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Amit Arya is the palliative care lead at Kensington Health in Toronto and a lecturer in the Division of Palliative Care at the University of Toronto. Samantha Green is a family physician who is faculty lead in climate change and health at the University of Toronto’s Department of Family & Community Medicine; she is also a board member at the Canadian Association of Physicians for the Environment.

Unprecedented temperatures scorched Canada this summer, and July was the hottest month on record globally. The effect of heat wave after heat wave has been devastating for seniors, as well as people with disabilities. Close to 500 people died in just five days during British Columbia’s heat wave, the majority aged 60 and older. In Ontario, 40 per cent of long-term care facilities are still not fully air conditioned – despite promises from the government in July, 2020, that the problem would be rapidly fixed – leaving the vulnerable people living there at continued risk.

As physicians, we have seen that older adults and people with disabilities have often been most at risk during successive waves of COVID-19, and are also most likely to fall ill and die during climate-induced heat waves. Our body’s physiology changes as we grow older, so that by the time we feel thirsty, we may already be mildly dehydrated. And those who have illnesses such as dementia and frailty are often dependent on caregivers to monitor for signs of dehydration and provide fluids. Similarly, older adults and people living with disabilities are more vulnerable to the adverse health effects of forest-fire smoke, and are least able to survive extreme-weather events such as droughts and floods.

If you think the pandemic has been incredibly difficult, remember that the World Health Organization and the Lancet have both declared climate change the number one health threat of this century. And just as we have seen with COVID-19, climate change will also not affect all Canadians equally.

Climate change threatens the very survival of older adults and people with disabilities now, with conditions only projected to get worse in the years to come. And so we must adapt and prepare immediately. We welcome the federal government’s National Adaptation Strategy, which is a preparation plan for climate disasters. We hope that it is provided with urgent funding so that it can be implemented.

Between Liberal red and Conservative blue, there’s a green gap

We need our provincial governments to mandate that long-term care facilities and other buildings such as retirement homes, group homes and seniors apartments install air conditioning or more efficient electric heat pumps. We would even argue that air conditioning should be classified as a medical device when it is used to enable vulnerable people to stay cool. Improved ventilation would likewise protect people from air pollution and forest-fire smoke.

Access to publicly available cool spaces must be prioritized and ensured for people who are vulnerable. An increase in urban green space will mitigate the urban heat island effect and provide valuable access to nature.

And, of course, we must also act now to mitigate the climate crisis itself.

August’s Intergovernmental Panel on Climate Change report confirms that we will see 1.5 degrees of warming by 2050 and must act now to avoid further increases, which would be catastrophic for both human health and the planet. Every fraction of a degree of warming will translate into millions of lives saved or lost.

With a federal election happening soon, we must demand an immediate end to fossil fuel development and subsidies. This means a shift to a low-carbon economy, which prioritizes jobs that do not extract from the land and lead to minimal or no carbon emissions.

So why not invest in caregiving?

Through the pandemic, seniors and people with disabilities died, not just from COVID-19, but also from dehydration and neglect, as there were not enough front-line staff, such as nurses and personal support workers, available to look after them. Canadian long-term care facilities continue to be understaffed, and there is a shortage of health workers in home care. Nurses and personal support workers remain underpaid, and left without benefits or paid sick days.

And, still, demand for caregiving work is accelerating, as the population continues to age, and 2021 is the year when baby boomers, our largest demographic cohort, start turning 75.

So we should consider improvements in caregiving as life-saving for vulnerable elders and people with disabilities, as well as crucial for the life of the planet. Caregiving is a climate-change investment.

As we are all aging on the same planet, this will affect all of us. Recent events have shown us that the climate crisis and the elder-care crisis both require action – not in the distant future, but today. By acting now, we have an opportunity to finally provide proper care for our elders, their cherished grandkids and the world those children in turn will grow old in.

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