Unsafe Living: Individuals Have the Right to Refuse Assistance

The in early March battled what would turn out to be the town's first fatal building fire in more than 15 years as Joseph Kozlowski, 85, died in the blaze.

The fire's cause was blamed on "an extension cord that may have been overloaded, but more importantly could not function correctly because there was a large pile of material on top of it," according to a press release.

In fact, the home at 2 Gage Road was itself overloaded.

“The home was extremely cluttered making an emergency escape from the home nearly impossible and making it extremely difficult for firefighters to gain entry, to conduct search and rescue, and to put out the fire,” State Fire Marshal Stephen Coan said in a press release.

A statement from Wayland Health Director Julie Junghanns indicated Kozlowski's living situation was not unknown to Wayland officials and assistance was offered.

"Compulsive Hoarding is a very difficult and complicated problem throughout the Commonwealth that many local officials and other agencies struggle with," Junghann's said in the statement. "In many cases people do not want help and make it clear that they have civil rights that they don’t want violated."

Wayland's Assistant Town Administrator John Senchyshyn said convincing a person that they need assistance is often the most difficult part of helping a person who has been identified as having a need.

“You can try to convince, cajole, maybe plead with them a little bit to have a person come over to your way of thinking," Senchyshyn said. "You can’t as a family member, much less as a neighbor, barge in and take control of it.”

Wayland Council on Aging Director Julie Secord said her organization often receives phone calls from family members and neighbors who are concerned about the living situation of an over-60-year-old in town. Many of those calls are simple well-being checks, but others set in motion a larger process.

"We do an investigation," Secord said of those more involved reports. "Certainly if we feel this person’s quality of life has been compromised … we encourage the person who called to contact protective services.”

COA officials can contact protective services, Secord explained, but the information is always better coming from the original person who reported the situation.

Protective services can then investigate -- that is, if the individual will allow that to take place. In fact, all of these steps, Secord stressed, are ultimately under the control of the individual being investigated.

"That person has the right to say, 'You're not coming in,'" Secord said. "We’ll do everything we can, but we have to respect that person’s rights.”

Wayland Fire Chief Vincent Smith said the "issue of competence is all important."

Smith said his EMTs and paramedics regularly confront competence issues when making medical calls. "We have the ability to ask questions and if they can show us that they have rational decision-making skills … we don’t force them to do anything," Smith said. "Generally speaking, it’s a question of whether they felt the person was competent to make decisions.”

A trip in an ambulance, Smith added, could be one way for officials to step into a situation in which an individual is perhaps living in an unsafe situation, but refuses assistance. Smith said if ambulance staff realizes a patient's living situation is unsafe, the staff can pass that information on to hospital officials who can then work within the hospital social service system to prevent a person from returning home to an unsafe environment.

Some situations are not only a danger to the person living that way, but also to public safety officials who may need to enter the building in an emergency. Even in those cases, Smith said, officials have little ability to enact changes unless it is a public building subject to codes compliance.

Smith said fire crews often stumble upon situations that could prove difficult in an emergency when they respond for standard medical calls or for other reasons. In those cases, awareness of that environment is informally circulated within the department, but no official action can be taken.

"These individuals still have rights, still have the ability to say ‘no’ and still have the freedom to live the way they choose,” Senchyshyn said.

Secord agreed, but added that it is still important for people to call the Council on Aging or local authorities if they suspect someone is living in an unsafe situation.

“We can't do anything if no one calls," Secord said. "Give us every chance to at least assist.”