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Preparing fire-based EMS for the ‘silver tsunami’

Bruce Moeller offers strategies for tackling the aging population, dubbed the “silver tsunami,” at Fire-Rescue Med 2018


In his session, Moeller will identify what is driving increased EMS demand, trends that will impact the patient mix and effective techniques to address the impact in EMS demand.


Fire-based EMS systems are experiencing ever-increasing workloads – and this is only the beginning. Drawing from generational demographics, Medicare data and decades of experience managing large EMS systems, Bruce J. Moeller, Ph.D., adjunct professor, University of Florida, will address strategies to manage the silver tsunami in fire-based EMS in a session at Fire-Rescue Med, June 11-13, 2018, in Henderson, Nevada.

Moeller will address the extent to which the expanding patient populations will increase fire-based EMS workloads and how to manage this extraordinary demand at the conference for fire-based EMS leaders, sponsored each spring by the IAFC Emergency Medical Services (EMS) Section to address hiring and retaining EMTs, public and private integration challenges, embracing technology, billing for services, illness prevention programs and more.

Moeller has been a certified paramedic for over 20 years, and has a diverse public-sector background, most recently serving as chief of staff and assistant county administrator in Pinellas County, Fla. Previously, Moeller served as fire chief and city manager for Sunrise, Fla; and director and chief of department for Broward County Fire-Rescue in Florida.

In his session, he’ll identify what is driving increased EMS demand, trends that will impact the patient mix and effective techniques to address the impact in EMS demand.

The aging population and demand on EMS

We asked Moeller to describe the scope of the increase in patient demand, but he noted it will vary from community to community. That said, here’s what we do know. While the youngest Baby Boomers will not turn 65 for another 11 years, the aging generation – born between 1946 and 1964 – is already challenging the country’s healthcare infrastructure.

According to the Population Reference Bureau’s Population Bulletin, the U.S. is experiencing one of the most significant demographic shifts in its history, as increasing life expectancy as well as trends in immigration and fertility combine to accelerate the growth in the share of the population ages 65 and older.

In his presentation, Moeller offers a case study exploring the impact of the aging population on fire-based EMS services over a 10-, 20- and 30-year projected horizon based on census data. “For any time period, the impact from population growth – let’s say from 8 percent to 10 percent – is doubled when you add the impact of an aging population,” Moeller noted. “That means you will soon have to address a 16-20 percent, or even higher, increased demand for service.”

“The number of people ages 65 and older in the United States has increased steadily since the 1960s, but is projected to more than double from 46 million today to more than 98 million by 2060. Between 2020 and 2030 alone, the number of older persons is projected to increase by almost 18 million as the last of the large baby boom cohorts reaches age 65,” the Population Bulletin reports. In addition, “the number of people ages 85 and older is projected to more than triple from 6 million today to nearly 20 million by 2060.”

Moeller will touch on peer-reviewed studies, along with his case study, that demonstrate a dramatic increased EMS utilization rate for those over 65, and even more so for those over 80 years old. “Not surprisingly, the types of events EMS will need to handle more frequently include generalized illnesses not well-defined; injuries (especially from falls); cardiac and respiratory problems,” Moeller said. One factor putting the aging population at even greater risk is the rising obesity rates.

Strategies to combat increasing demand on fire-based EMS

Moeller advises the following actions for fire-based EMS systems of care to mitigate the increase in senior care emergencies:

  1. Gather data from the U.S. Census Bureau as well as local planning departments and agencies to understand your community’s demographics.
  2. Evaluate your community needs – now and in the future – considering the impact from an aging population.
  3. Be prepared to handle the increased demand. This means either adjusting your deployment plan or adding resources. For many communities, if you increase call volume by 3,000 calls per year, you need another unit.

Moeller hopes to leave his audience with a relatively straight-forward methodology to help them define the potential impact on EMS from an aging population within their communities.

As a previous member of the IAFC EMS Section Board, Moeller has presented at Fire-Rescue Med in the past, and identifies attendees as “some of the most engaged fire-based EMS leaders we have in the nation.” To register today, or for information about upcoming conferences, visit

Kerri Hatt is editor-in-chief, EMS1, responsible for defining original editorial content, tracking industry trends, managing expert contributors and leading execution of special coverage efforts. Prior to joining Lexipol, she served as an editor for medical allied health B2B publications and communities.

Kerri has a bachelor’s degree in English from Saint Joseph’s University, in Philadelphia. She is based out of Charleston, SC. Share your personal and agency successes, strategies and stories with Kerri at