Older persons and heat risk: Taking action to save lives
For older individuals around the world, hot weather comes with serious challenges. On the 2024 International Day of Older Persons (1 October), the Global Heat Health Information Network calls on governments and health organisations to ensure that evidence-based targeted policies and measures are developed to protect older persons from extreme heat.
An ageing global population is converging with record-shattering heat - driven by climate change. Whether you look at the human cost of chronic heat in places like Singapore or Arizona, or the impacts of severe heatwaves in Paris, Buenos Aires or Karachi, older persons make up a disproportionate majority of heat-related deaths.
Older persons are among the most vulnerable to heat illness and death
People over the age of 65 are particularly vulnerable to extreme heat due to the interaction of physiological, environmental, and social factors. As we age, our bodies become less efficient at regulating temperature, making it harder to cope with extreme heat. Chronic health conditions and certain medications can also make older adults more sensitive to heat stress. Older people are also less likely to access primary care in hot weather.
Many older individuals also face social challenges and multiple disadvantages. Poverty rates for older people are higher than for the total population in around two-thirds of countries. Ageism (discrimination against older people) is a barrier to health and social care. Older people are more likely to have low quality housing, including a lack of access to air conditioning or other cooling systems, or be less likely to use air conditioning due to cost or cultural beliefs. Stress associated with social isolation and living alone can further increase their heat risks, as it may prevent them from getting timely help during a heatwave.
"The usual challenges of ageing, like reduced heat tolerance and pre-existing health conditions, put seniors at greater risk during extreme heat." said Joy Shumake-Guillemot, head of the WMO-WHO Joint Office for Climate and Health and Global Heat Health Information Network co-lead, "This is often worsened by social isolation, limited mobility, and economic constraints that make it harder to access cooling or healthcare. As heatwaves intensify, it's vital we address these vulnerabilities to protect the most at-risk, including our seniors."
How can we protect older individuals from heat?
On this International Day of Older Persons, our Network calls on governments, community organisations, health workers, and international organizations to be aware of the unique heat risks facing seniors, and take urgent action to protect them. National and local heat health action plans should include specific strategies for addressing heat risks in older persons, both in the community and in social care homes.
Consider the following scenarios, where tragic outcomes could have been avoided with simple actions:
The unaware neighbour
Mrs. Garcia, an 81-year-old widow, lives alone in an old apartment with no air conditioning. She relies on a small fan to stay cool. During a heatwave, she becomes increasingly lethargic and confused but is unaware of the severity of her condition. She suffers from heat exhaustion that quickly escalates to heatstroke because no one checks on her.
What could have been done?
- Community and Family Check-ins: Neighbours or family members should regularly check on the elderly, especially during extreme heat. A simple daily visit or phone call could have alerted someone to Mrs. Thompson's condition.
- Cooling Resources: Local community services could offer accessible cool spaces - including transportation, or distribute portable air conditioners and fans to at-risk seniors.
- Education: Increasing awareness of effective low-cost cooling options and available support can empower the vulnerable to take action to protect themselves.
The isolated care home resident
Mr. Ward, a 78-year-old living in a care home, spends most of his day indoors without proper ventilation or air conditioning. He takes medications that reduce his body's capacity to handle heat, but the staff is unaware that he has become severely dehydrated. Mr. Ward's condition deteriorates, leading to hospitalization for kidney failure.
What could have been done?
- Staff Training: Care home staff should be trained to recognize signs of heat-related illnesses and dehydration, and know which residents have preexisting conditions or take medications that increase their risk. Regular hydration checks - for example by checking urine colour - and ensuring that residents are kept in cool environments can save lives.
- Facility Upgrades: Care homes must be equipped with adequate cooling systems. Governments and NGOs can provide funding to upgrade outdated facilities, and policies can be established to ensure maximum temperature limits in care homes.
The active senior
Mrs. Lee, a 74-year-old woman, takes a daily morning walk. On an exceptionally hot day, she decides to go out at her usual time. She underestimates the heat because she doesn't realize that temperature is measured in the shade where it is 10-12°C degrees cooler than in direct sunlight, and, after 20 minutes, she starts feeling dizzy and disoriented. Mrs. Lee collapses due to heat exhaustion. A passerby calls for help, but she passes away en route to the hospital.
What could have been done?
- Weather and heat stress awareness: Seniors should be advised to monitor weather forecasts and avoid outdoor activities during peak heat hours (typically between 10 a.m. and 4 p.m.). It's important for the vulnerable to understand how hot they might get when looking at a weather forecast by considering the temperature as well as humidity, wind and cloud cover, the activities they have planned and what they will be wearing.
- Community Programs: Local senior centres can offer indoor exercise programs or early morning/late evening group walks in cooler settings.
- Protective Measures: Seniors should be encouraged to wear light clothing, wide-brimmed hats, and carry water bottles when venturing outside.
These are just a few examples of extreme hot resulting in all-too-common tragedies. The dangers of extreme heat for older people are real and growing, but they are also preventable. With awareness, preventive actions, and supportive resources, many of these impacts can be avoided.
We call on everyone to help save lives in any capacity they can, including checking on their elderly neighbours and relatives, advocating for community cooling resources, educating seniors and caretakers on heat safety, supporting cooling upgrades to care facilities, and getting involved in local organizations and volunteer programs that offer heat relief assistance to seniors. Join us in our efforts to protect everyone - including seniors - from the rising risks of extreme heat.
"Every life has equal value. Our rights do not diminish with age."
Michelle Bachelet, UN High Commissioner for Human Rights (12 May 2021)