ClimaCare: Climate Resilience of Care Settings

The UK’s growing older population, and particularly people over 65 residing in care settings, are at the highest risk of heat-related mortality. Understanding the factors that contribute to high indoor temperatures in care homes is crucial in developing strategies to avoid summertime overheating and the associated negative health impacts, which are expected to intensify as a result of climate change. The pilot project is undertaking preliminary work in five care settings in London to monitor the summertime conditions experienced by residents and staff, model future overheating risks and investigate the effectiveness of different strategies for reducing the risk of overheating. It will then bring together the learning from monitoring and modelling in expert workshops to explore the implications for guidelines and regulations, and the potential for scaling-up the project to a national scale. The work will be of interest to relevant stakeholders from the built environment, social care, public health and policy development.

As a result of global climate change, the UK is expected to experience hotter and drier summers and heatwaves are expected to occur with greater frequency, intensity and duration. According to recent climate change projections by the Met Office, increases in mean daily temperatures could be up to 5.4 deg. C during the summer months and 4.2 deg. C during winter by 2070 under a high emissions scenario. In 2003, 2,091 heat-related deaths were reported in the UK alone as a result of the European heatwave, meaning future temperature increases could lead to a parallel rise in heat-related mortality. The UK also currently has a rapidly growing number of old people, with people aged 75 or over expected to account for 13% of the total population by 2035, compared with 8% in 2012. Older populations are more vulnerable to climate-induced effects as they are more likely to have underlying, chronic health complications, making them more vulnerable to heat stress. The 2003 heatwave demonstrated that older people in care settings are at the highest risk of heat-related mortality. People aged over 65 years spend more than 80% of their time in residential environments or care settings, and people aged over 85 years more than 90%. Therefore, the indoor environment is a huge moderator of heat exposure in older populations: poor building design and the lack of effective heat management in care settings may contribute to increased indoor heat exposure with detrimental health impacts falling on the most vulnerable residents. Care facilities function as both a home for residents and a workplace for staff, meaning that the people sharing those spaces can have diverging needs and preferences making overheating prevention measures difficult to enforce. Interactions between staff and residents play an important role in preventing overheating in care settings and it has previously been noted that staff are often made to prioritise warmth due to wide recognition of the detrimental effect cold weather can have on old-age health, leading to overheating risks being overlooked. Understanding factors that contribute to indoor summertime overheating in care homes is crucial in developing methods to prevent overheating and the subsequent negative health impacts.

Previous research by the applicants has indicated that care facilities are already overheating even under non-extreme summers, highlighting the need to develop timely prevention measures given the way temperatures are expected to rise in the UK over the next century. A key target for climate adaptation in care settings is to limit such risks by introducing passive cooling strategies via building design and occupant behaviour. Development of passive cooling strategies will reduce the likelihood of uptake of mechanical cooling, which would undermine government efforts to reduce greenhouse gas emissions. Therefore, the principal aim of the project is to undertake preliminary work to develop methods that will support a system of care provision in the UK that is adequately prepared for rising heat stress under climate change. The project will undertake pilot work in five care settings in the UK to monitor the thermal environment and conduct surveys with residents, frontline care staff and care home managers. Within these buildings, it will test novel approaches for understanding the comfort levels of the residents and relating this to the thermal environment. It will also test novel measurement techniques for assessing impact of heat on the health of the residents. Via detailed modelling work, it will then test methods to assess future overheating risks and to evaluate the effectiveness of overheating mitigation strategies. Throughout the project the work will bring together multidisciplinary research perspectives with those of care home practitioners and other stakeholders. Via these packages of work, plans for the large-scale project that is so urgently needed in this area will be developed.