My elderly parents are very happy in their decision not to have air conditioning. They live in a 50 year old brick house, with insulation and window coverings, the same one in which we enjoyed our childhood spent mostly outside – apart from the odd really hot day when the shades were drawn and the warm north winds swirled outside. They declined the air conditioner we offered to install for them in November, as they didn’t feel they needed it.
This year was different. The heatwaves were hotter and longer, the overnight temperatures soared. They have already sweltered for many more days than in the past, and both take tablets for heart problems. No surprises that they have had a few “dizzy spells” in the heat. One was almost hospitalised.
So, as previously they went with fans and a wet cloth in the hot part of the third day of several heatwaves – a strategy similar to what we use in hospital when people with heat stroke need active cooling. Many of their friends feel the same and are reluctant to buy an appliance they have managed without for 80 plus years. Unfortunately they are now in one of the vulnerable population groups who really suffer – and end up in hospital – during these heatwaves we are seeing more frequently. Other vulnerable groups are their smaller grandchildren, athletes, outdoor workers and people with mental illness to name a few.
Our elders have spent a lifetime going without so the next generation (mine) could enjoy some of the comforts and advantages they did not, growing up during the depression and the second world war. And while the Coalition’s “keep the lights on” slogan may help in the short term, it has no consideration of long or intermediate term effects, and it will actually compound things in the longer term without renewable energy – a legacy this proud generation does not want either. Most of my older patients are very interested the world they will leave their grandchildren. They spent their lives working toward a better world and continue to contribute, even in their dotage.
I care for people like my parents at work every day. Often they live at home and are fiercely independent. It is on the third day of a heatwave when we typically see droves of elders in hospital as they have fainted, fallen over or feel like they will faint in the heat. Others are semiconscious and very unwell, with kidney and other organ failure. All of them have been affected by the heat.
In the heatwave that resulted in the Black Saturday fires 10 years ago many more people died of heat-related illness than died in the fires. They didn’t arrive by chopper and didn’t pass away immediately or from burns. But they did succumb and are an important group suffering in this warming climate. The Australian College of Emergency Medicine created a “heat health resource” a couple of years ago, and state governments run heatwave warnings. The media penetration of these warnings is variable and there is work to be done, as many elders don’t have access to electronic media themselves.
In spite of these interventions (and phone checks and reminders, as in the case of many families like mine) we still see a surge in presentations of elderly patients on hot days, and even more so on day three of any heatwave. While seniors are bombarded with information about retirement savings (if they have any) and assisted accommodation, we need to remind ourselves that they are vulnerable in the heat. We need to help them stay cool and urge them to rest and to drink more, so they can stay well in the community where they prefer to be anyway.
• Marianne Cannon is an emergency physician
