Summertime overheating is a key risk for the elderly, as heatwaves coincide with increasing mortality rates [1]. The 2003 ten-day heatwave across England and Wales, caused a 33% increase in deaths for those aged above 75 [2]. The number of deaths in care homes were 9% higher compared to those at home, highlighting the vulnerability of care homes to warmer climates.
The demand in state and privately funded care homes is increasing in the UK, due to the rising population of people aged above 65 years old. Staff have already reported the restrictions on cooling the homes, as they have been designed in the UK to keep residents warm against the cool UK temperatures. However, the UK are expected to get an increase in heatwave frequencies and projected future summer temperatures to reach up to 6°C higher, by 2070 [3].
Heat-related mortality rates could increase by 257% by 2050, in the UK, majorly affecting the elderly [4]. Excessive heat is also linked to numerous medical conditions, such as cardiovascular disease and respiratory disease and affect sleep quality and duration and medication effects. The elderly are more at risk as a vulnerable group, which is heightened during high night-time temperatures.
A recent study, by Gupta et al., (2021) has found that care homes are already experiencing overheating; exceeding temperature limits set out by Public Health England [1]. The two studied London-based care homes, a modern and an older building, exceeded indoor temperatures of 30°C during the day; significantly higher than the recommended 26°C. The older care home possessed higher temperatures than the modern home, with a difference of only 0.4°C between outdoor and indoor temperatures. Both buildings never fell below 20°C, even during unoccupied hours. Bedroom temperatures increased overnight, suggesting night-time cooling strategies, opening window/doors, were likely not used, due to disturbance and safety risks.
Strategies to reduce these indoor temperatures need to be implemented imminently, particularly to help with bedroom temperatures for residents. Both care homes have found that temperatures of offices and lounges rose and fell with outdoor temperatures, highlighting the vulnerability of care homes to climate change. Overheating risks will increase significantly, with projections for 2080 to reach temperatures up to 39°C, during a heatwave.
Features of rooms that reported the lowest temperatures included ground floor locations, shading by trees, frequent ventilation by windows or doors, while the higher temperatures rooms were disadvantaged by south facing orientation, top floor locations and exposed windows, allowing great solar gains.
The study analysed different combinations of strategies, including air conditioning (AC), ventilation (windows open at night), shading (side fins/louvres) and reflective surfaces (high wall albedo). The most effective strategy, to reduce temperatures and cooling loads, for the current climate was determined to be a combination of all strategies studied. This was also the most energy efficient strategy for future climates, but not the most effective, as the continuous use of AC, had the highest impact on reducing the indoor temperatures. However, it is important to balance passive and active strategies, as the use of AC alone, increases the energy consumption, cost and cooling load.
The use of night-time ventilation is an effective strategy for the current climate, but less so for future climates, as temperatures increase. Therefore, it is worth investing in long-term strategies now, which can help reduce the impact of future climate change, benefitting both staff and residents. Investments like these can also make your care home compliant with climate change and health care regulations.
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[1] https://doi.org/10.1016/j.enbuild.2021.111418
[2] Mortality in Southern England during the 2003 heatwave by place of death | Request PDF