Book excerpt: The expanding older adult population may require ever-increasing amounts of public services, health care, and additional services. Of particular importance to fire and emergency medical services (EMS) is finding a way to accommodate a vastly increased demand for services from an already large and continually growing segment of the population--a group that is at a much higher fire risk than the rest of the population. Older adults represent one of the highest fire-risk populations in the United States. As a result of progressive degeneration in physical, cognitive, and emotional capabilities, older adults present unique challenges in terms of fire protection, prevention, and safety. Complications associated with aging increase the likelihood that an elderly person will accidentally start a fire and, at the same time, reduce his or her chances of surviving it. Older adults experience a disproportionate share of fire deaths; in 2007, older adults (aged 65 and older) represented 13 percent of the U.S. population but suffered more than 30 percent of all fire deaths. Additionally, the relative risk of individuals aged 65 and older dying in a fire is 2.6 times greater than that of the general population where the relative risk equals 1.0. There is more of a risk of fire death as age increases. The relative risk for adults ages 65 to 74 is 1.9 but soars to 4.4 for those older than 84. As the Nation's older adult population grows, the fire death toll will likely rise in direct proportion to that growth unless measures are taken to ameliorate the risks associated with this group. The fire safety community must address the fire safety needs of older adults or be faced with the potential of a severe public health problem.