Overheating in care settings: magnitude, causes, preparedness and remedies

Abstract

Research in UK and elsewhere has highlighted that older people are particularly vulnerable to negative health effects of overheating. This paper examines the magnitude, causes, preparedness and remedies for addressing the risk of summertime overheating in four case study residential care and extra-care settings across the UK, spanning different building types, construction and age. The methodological approach adopted is interdisciplinary, drawing from building science and social science methods, including temperature monitoring, building surveys, and interviews with design and management teams. The findings suggest that overheating is a current and prevalent risk in the case study schemes, yet there is currently little awareness or preparedness to implement suitable and long-term adaptation strategies (eg. external shading). There was a perception from designers to managers, that cold represents a bigger threat to older occupants' health than excessive heat. A lack of effective heat management was found across the case studies that included unwanted heat gains from the heating system, confusion in terms of responsibilities to manage indoor temperatures, and conflicts between window opening and occupant safety. Given that care settings should provide protection against risks from cold and hot weather, design, management and care practices need to become better focused towards this goal.

Care provision fit for a warming climate

“…Table 1 outlines the key characteristics of the case studies and other important criteria considered during the selection process. In addition, refer to Gupta, Barnfield, and Gregg (2016) for more detail on the case studies and the selection process. (1) climate change projections were selected for modelling (hazard),…”

Impact of extreme weather events and climate change for health and social care systems

“…Modern or temporary buildings may perform worse in terms of thermal regulation than older buildings [ 22 , 28 , 21 , 29 ]. There is relatively little evidence on impacts of extreme heat in other facilities, such as care homes, though some case studies suggest problems associated with poorly adapted equipment, structural design and care practices [ 2 , 30 ], and lack of awareness among designers and managers regarding the need for heat management as well as avoiding risks of cold [ 31 , 32 ]. More research is needed on the extent of such problems, especially since mortality risks during heatwaves are particularly high for older people in care homes [ 33 – 36 ].…”

Vulnerability to heatwaves and implications for public health interventions – A scoping review

“…Dysfunctional thermoregulatory mechanisms, chronic dehydration, medications and diseases involving the systems that regulate body temperature are further identified risk factors which render elderly and multi-morbid patients such as diabetics more vulnerable to heat (Worfolk, 2000;Yardley et al, 2013a ;Yardley et al, 2013b). Other studies also looked at heatwave vulnerability in nursing and residential homes and criticize the lack of effective heat management which make people in need of care more vulnerable (Brown and Walker, 2008;Gupta et al, 2017;Rest and Hirsch, 2015 ;Skinner et al, 2009). Children due to Public health interventions target different groups in specific locations and address intrinsic as well as extrinsic risk factors.…”