Does your service get called to conduct welfare checks on citizens? In many communities, welfare checks, sometimes called well-being checks, are conducted by law enforcement agencies, but in others, EMS and fire departments are regularly dispatched for wellness checks or are called on when law enforcement is busy with other calls.
While the term “welfare check” sounds innocuous enough, these calls have the very real possibility of being dangerous for the public safety responders knocking on the door. Dogs have attacked providers. Shots have been fired and responders have been injured and even killed during welfare checks.
Welfare check safety
Unfortunately, not everyone appreciates being checked on, or even having their doorbell rung. The very reason the person needs to be checked on or the issue preventing them from answering calls from loved ones may cause them to respond inappropriately to uniformed personnel stepping onto their porch.
Consider the person that has mental health illness. A wide range of disorders may lead to the home occupant mistaking firefighters or EMS for intruders or “authorities” coming to lock them up. Someone with suicidal ideation could use their shotgun on someone interrupting their plan, rather than themself.
Alternatively, it is not uncommon to find property owners or occupants who are wary of any trespassers, even more so those in uniform. Some consider any entry onto their property unlawful and invoke “castle doctrine” laws to take any means to defend their home.
The bottom line is that anytime you are answering a wellness check call, it is best to be prepared for anything. Don’t just assume that you are going to meet a friendly little grandmother who got busy baking cookies and didn’t notice that her phone battery was depleted.
Questions to ask dispatch about a welfare check
Start with getting good information from dispatch.
[Fill out the form on this page to download these questions]
- Exactly why does a welfare check need to be done?
- Who is the caller (is it the daughter calling from two states away about her 90-year-old mother who lives alone, or the boss of an unstable employee who told coworkers that he wouldn’t be coming to work ever again)?
- What did the caller report about the situation?
- Did they offer any clues as to why the subject hasn’t been heard from?
- Did they have contact with the subject?
- Do they have reason to suspect the subject is in danger?
- Do they know the best way to approach and access the house (e.g., does the subject prefer the side-door or access through the garage; is there a door code or a key hidden under a flowerpot)?
- Has law enforcement been called there before?
- Are the occupants known to be unfriendly?
- Is the address associated with an at-risk person due to medical conditions, disabilities, age or mental health needs?
- Do the dispatchers know anything else about this address?
Don’t be afraid to ask the dispatcher for this information. Most police officers have computer aided dispatch (CAD) access in their patrol cars and can see this additional information directly. The dispatcher may not think about sharing it with you if you don’t have CAD notes available in the ambulance.
Situational awareness: Scene survey
As with any call we respond to, a scene survey is an important part of your arrival. As you roll up, take a moment to assess the property, starting with any clues that the occupant may be less than friendly to anyone approaching their home.
- Is there an abundance of “No trespassing” signs?
- Are there conspicuously-placed security cameras aimed down the driveway?
- Are all the windows blacked-out?
And then there is the matter of security gates. Opening any locked gates should probably be left to law enforcement.
Next, start to look for anything that might indicate the subject is in trouble.
- Is there mail or packages piled up on the porch?
- Are there lights on inside the house that maybe shouldn’t be for that time of day or vice versa?
- Are there significant numbers of flies, smoke or condensation on the inside of windows?
- Are there any unusual sounds or foul smells that could be a sign of a problem brewing inside the building?
MORE | Situational awareness: Your primary weapon in violence prevention
Approaching the door
Once you are ready to check to see if the subject is in the residence, it is time to knock on the door, ring the doorbell or both. Before you knock, check where you are standing and avoid being directly in front of the door or any windows. You want to be visible in case someone looks out the door, but at the same time, not in the path if they respond with a shotgun blast through the door or windows. Call out “fire department” or “EMS” to let them know who is on the porch. Listen for any response inside either from someone calling out or somebody moving within the home.
As a best practice, have one partner up on the porch while the other one stands a little further from the building. If you need to retreat, you don’t want to both be trying to exit the same steps or path in. The further out partner can also be watching other windows for signs of movement.
Forced entry
Whether firefighters or EMS providers should perform a forced entry and break through locked or otherwise secured doors for a wellness check is always a debate. Check your service’s policies and procedures and, whenever possible, involve law enforcement. Typically, an imminent threat, or known injured or ill party must be confirmed before forced entry can be justified.
- Can you look through a window and see an apparently injured patient on the floor?
- Do you hear a child calling for help?
Don’t let your guard down once you are in the home. Always be wary of threats and be prepared to retreat to safety or take cover — even if that means leaving your equipment or a patient behind.
Making contact
Once you are inside the residence or in contact with the subject of the welfare check, you next need to determine if they are a patient or not. Some agencies only consider a person a patient if they ask for your help or if you observe an indication that the person is ill or injured. If they are, in fact, a patient, then initiate the appropriate assessment and treatment, and advise dispatch that the welfare check has become an EMS call.
Unfortunately, many welfare checks end up with the party being found deceased. If that is the case, consider the situation a crime scene until proven otherwise and exit the building while disturbing as little of its contents as possible. Document what you did and observed, and contact law enforcement as well as the medical examiner or coroner.
If the patient is not ill or injured but needs some sort of attention for an unsafe living condition or mental health crisis, then social services or an appropriate agency is probably needed. This might include elder or child abuse or neglect conditions; an unsafe building; or lack of food, water, heat or electricity. If these conditions are encountered, it is likely best that law enforcement be dispatched to the scene to document the conditions and follow up with the appropriate resources.
Don’t assume that a welfare check will be a quick and easy call where it is OK to let your guard down. Approach the call with your eyes open, a safety mindset and be prepared for just about anything.
Stay safe out there.
