By Nicholas Schou
As the sobering reality of climate change looms larger, older people find themselves more vulnerable than ever to the ravages of extreme weather events and rising temperatures. Amid the increasing frequency of heatwaves and other climate change-related natural disasters, a realization has begun to emerge among health professionals that the nursing profession is ideally positioned to play a leading role in creating new strategies for climate resilience among older adults.
Few people are as familiar with the crisis facing older people in the face of climate change as Danielle Arigoni. The author of the 2023 book Climate Resilience for an Aging Nation provides startling statistics to underscore the urgency of the intersection of climate change and aging. “In 2019, only 1.2 million out of 55 million older adults aged 65 and older lived in nursing homes” in the United States, Arigoni says. Meanwhile, she adds, 30 percent of the other 55 million older adults live alone.
This growing demographic of older adults without immediate familial support, Arigoni argues, has significant implications for disaster preparedness and response. “Eleven percent of people over 75 do not have kids,” she explains. “But 20 percent of those aged 55 to 64 do not have kids.”
Given these numbers, a community resilience plan needs to acknowledge that climate change impacts older adults differently, Arigoni asserts. “If it assumes that everyone can respond equally,” she says, “it is really doomed to fail.”
One recent success story, says Arigoni can be found in the experience of Portland, Oregon, where 1,000 people, with an average age of 67, succumbed to heatwaves in 2021 and 2022. Realizing the city’s older population tended to live alone and in homes that had no air conditioning, the city updated its emergency plan for future heatwaves to include the distribution of portable air conditioning units to older adults.
Elsewhere, in New York state, officials want to create two million climate-ready homes, Arigoni notes, while in New Orleans, a city repeatedly ravaged by disasters, innovative initiatives are underway to protect older adults. “Now New Orleans is creating Resilience Hubs,” she says. “They are designed to allow ready access by older adults who don’t drive, providing safety and security that they otherwise wouldn’t have.”
Nurses are in a perfect place to help people survive in an emergency.
With coordinated efforts and investments in resilience, Arigoni believes that communities can mitigate the impacts of extreme weather events and ensure that older adults are not left behind in the face of environmental challenges. Yet she also underscores the critical role of nurses, especially home care workers, in advocating for climate resilience and ensuring the safety of older adults in their care.
“Nurses can not only bring climate change awareness to their patients,” she asserts, “but they are in a perfect place to assess whether there are things in place to help people survive in an emergency.”
Of course, for nurses to have a measurable impact on climate resiliency for older Americans, the nation’s healthcare system—complete with its deepening shortage of nurses—needs to be fixed. “Although the elderly population is highly vulnerable to climate-related changes (such as heat waves), the healthcare system has allocated few nursing resources to protect their health in our ever-changing climate,” says E. Alison Holman, associate dean of academic personnel at the Sue & Bill Gross School of Nursing, and an expert on collective trauma whose work often centers on climate-related catastrophe. “The nursing profession is uniquely positioned to promote climate resiliency among the elderly as more people are choosing to stay at home rather than go to nursing homes. Nurses often provide home care for elderly patients; if we had more resources focused on addressing the climate-related health challenges home-bound elderly patients face we could prevent unnecessary deaths.”
The Covid pandemic served as a of older adults during emergencies, highlighting the importance of proactive measures to address their unique needs, says Nathan Tabita, UCI Health’s hospital safety officer and manager of environment of care and emergency management. During the pandemic, Tabita witnessed firsthand the challenges faced by older adults during emergencies.
“The elderly had difficulty accessing a lot of the resources we had available,” Tabita recalls. “In order to get a vaccine appointment, you had to do it online, manage it electronically. We saw some disparity there with the elderly, and they were significantly impacted by that.”
Tabita emphasizes the necessity of communication and preparedness, particularly in ensuring access to healthcare and essential resources for those living alone or with limited mobility. “Elderly people are going to be significantly impacted if they can’t get out of their place of living, or live alone, or can’t communicate,” he explains. “Our communication is based on sending alerts to cell phones, so how do we reach out and communicate with them?”
Recognizing that dilemma, California’s Office of Emergency Services has recently added to its emergency response criteria new standards for reaching out to older adults that UCI Health is now using for training purposes.
Jocelyn Ludlow, director of simulation at the Sue & Bill Gross School of Nursing, echoes Tabita’s belief that emergency response experts shouldn’t overlook the needs of older adults. The nursing school currently employs simulations involving manikins constructed to look realistically like older patients. Mark Lazenby, the nursing school’s dean, also believes that preparing nurses for handling the needs of older patients during emergencies is critical to the school’s mission. “Reducing vulnerability is a key priority for the Sue & Bill Gross School of Nursing, and planning the care of older adults in emergencies is an excellent example of where funds targeted specifically at nursing would have a significant positive impact,” he says.
UC Irvine is also spearheading an initiative to radically improve disaster preparedness for senior living facilities. Led by a collaborative team of experts from various fields, the Enabling Disaster Resilience in Aging Communities via a secure Data Exchange (CareDEX) program began two years ago with the aim to enhance emergency response, disaster resilience, and community wellbeing, with a specific focus on older adults and the utilization of technology. Julie Rousseau, a nurse and a project scientist in UC Irvine’s geriatric medicine and gerontology department, is a key figure in the initiative. “When we first went into this years ago, we were very concerned that if you went on governmental websites with regard to disasters, there was a lot of info for pediatrics, but scant info for older adults,” she says.
One of the key components of the CareDEX initiative is the integration of technology to improve disaster response capabilities. Utilizing advanced data analytics and remote sensing technologies, the program aims to provide real-time information and support to senior living facilities during crises. “We developed a regional view so that in the event of a disaster, facilities can access vital information about nearby hospitals, mutual aid facilities, and potential evacuation routes,” explains Zenhui Hu, a member of the team specializing in risk management.
CareDEX is also developing community outreach to ensure the project’s effectiveness and inclusivity, says Chris Davison, who works on scenario development and evaluation. “We’re working to take CareDEX to rural areas where they may not have the capacity to build resilience for older adults,” he says.
The only time [disaster preparedness] gets a spotlight is when a lot of older adults are impacted, and that’s too late.
Julie Rousseau
Nalini Venkatasubramanian, a professor of computer science at UC Irvine and the CareDEX principal investigator, says that the CareDEX team is reaching out to other parts of the country and beyond in an effort to build their simulation data. “We are working with folks in Japan who have a very large aging population and very similar disasters to California with earthquakes,” she says. “We’re also talking with the city of San Antonio with regard to heat waves and hope to be looking at hurricanes in Louisiana at some point soon.” The CareDEX initiative has already garnered attention and support from various stakeholders, including government agencies and advocacy groups such as the National Fire Protection Association and the National Hazards Center. Looking ahead, the project aims to further expand its reach and impact by continuing to develop innovative solutions and forging partnerships with stakeholders across different sectors, says Rousseau, adding that it’s critical to the project’s efforts to address the challenges of disaster preparedness for older adults. “We all really do feel that this is overlooked,” she says. “The only time it gets a spotlight is when a lot of older adults are impacted, and that’s too late.”
The sooner America’s nurses and other health professionals begin to recognize the challenge and create a solution, the better, agrees UCI Health’s Tabita. “The next big disaster is inevitable,” he says. “But if we work together, we can ensure that our elderly population is not left behind.”
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About the Author: Nicholas Schou is an award-winning journalist with 25 years of experience in print media. He is also the author of several books on national security, the media, and the war on drugs.
