Why Climate Emergencies Can Be Especially Hard on Seniors

When a wildfire threatens a community, the order can sound simple: evacuate. But for an older adult, leaving home on short notice can be anything but simple. There may be medications to pack, mobility issues to consider, pets to find, transportation to arrange and decades of memories left behind.

And increasingly, climate-related emergencies are not isolated events. Wildfires, extreme heat, wildfire smoke, floods and extreme cold are putting additional pressure on a healthcare system that is already struggling to keep up.

Dr. Bhavini Gohel, a clinical associate professor at the University of Calgary’s O’Brien Institute for Public Health and Department of Family Medicine, says she has seen the problem firsthand. Gohel was on the front lines during COVID-19 and was involved in evacuations during Alberta floods. “What we’re seeing is that climatic events and climate-related disasters are putting a strain on an already strained healthcare system,” she says. In the winter, that can mean extreme cold. In the summer, there are wildfires, smoke and heat-related illnesses. All of that can mean more people showing up in emergency departments at a time when hospitals are already dealing with surgical wait times, emergency-room pressures and workforce burnout. Older adults are particularly vulnerable.

As people age, the body’s ability to adapt to changes in temperature and air quality can decline. Many older adults also live with multiple medical conditions and take medications that can affect their ability to cope with extreme heat or poor air quality. There are financial considerations too.

Many seniors live on fixed incomes. Something as simple as purchasing a high-quality air filter to protect against wildfire smoke may be an added expense. “Many are on pensions and they don’t have the ability to get MERV 13 filters,” Gohel says. The result is a population that can have a harder time adapting when an environmental emergency hits. The wildfire evacuation in Summerland, B.C., this summer provides a vivid example. 150 homes were destroyed and an 80 year woman died as she was attempting to leave her home.

 
Mayor Doug Holmes says the fire moved so quickly that there was no time for the usual evacuation alert in many parts of the community. Instead, people were told to get out. Summerland has a large seniors population, including people living in seniors’ residences and others living independently. Holmes says the community immediately began helping older residents. Some seniors’ homes were given an alert even though they were not believed to be immediately threatened. That gave staff time to organize buses and prepare residents for evacuation. It turned out to be an important decision. The evacuation eventually involved 20,000 people, overwhelming systems designed for much smaller emergencies.

“Those first two days were pretty chaotic for everybody,” Holmes says. Some people, including seniors, slept on the floor of an evacuation centre before hotel rooms could be secured. For older adults, Holmes says, the uncertainty was particularly difficult. People were worried about whether their homes were still standing. They were separated from their routines, their gardens, their belongings and their communities.
“You’re away from home and your normal routine,” he says. One of the most emotional moments for Holmes involved an elderly woman who was reunited with her cat at the evacuation centre.
An animal rescue worker brought the cat to her. “She was so happy to see her cat,” Holmes recalls, becoming emotional as he tells the story.

Holmes also remembers his elderly aunt. The evacuation order came around midnight, while she was asleep. She didn’t drive at night, so Holmes called her, drove to her home and helped her pack.
She followed him out of town. Holmes says similar scenes were unfolding throughout Summerland, with people checking on elderly neighbours, friends and relatives. “It certainly was more difficult for seniors, but at the same time there was always somebody there to help them,” he says. That community support can be critical. But Dr. Gohel says communities also need to look at what happens to healthcare when an emergency strikes.

During the Alberta floods, she says the normal healthcare system was disrupted. And that raises a difficult question: What happens when a climate emergency hits at the same time as another crisis? Gohel calls these “polycrises” – situations where several problems happen simultaneously.

A wildfire could be followed by extreme heat. A flood could coincide with an infectious disease outbreak. A power-grid failure could happen during a heat event. “We know that we don’t have single events,” she says. “Everything happens in class events.” Her Climate Health System Alliance is working on ways to prepare healthcare workers for those scenarios, including using artificial intelligence modelling to show what could happen if multiple emergencies occur simultaneously. The goal is to help healthcare workers answer questions before the crisis happens: If a hospital floods, where do patients go? Where do staff work? How are services moved? What happens to supplies?

Gohel says Alberta needs to become more climate-resilient, but that resilience is not only about surviving an emergency. It also means reducing the healthcare system’s own environmental footprint. Healthcare produces enormous amounts of waste and contributes significantly to greenhouse-gas emissions.
Gohel points to examples where reducing waste has also saved money. At one Alberta hospital, changing how certain pain medications were administered saved thousands of dollars a month, reduced waste and freed up nursing time.

Other relatively simple changes include avoiding unnecessary blood tests, switching some medications from intravenous to oral delivery when appropriate and focusing more on preventative care.
And preventative healthcare may be particularly important for seniors. Vaccinations, managing chronic conditions and keeping people out of hospital in the first place can reduce pressure on a healthcare system during a climate emergency. For Gohel, this is where the connection between climate change and healthcare becomes especially clear.

“No one is immune to climate change,” she says. “Climate change doesn’t respect borders.” She believes older adults need to be at the centre of the conversation because they are among the people most likely to be affected when climate-related health problems increase.

But Summerland’s experience also demonstrates something else: older adults should not simply be viewed as vulnerable people who need to be rescued. They can be an important part of the solution.
Holmes says many of Summerland’s emergency-support volunteers are seniors themselves. “The great thing about having a lot of seniors in your community is that you have a huge volunteer base,” he says.
Older adults were helping other older adults. That social connection can be one of the most important forms of emergency preparedness.

Holmes believes the lesson from Summerland is simple: don’t wait until a crisis to find out who needs help.
“You don’t wait for a crisis to happen before you look after each other,” he says. “Do it now before there’s a crisis.” That means knowing which neighbours live alone, who doesn’t drive, who may need assistance walking, who relies on medical equipment and who might need help getting to an evacuation centre.
It also means making sure seniors know where cooling centres are located, how to protect themselves from wildfire smoke and what they should take with them if they have to leave home quickly.
Climate emergencies are becoming a new reality for communities across Canada. And for older adults, the risks extend far beyond the immediate threat of flames, floods or extreme temperatures.

There is the disruption to healthcare, the loss of routine, the possibility of isolation and the psychological impact of not knowing whether home will still be there. But Summerland also offers another lesson. In the middle of an emergency, neighbours can become caregivers, strangers can reunite people with beloved pets, seniors can become volunteers, and communities can discover strengths they didn’t know they had.
The challenge now is to turn those lessons into preparation before the next evacuation order comes.

Watch the full story on Unison TV