Elderly and disabled residents who dial 911 for help with getting out of bed or getting into a wheelchair have cost the Howard County fire department at least $25,000 in the past two years.
Fire officials say the county's growing elderly population and greater demands on the department are forcing them to ask whether they can or should continue to answer such calls.
"This is just starting for us, and it's going to get worse," said Battalion Chief Donald R. Howell.
"For the foreseeable future, we will continue to respond. We are doing this because there's been no alternative solution. But we feel in the long-run, it's probably not the best utilization of emergency services."
The department responded to 14,000 calls last year, about 5 percent more than in 1990 and 50 percent more than 10 years ago. Each call costs at least $100, according to Chief Howell, who said that was a conservative estimate.
The fire department has identified at least six residents who call 911 regularly, saying they need emergency help, but really needing basic human services. Among the calls:
* A senior from Elkridge, who has called emergency squads more than 150 times since 1990 -- some times twice a day -- to look at bruises and quell anxiety attacks. On some occasions, she has asked to be taken to the hospital, where she was promptly released. On 25 of those occasions, she refused medical treatment.
* A west Columbia resident who is disabled and who called 44 times last year for help getting into or maneuvering a wheelchair; and another who called 15 times requesting similar help.
* Two west Columbia seniors who called a total of eight times for diaper changes and for emergency workers to feed them and give them water.
Chief Howell said there have been other similar calls, but emergency personnel have stopped documenting them.
Elderly and disabled residents aren't the only ones who call 911 service for non-emergencies. A few families -- mostly from Columbia -- use it as their primary health provider, calling when a member falls ill.
The department fears that people who routinely call 911 for help are falling through the cracks of society.
"These are just symptoms," Chief Howell said. "We need to be more cognizant of our special population and its needs."
But other county departments see no alternatives. The Department of Social Services says it can't give round-the-clock service. It has only two full-time aides who serve 12 elderly and disabled people, checking on their welfare, doing light house keeping and grocery shopping.
"We don't have 24-hour aid service," said Thomasine Baskerville, social services supervisor. "There's not enough trained aid available, mostly because of budget constraints."
Ms. Baskerville suggests neighbors or church organizations should pitch in to help.
While the county Office on Aging can direct elderly and disabled people to such services as home health care or home meal delivery, some people won't accept help, said Phyllis Madachy, director of Adult Community Evaluation Services.
"Sometimes people are fearful of the alternatives," she said. "Unfortunately, it's a widely held belief that if you don't live in your home, the only alternative is a nursing home. That's not true at all."
The fire department is looking for suggestions or other organizations that could help the people who are calling. "We are certainly open to suggestions," Chief Howell said. "If there are any agencies out there I'm not aware of, or any sort of assistance that we can provide to them, I'm open to learn about it."