Care home residents face rising risk from heatwaves, new editorial warns
Researchers and clinicians have warned that rising temperatures are creating an urgent and under-recognised threat to older people living in care homes, where frailty and environmental exposure combine to significantly increase the risk of heat-related illness and death.
In a commentary published in Age and Ageing, Dr Mary Ní Lochlainn, NIHR Clinical Lecturer at King’s College London, highlights growing evidence that heat-related mortality in English care homes rises sharply even at temperatures commonly experienced during UK summers.
The article discusses emerging research on heat-related deaths in social care settings and examines whether Care Quality Commission (CQC) ratings can help identify care homes most in need of heat adaptation measures. The findings suggest a clear gradient in risk, with higher mortality observed in care homes with poorer inspection ratings. However, even care homes rated as “Good” still showed significantly increased risk during warmer periods, suggesting that vulnerability is widespread across the system.
Analysis presented in the commentary shows that mortality risk in care home residents increases substantially at around 25°C compared with cooler baseline conditions. This reinforces concerns that harmful heat exposure is not limited to rare extreme events, but occurs across a much broader range of conditions in the UK climate.
“Heat-related risk in care homes is often underestimated because we do not typically think of UK summer temperatures as dangerous, yet the evidence shows clear and consistent increases in mortality,” said Dr Mary Ní Lochlainn.
The editorial highlights that care home residents are particularly vulnerable due to high levels of frailty, multiple long-term conditions, and reduced ability to regulate body temperature. As a result, environmental stressors such as heat can rapidly lead to clinical deterioration.
Dr Ní Lochlainn also notes that heat risk is not yet routinely recognised as a core patient safety issue within health and social care systems, and is rarely included in inspection reports or formal care standards.
“There is still a lack of recognition of heat as a clinical risk comparable to other established safety concerns such as falls or infections,” she said.
A key concern raised is the lack of real-world monitoring of indoor temperatures and physiological responses during heatwaves in UK care homes, which limits the development of effective adaptation strategies. Dr Ní Lochlainn highlights ongoing research efforts at King’s College London’s Centre for Ageing Resilience in a Changing Environment (CARICE) as an important step towards addressing this evidence gap.
The commentary also explores how organisational quality, as reflected in CQC ratings, may influence risk. While poorer-rated care homes show higher heat-related mortality, the findings suggest that even higher-rated homes remain insufficiently protected, pointing to a systemic issue rather than isolated failures.
Dr Ní Lochlainn said:
“Even modest increases in temperature can have serious consequences for frail older adults. Heat needs to be recognised as a fundamental safety issue in care provision, not just an environmental inconvenience.”Dr Ní Lochlainn added:
“Our findings suggest that protecting older adults from heat requires system-wide change. This includes better infrastructure, clearer accountability, and integrating heat risk into regulatory frameworks for care homes.”
The commentary concludes that climate change, combined with an ageing and increasingly frail population, is creating a “perfect storm” of vulnerability. Without urgent adaptation, heat-related harm in care homes is likely to increase, raising important ethical and clinical concerns about preventable risk in social care settings.
Read more: system under heat: care homes, frailty and climate vulnerability | Age and Ageing | Oxford Academic