluding arson) why fires start: apathy, ignorance and carelessness. These can generally be attributed to lack of fire safety knowledge, recklessness and failure to pay attention to small details. Appropriate fire education and being able to identify and respond to hazards is therefore crucial in fire prevention (VIC DoH 2018).
It is also important to remember the fire triangle of heat, oxygen and fuel. In order for combustion to occur, all three of these elements must be present. Removing one is the key to extinguishing a fire.
Heat can be removed by cooling the combustible material, usually with water.
Fuel can be removed by starving the fire, i.e. removing the combustible material or fuel (e.g. gas).
Oxygen can be removed by smothering the fire with a dry powder, chemical extinguisher or fire blanket.
(VIC DoH 2018)
In the event of a fire, you must always ensure that the chosen extinguishing method is appropriate for the type of fire you are dealing with. For example, water must not be used to extinguish an electrical fire as this could result in electrocution (VIC DoH 2018).
Methods of Spreading
There are a number of ways in which fires can spread:
Convection: When liquids and gases increase in temperature they expand, become lighter and rise, transmitting heat upwards.
Conduction: Heat is transmitted through a material, igniting something combustible on the other side.
Radiation: Heat waves are absorbed by other surfaces or materials.
Direct burning: Flames make direct contact with fuel and ignite it.
(VIC DoH 2018)
Managing Fire Hazards Around the Home
Most house fires start in kitchens, bedrooms and lounge areas (Fire and Rescue NSW 2017).
The following table lists common causes of fires around the home. When caring for a client in their home it is important to recognise and address any fire hazards that are present, and ensure the client is informed about potential risks.
Look out for these fire hazards:
Type of Fire
Flammable items (e.g. oven mitts, tea towels) next to the stove
Grease and residue on grills, fans and cooking surfaces
Unsafe microwave use (e.g. heating unapproved or inappropriate articles such as metals)
Heaters being left on during the night or when nobody is home
Clothes and curtains being kept close (less than one meter) to heaters
Faulty appliances or power cords
Unused appliances switched on at the powerpoint
Extension cords under carpets or rugs
Smoking in bed
Electric blankets being left on for more than 30 minutes
People, animals or objects being placed on top of electric blankets while they are in use
Laptops being left on the bed
Unclean lint filter in the clothes dryer (should be cleaned after every load)
Stopping the clothes dryer before completing its cool cycle
Dust build-up in the clothes dryer
Lack of ventilation and air space around the clothes dryer
Clothes dryer being left on while nobody is home
Living area fires
Unclean chimney or flue
Lack of fire screen in front of an open fire
Candles, incense and oil burners being kept close to flammable objects (e.g. curtains)
Unattended candles or open flames
(CFA 2013; QLD Fire and Emergency Services 2016; Fire and Rescue NSW 2018)
Smoke alarms are an integral component of fire safety in the home. Most fire fatalities involving older adults and people living with disabilities can be attributed to a lack of working smoke alarms or poorly located smoke alarms (CFA 2012).
The following are recommendations for household smoke alarms:
There should be at least one smoke alarm per floor.
There should be a smoke alarm in each bedroom, as well as in living spaces (including hallways and stairways) and garages.
Smoke alarms should be hard-wired and interconnected.
Smoke alarms should be placed on the ceiling.
Smoke alarms should not be placed in or near bathrooms and kitchens.
Smoke alarms should be tested every month and vacuumed every six months.
Batteries should be changed every year.
Smoke alarms should be replaced every ten years, or according to the manufacturer’s instructions.
(Fire and Rescue NSW 2018)
General Fire Safety Tips
The following tips will help reduce the risk of fire and ensure older adults and people living with disabilities are able to evacuate quickly if necessary.
The client’s bedroom should ideally be close to the exit of the home.
The client’s home should be kept free from clutter, especially bedrooms, pathways and doorways.
Aids (e.g. glasses, walking frames) should be easily accessible in the bedroom at night.
A mobile phone should be kept beside the client’s bed at night.
Clients with personal alarms should wear them to bed.
Doors should never be deadlocked when the client is home. Keys should be left in or near deadlocks.
Any mobility difficulties in day-to-day life should be addressed, as these could impede on evacuation in an emergency.
The client should consider assistance services if they are having difficulty performing certain tasks (e.g. cooking).
There are specialised smoke alarm systems for clients with hearing and mobility impairments.
Medical oxygen should always be used in accordance with the supplier’s safety advice.
(CFA 2012; SA MFS 2020)
What to do if a Fire Occurs
As well as checking that the client’s home is safe and free from hazards, you should ensure the client is appropriately informed about what to do in an emergency situation.
It is important that the client has a well-formulated escape plan that outlines several evacuation routes. The client should familiarise themselves with their escape plan and keep it somewhere prominent (e.g. on the fridge) as a reminder. They should practice their escape plan at least twice per year (NSW Fire Brigades 2008).
In the event of an emergency, the client may be unable to evacuate due to mobility difficulties or other factors. The client should know what to do in this situation. Generally, the best option is to call triple zero (000), get down low on the floor, close the door of the room and place towels, bedding or clothes at the bottom of the door to prevent smoke from coming in (SA MFS 2020).
Clients who are receiving home care are often more at risk of harm from house fires due to age or disability. Ensuring that your clients are appropriately educated about fire safety and that their homes are free of fire hazards is essential in reducing the likelihood of injury or death from fire.