A few years ago, an older relative of mine fell at home. Nothing was broken, no ambulance was needed, but they could not get up on their own. I arrived, but I could not lift them from the floor.

I called 112. They suggested going outside to find someone who could help. I remember that feeling of helplessness very clearly: a person is on the floor, you cannot lift them alone, and the emergency number has no solution other than telling you to look for a random stronger person.

In the middle of a workday, there was no one suitable on the street. I probably would not have dared to bring a random burly man into my older relative's home anyway. In the end, I called my partner, who was about an hour's drive away. He drove to Tallinn specifically to help lift an older person off the floor.

This experience came back to me vividly when ERR reported on September 1 that the Emergency Response Center can no longer send police to help a fallen older person. On September 5, ERR reported that the Interior Ministry agreed to temporarily continue organizing assistance outside working hours. On weekdays from 9 a.m. to 5 p.m., help is organized by the local municipality; at other times, national emergency services — ambulance, police or rescue — will respond for now.

Police reportedly handled about six hundred such calls a year. The temporary compromise eases the sharpest gap: at least outside working hours, help does not depend on a municipal social worker. But this is not a permanent solution.

The Interior Ministry's starting point is not wrong. Police should not be Estonia's regular in‑home lifting service for older people. But the temporary compromise does not answer the question of what permanent system should respond. On weekdays, organizing help falls to the municipality, but even here the answer cannot simply be "a social worker."

The law did not change on September 1. Police had responded to such calls based on a work‑organization agreement made in 2016 between the Emergency Response Center and the Police and Border Guard Board (PPA). Now PPA decided to stop responding in cases where there is no danger requiring police intervention. The temporary compromise made on September 5 adjusted work organization, not the legal framework.

The need to change the previous arrangement did not arise overnight. In the summer of 2025, PPA had already raised the issue that police lack the necessary skills and equipment to assess and assist a fallen person, including lifting devices.

The Interior Ministry and the Social Affairs Ministry had been looking for a solution for a long time, yet by September 1 — when police stepped away from their previous role — no new agreed‑upon system existed. The Social Affairs Ministry and representatives of municipalities said this publicly. The September 5 agreement fills the most urgent gap, but it is explicitly temporary. A permanent solution is still missing.

A social worker with a university degree is not a human forklift

The Social Welfare Act defines a social worker as a person with higher education and professional training. Higher education does not give them supernatural physical strength. If an adult child cannot lift their parent off the floor, there is no reason to assume a lone social worker can.

Lifting an adult off the floor is a skill. An older person may be weak, may have osteoporosis or balance issues. They may have fallen in a cramped bathroom, between a bed and a wall, or into a position that is difficult to move them from. Improper lifting can injure the fallen person. An injury that was not initially noticed may worsen, or the person may fall again while being helped up. The risk to the helper is just as real, because lifting incorrectly can injure their back.

Experience from several European countries shows that the problem should not be reduced to choosing between "police, ambulance or social worker." What matters is whether there is a round‑the‑clock service for older people living at home — one that does not stop at receiving an alert or notifying a relative, but can send physical assistance when needed.

This distinction is important. An older person may already be a home‑care client, receiving meals, cleaning help or other daily support. But that does not mean that at 2 a.m. on a Saturday, someone is available to come help them up after a fall. A safety button does not solve the problem by itself. If pressing the button only triggers calls to a child, neighbor or the Emergency Response Center, the question of who actually goes to the home remains unanswered.

This is where solutions in several nearby countries are interesting. In Sweden and Norway, safety alarm services are linked to the ability to send a home‑care or other response worker to the person when needed.

Finland uses turva‑auttamispalvelu, or safety assistance service, whose purpose is precisely to send a safety assistant to the person's home when help is needed. In Germany, a similar function is provided by hausnotruf, where a round‑the‑clock center assesses the situation and organizes help as needed.

Latvia's solution is also legally notable. There, the service provided through the drošības poga, or safety button, has national requirements: alerts are received around the clock, the situation is assessed, and help is organized at the person's home when needed. If the situation requires ambulance, rescue or police, they are involved.

There are also solutions in Estonia where response does not stop at a phone call. In Tallinn's social emergency service, a response team can drive to a fallen person. At the same time, this is not the general model for Estonia's safety‑button services. For example, Medi's standard alarm‑button service usually means contacting the person's designated contact and, if needed, the Emergency Response Center. Its own response team is separate and geographically limited.

A social welfare task, but not necessarily a social worker's job

Under Section 17 of the Social Welfare Act, the goal of home‑care service is to ensure an adult's independent and safe coping at home. Assistance is provided with tasks the person cannot perform alone due to their health or functional ability. If a person is lying on the floor and cannot get up without another person's help due to age and reduced functional ability, that fits this framework quite well.

The problem is that our home‑care services are built primarily for planned assistance. A person's need for help is assessed, a service is assigned, and the necessary tasks are agreed upon. This system is not designed to respond to a call at 2:17 a.m. when someone suddenly needs immediate physical help.

That is why it is not enough for the state to tell municipalities that "this is now your social‑services task." The task must come with the capacity to actually fulfill it. A social‑welfare responsibility does not mean a social worker must personally drive out and lift someone. Organizing the service and physically providing it are two different things.

This is also a question of fundamental rights.

Helping an older person off the floor may seem too mundane a problem to bring up the Constitution. In reality, it is exactly in these everyday situations that we see whether constitutional principles truly mean anything for a person.

Section 28 of the Constitution states that everyone has the right to health protection. Even more directly, it guarantees an Estonian citizen's right to state assistance in old age. Section 10 ties our system of fundamental rights to human dignity and the principle of a social state, and Section 14 places the duty to ensure these rights on both the state and municipalities.

The Constitution does not have a separate section titled "the right to dignified aging." Yet the requirement for dignified aging grows directly out of human dignity, health protection, the right to assistance in old age, and the principle of a social state.

The Supreme Court has emphasized that Section 28(2) establishes the right to receive state assistance in old age and that older people are a socially vulnerable group with heightened need for support. The state has broad discretion in designing systems to address social risks, but the system created must actually allow people to receive the assistance required by the Constitution.

This does not mean police must respond to every fallen person or that the state must remove every difficulty from someone's life. Individuals and families also have responsibilities. But family help cannot mean assuming that every older person has a physically strong child, neighbor or son‑in‑law nearby who can get in a car at night or during the workday and drive over.

In an aging society, falls and the resulting need for help are entirely predictable. The state's positive obligation does not necessarily mean one specific agency must provide assistance. It means a functioning system must exist.

Can assistance depend on where someone lives?

 Social welfare in Estonia is largely organized by municipalities, and that makes sense because local authorities know their residents and local conditions best. But that does not mean access to assistance necessary to protect fundamental rights can depend on which of Estonia's 79 municipalities a person happens to live in. As a result, the actual content and availability of help can vary widely. Narva, for example, is testing a system of community well‑being workers.

The Supreme Court has stressed in the context of social services that regardless of how the state and municipalities divide responsibilities, the legislature is ultimately responsible for ensuring fundamental rights are realized. The state must not allow a situation where access to an essential public service depends heavily on the capacity of a person's municipality.

This does not mean every municipality must provide the service in exactly the same way. Local autonomy allows choosing solutions suited to local conditions. In one area, that may be a shared mobile team; in another, a professional service provider; in a third, some other effective solution.

At the state level, it should be decided what assistance a person must receive regardless of where they live. If an older person's unexpected need for help must be met with round‑the‑clock access to appropriate assistance, then this is important enough from a fundamental‑rights perspective that its basic principles should not emerge as the sum of 79 different municipal practices and ad‑hoc agency agreements.

We need a 24/7 rapid home‑assistance service

The system itself could be fairly simple. When 112 receives a report of a fallen older person, the Emergency Response Center must first assess the health risk. The person or their spouse should not have to decide whether the fall may have been caused by a stroke, heart issue or other acute medical problem, or whether an injury occurred. If there is reasonable suspicion, an ambulance goes.

If no medical need appears and only physical help is required to get up, the call is directed to a regional rapid home‑assistance team. A standard response must be organized so that one worker does not have to haul an older person off the floor by force. This may mean a two‑person team or appropriate lifting equipment and training to use it.

Repeated falls should trigger a standard assessment of support needs. If a person already needs help multiple times to get up from the floor, they may need home modifications, assistive devices, physical therapy or home‑care service. A repeated call could therefore be a pathway to preventive and longer‑term assistance.

Estonia is aging. That means these calls will increase. Police should not be an in‑home lifting service for older people, ambulance should not be a substitute for social welfare, and a university‑educated social worker is not a human forklift. But an older person lying on their floor unable to get up must have certainty that help will come — not an hour later in the form of a family member driving from another city, and not as a random passerby from the street, but as part of a deliberately built assistance system. Dignified aging means this as well.

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