Abstract

This paper brings together objective and subjective data on indoor temperature and thermal comfort to examine the magnitude and perception of summertime overheating in two London-based care homes occupying modern and older buildings. Continuous monitoring of indoor and outdoor temperature, relative humidity and CO2 levels was conducted in summer 2019 along with thermal comfort surveys and semi-structured interviews with older residents and staff of the care settings. Indoor temperatures were found to be high (>30°C) with bedroom temperatures often higher at night than daytime across both care settings. Limited opening due to window restrictors constrained night-time ventilation. Overheating was prevalent with four out of the five monitored bedrooms failing all four overheating metrics investigated. While 35–42% of staff responses perceived indoor temperatures to be uncomfortably hot, only 13–19% of resident responses were found to do so, indicating that elderly residents tend to be relatively insensitive to heat, leaving them open to overheating without realising it. Residents and staff in the modern care setting were less satisfied with their thermal conditions. As hybrid buildings, care settings need to keep both residents and staff comfortable and healthy during hot weather through night-time ventilation, management of heating and supportive institutional practices. Practical application: Care home designs have focused on keeping residents warm through the winter, neglecting the risks of summertime overheating. Care homes are hybrid buildings serving as living spaces for vulnerable older residents and offices/workspaces for staff. Providing comfort to both groups during periods of hot weather is challenging. Opportunities for ventilation are limited by Health & Safety regulations that mandate up to 10 cm maximum window openings and institutional practices that result in windows routinely kept closed, particularly at night. Utilising natural and where possible cross-ventilation should be considered along with external shading. Heating should be managed to avoid unwanted heat gains in the summer.

Highlights

  • The relationship between high external temperatures and an increase in mortality has been well studied.[1]

  • Monitored outdoor operative temperatures were found to be as high as 35 C at both sites during the hottest days of the summer (Table 5)

  • This paper has empirically assessed the magnitude, duration and perception of summertime overheating during summer 2019 in two contrasting care settings - one modern and one older care home located in London

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Summary

Introduction

The relationship between high external temperatures and an increase in mortality has been well studied.[1] Excessive heat has been linked to heat exhaustion and heat stroke, which in turn can lead to cell, organ and brain damage and even death.[2] Heat increases the risk of dehydration which has been linked with increased risk of bloodstream infections.[3] Public Health England have identified the relatively low temperature of 24.5C as the threshold above which excess heat-related deaths may become apparent, principally through cardiovascular and respiratory disease.[2] The global Covid-19 pandemic has disproportionately affected the elderly, those in care homes. Despite care homes being known to be vulnerable settings for heatrelated mortality and morbidity, research in this area is limited, both in scope and scale – some focussing on environmental monitoring, others on feedback from residents, but rarely both

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