The scorching heatwaves that have become more frequent and intense in recent years pose significant health risks, especially for vulnerable populations such as older individuals. Among this group, the combination of extreme heat and electrical power cuts can lead to dire consequences, exacerbating the dangers of hyperthermia and contributing to a distressing phenomenon known as ‘high-rise prisoners’.

Rising threat of hyperthermia

As global temperatures continue to rise due to climate change, the frequency and intensity of heatwaves have escalated, putting older adults at a heightened risk.

The physiological changes that come with ageing, such as decreased ability to regulate body temperature, reduced thirst sensation and chronic health conditions make them more susceptible to heat-related illnesses like hyperthermia.

Hyperthermia occurs when the body absorbs more heat than it can dissipate, resulting in an elevated core temperature. This can lead to heat exhaustion or, in severe cases, heatstroke, which can be life-threatening if not promptly treated. This condition, which is characterised by elevated body temperature due to extreme heat exposure, poses significant biopsychosocial challenges for older individuals.

Physiologically, ageing leads to reduced heat regulatory capabilities and heightened vulnerability to heat-related stress. Concurrently, chronic health conditions and medication use can exacerbate the impact of hyperthermia.

Psychologically, older adults may experience anxiety and fear during heatwaves and power cuts, especially those living alone or with cognitive impairments such as older persons with dementia and their caregivers, who may struggle to recognise the severity of the situation.

Socially, economic constraints can hinder access to proper cooling systems and essential supplies, while limited social support may lead to social isolation during such events. Furthermore, the challenges posed by high-rise buildings, particularly for those with mobility issues, can intensify the risks.

Unplanned electrical power cuts

The rising threat of heatwaves to older individuals is compounded by the double jeopardy of electrical power cuts. As extreme heat events become more frequent and intense, older adults increasingly rely on electrically powered cooling systems like air conditioning and fans to find relief from the scorching temperatures. However, electrical power cuts during heatwaves disrupt these essential resources, leaving older individuals exposed to hazardous conditions.

Power cuts might occur due to overloaded power grids struggling to cope with high energy demands during heatwaves or as a result of damage caused by extreme weather events. This critical combination of extreme heat and power cuts leaves older people vulnerable, deprived of their means to regulate body temperature and protect themselves from hyperthermia.

In particular, those living in high-rise buildings face additional challenges, as access to functioning elevators becomes limited or non-existent during power outages, rendering evacuation attempts nearly impossible for those with mobility issues.

Addressing this double jeopardy necessitates a comprehensive approach that includes improving infrastructure resilience and implementing targeted emergency plans to protect the well-being of older individuals during extreme weather events.

Plight of ‘high-rise prisoners’

In this context, the term ‘high-rise prisoners’ emerges as a poignant metaphor for older individuals with cognitive or mobility issues who find themselves confined and isolated due to the combination of heatwaves and electrical power cuts. These older individuals often live in flats with limited access to assistance, which exacerbates the difficulties they face during extreme weather events.

Urgent need for comprehensive measures that safeguard and support the elderly

The physical constraints that come with residing in high-rise buildings can make evacuating during emergencies, such as power failures or extreme heat, a challenging task. For those with mobility impairments, the absence of functioning elevators during power cuts can be insurmountable, rendering even a temporary ‘escape’ to cooler areas impossible.

Moreover, older people with cognitive impairments such as older persons with dementia, may struggle to comprehend the gravity of the situation, further intensifying their vulnerability. They might not be aware of the risks posed by hyperthermia or know how to seek help, leaving them at the mercy of their living conditions.

Call for action: mitigation and support

Addressing the impact of heatwaves and power cuts on older people demands a comprehensive and multifaceted approach. Governments, community organisations and healthcare providers must work collaboratively to implement strategies that protect and support older individuals during extreme weather events:

• Public awareness campaigns: Launching educational initiatives to raise awareness among older individuals and their caregivers about the dangers of hyperthermia and how to seek help during emergencies.

• Community support: Establishing support networks to check on vulnerable older adults during heatwaves and power cuts, ensuring they have access to necessary resources. Community centres and local organisations can organise heatwave-preparedness programmes, providing older individuals with cool spaces and activities to combat social isolation during extreme temperatures. These initiatives can create a sense of community and support, easing the psychosocial impact of heatwaves.

• Infrastructure resilience: Proactively investing in infrastructure upgrades to minimise power cuts and ensuring adequate alternative cooling facilities in high-rise buildings, particularly for those with mobility challenges.

• Emergency preparedness: Developing targeted emergency plans that address the unique needs of older individuals with cognitive or mobility impairments, especially during unplanned power cuts that occur during heatwaves.

• Heat-related healthcare: Training healthcare professionals to recognise and respond promptly to signs of heat-related illnesses in older patients. Even helplines focused on providing support to such issues can be of invaluable support.

In conclusion, the combination of heatwaves, hyperthermia and electrical power cuts poses a formidable threat to the well-being of older individuals.

The concept of ‘high-rise prisoners’ underscores the urgent need for comprehensive measures that safeguard and support this vulnerable population during extreme weather events.

By proactively addressing these challenges, we can protect the dignity, health and safety of older people in the face of an increasingly warming world.

Christian Borg Xuereb is head of the Department of Gerontology and Dementia Studies at the Faculty for Social Well-being, University of Malta. He is also a registered health, academic and research psychologist with special interest in geropsychology. He is the public relations officer of the Maltese Association of Gerontology and Geriatrics (MAGG).