Climate change places older adults at greater risk

We need to plan better to protect vulnerable seniors from the impact of climate change By John Muscedere and George Heckman Canadian Frailty Network  An elderly man in Ottawa spent most of last winter snowed in, unable to leave his home, surviving on canned food. Last summer, 54 people died as a result of a heat wave in Quebec, many of them older adults. Seniors’ communities were quickly evacuated during floods in Calgary, but evacuated residents sat and slept on crowded chairs and cots for three days. These are not disaster movie scenarios, but recent catastrophic events linked to climate change that have directly imperilled Canadians in their own homes – especially our most vulnerable older citizens. Climate change can affect us directly through natural disasters – such as flooding, poor air quality, forest fires and extreme temperatures – and indirectly – through changing infectious disease patterns such as West Nile Virus and Lyme disease. Climate change events don’t affect every Canadian equally. Those who are older and more vulnerable – or frail – find themselves at increased risk. Canada’s population is aging and its most rapidly growing segment is that of people over the age of 80 years. This trend will continue for the foreseeable future, in tandem with the increasing frequency and severity of natural disasters due to climate change. At the same time, in accordance with their preferences, more Canadians, including many with complex health needs, are aging at home. They are usually supported by community health agencies but are often far from their families. But extreme climate and weather events may prevent these services from delivering care, leaving seniors isolated and at-risk. The risk is amplified for those seniors who are frail. Frail individuals are those in whom aging has exacted a toll, and the Canadian Frailty Network characterizes frailty as a state of increased vulnerability and functional decline. Individuals with frailty are more likely to have multiple medical problems, take multiple medications, and be limited in their ability to get around and carry out activities of daily living. Now, think about what happens if the power goes out for an extended period. Those using mobility aids like scooters, walkers or canes aren’t easily evacuated if elevators don’t work. Many medical devices, like CPAP machines, nebulizers, or dialysis machines, won’t work either. If landlines or the Internet are interrupted, and as mobile phones run out of power, how can these physically isolated people let others know they’re in danger? Canadian seniors take an average of seven drugs, with one-quarter taking more than 10. Any lapse in access to medication can be life-threatening. Frail seniors also have challenges regulating their body temperatures during extremes of heat or cold. They’re also more susceptible to dehydration, infections and respiratory and cardiac problems from weather events and pollution. And ice and snowstorms result in more falls and fractures. The mental health consequences can also be severe, ranging from depression and anxiety due to social isolation, to post-traumatic stress disorder (PTSD) from the experience of a severe weather event. For a frail senior, such mental health problems lead to further disability and even premature death. These are not worst-case scenarios. These events and their consequences are happening now and they’re increasingly common. Notwithstanding the need for our governments to address the root causes of climate change, a strategy to protect vulnerable seniors from climate change is also required now. Every senior needs an emergency preparedness plan, developed with families, friends and neighbours, and home care agencies. But government agencies and disaster management agencies must also consider and take into account the unique needs of frail Canadians. A good place to start would be with primary care and community support agencies, where existing standardized assessments could support the creation of a registry of individuals who would require more help during disaster. Knowing where these vulnerable seniors live would help planners know where to deploy community services such as cooling shelters for extreme heat or Snow Angel programs to help clear snow and ice. Through the recognition of the increased vulnerability of our aging and frail population and better planning, Canada can ensure they’re as protected and prepared for emergencies as any other group as we face climate change together. John Muscedere is the scientific director of the Canadian Frailty Network, and a professor of Critical Care Medicine at Queen’s University. George Heckman is the Schlegel Research Chair in Geriatric Medicine and an associate professor at the University of Waterloo, an assistant clinical professor of Medicine at McMaster University, and a researcher with Canadian Frailty Network.

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