5 Increasing Health Risks for Older Adults Due to Climate Change

With over one-third of California long-term care communities located in areas that are at high risk for fire, it would be difficult to find someone more on edge than a long-term care facility operator during California's fire season. 

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Unless you are a care manager for older adults in Florida during hurricane season.

While Liz Barlowe of Barlowe & Associates in Seminole, Fla., and her clients have evaded severe storms, she creates a disaster plan with her clients annually. This includes a transfer to a safe place for them to stay with access to medical attention and an ample supply of food, or the presence of a caregiver who can ride out the storm with them in their home. 

The recent UN Climate Change Conference confirmed what people like Barlowe already know: Climate change is causing increasingly severe weather events that are impacting public health and safety.

Older adults are particularly vulnerable to these impacts. While global leaders work towards containing warming, the rest of us can do our part towards minimizing the associated health risks. Being aware of the following five risks and taking simple precautions can go a long way towards staying safe:

Many older adults in the U.S. live in areas that are disproportionately impacted by forest fires, hurricanes, coastal flooding and heat waves. For example, nearly 20% live in a county struck by a hurricane or tropical storm during the past decade. Among those at highest risk during a weather event and potential evacuation are individuals with mobility challenges or living with dementia.

A lack of available medical care can compound the risk for all older adults, and especially those with chronic health conditions, in ensuing days and weeks.

Hurricane Katrina, in which 60% of flood-related deaths were older adults, hit close to home for Michael Smyer, professor at Bucknell University in Lewisburg, Pa., and founder of Growing Greener, an organization that encourages older adults and others to work towards climate change. Born and raised in New Orleans, Smyer realized the risk for all older adults, including those in long-term care communities. 

"If we think about the people who were already at risk because of chronic illness before the storm in New Orleans, then you put them at risk when a facility is flooded and power is out, they are at very highly elevated risk for adverse outcomes," Smyer said.

For those aging in place, preparing for an extreme weather event is important. This includes putting together a "go bag"of essentials including prescription medications and a change of clothing, arranging an evacuation route and family communication plan and setting up weather and emergency alert notifications.

Heat is the leading cause of weather-related deaths in the U.S., and heat waves are only expected to increase in frequency, severity and duration.

The good news is that these deaths are preventable, mainly by ensuring that those at risk remain in an air-conditioned environment during a heat wave. This means remaining vigilant as a community and intervening on behalf of older adults when necessary. 

"It is a population that we need to make sure is very well connected to family or other social networks that will look out for them during these events," said Ruth McDermott-Levy, a professor at Villanova University and expert in environmental health and public health nursing.

An older adult's body does not sense heat as readily as a younger adult due to thermoregulation, explained McDermott-Levy. It is why an older adult may be wearing a thick wool sweater while the home temperature is 80 degrees. The person's body doesn't have the capacity to sense the heat even though they are experiencing the heat.

Consequently, during a dangerously hot day, they may not respond to the conditions as quickly as a younger person might. In addition, chronic health conditions and the medications prescribed for these conditions can further increase the risk of an adverse response to heat.

Many older adults lead active, social lives. With retirement comes fewer commitments on their time, and in turn, more opportunities for outdoor activities like golfing, hiking or fishing. These are the individuals most at risk for exposure to disease carried by mosquitoes or ticks such as West Nile fever, Lyme disease or the Zika virus disease.

Vectors, organisms that spread infection by carrying a pathogen from one host to another, thrive in warm, wet conditions. The increased risk of exposure to vectors is due to a lengthening of warm-weather seasons and an increase in the insects' geographic range.

It is important to remain physically active as we age, but keep in mind precautions to prevent against these tiny, virulent pests.

This includes wearing long sleeves, pants and a hat, as well as applying insect repellent with 20 to 30% DEET before going out. 

As the world warms, heavy downpours and flooding increase. As a result, fresh produce is at a greater risk of contamination from nearby livestock or wild animal feces. In addition, parasites like cryptosporidium and giardia can sicken the population through drinking and recreational water.

Because older adults typically have an immune response that is less effective than that of the general population, they are more vulnerable to water-borne illnesses. A decrease in electrolytes can result from the ensuing gastrointestinal symptoms. Be aware that this may present as confusion or dementia, but is temporary until the person's fluids have been replenished.

Climate change impacts respiratory health in two ways. First, it aggravates pre-existing diseases. One of the most common is chronic obstructive pulmonary disease (COPD), which disproportionately impacts older adults. 

The danger comes with rising temperatures which increase ground-level ozone, causing inflammation and tissue damage in lungs. Another danger is particulates emitted during the increasingly long and intense wildfire season. This pollution doesn't just impact older adults who live near the wildfires; the particulates can travel thousands of miles from the source.

In addition, warmer temperatures contribute to longer and longer pollen seasons. Between 1995 and 2015, the ragweed pollen season expanded between 6 and 21 days in various locations around the U.S. Intensity has increased, too. Each plant is producing more pollen and allergens.

This increased exposure may lead to a rise in the number of people living with allergies and asthma, conditions that can develop at any stage of life. However, like with other illnesses, older adults have a slower immune response for fighting respiratory disease.  

To protect yourself or an older loved one from dangerous levels of air pollution and allergens, check the U.S. Air Quality Index (AQI). It uses a simple color-coded system to report the air quality in your area. Restrict your outdoor activities when air quality is poor.

Throwing up your arms in despair is not the only way to deal with these new health challenges. Far from it. Taking proactive steps like staying active, maintaining a healthy diet and maintaining social networks are important, said McDermott-Levy. 

"All of those things that you were taught all along 一 it helps make you more resilient," she said.

Some older adults also become active in seeking climate change solutions. "Older adults are not only potential victims of climate change but also potential leaders of climate action," Smyer said. 

Importantly, they can help break what Smyer calls the "climate silence habit," shying away from discussing climate change with family and friends.

Grandparents often share a special bond with grandkids, many of whom care about global warming. Initiating an intergenerational conversation can go a long way towards breaking the silence, Smyer said.

Jenny Wisniewski is a freelance writer based in Milwaukee. She writes about elder care, the environment and travel. More of her work can be found at jennywisniewski.com and on LinkedIn. Read More