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Ontario legislation that mandated air conditioning in all resident rooms in long-term care (LTC) homes has saved dozens of lives, according to a new study.
“Air conditioning is no longer a luxury. It is actually an essential health need,” said lead author Nathan Stall, the geriatrics lead at Sinai Health, whose study was published this week in the medical journal JAMA Internal Medicine.
The two year study looked at 73,578 resident deaths in Ontario between 2010 and 2023. It found residents in nursing homes without air conditioning in their rooms had an eight per cent higher chance of dying in extreme heat days compared with residents of homes with air conditioning, especially as as extreme heat “poses a serious health risk to older adults.”
Using data collected from those 13 years, researchers conducted a simulation that found the policy change averted 33 resident deaths between 2020 and 2023. The number of observed deaths in that time period was 308 while the simulated deaths in cases where air conditioning was not installed was 341.
In 2021, the province mandated all LTC resident rooms have air conditioning installed by June 2022.
Ontario Premier Doug Ford promised the change during the height of the COVID-19 pandemic in 2020, after CBC News pressed him about reported sweltering conditions in LTC rooms.
At that time, there were 339 homes without air conditioning, representing just over 55 per cent of the total. A spokesperson for the Ministry of Long-term Care told CBC News all LTC homes now have air conditioning in resident rooms, except for two that are “exempt due to ongoing redevelopment.”
The provincial requirement states operators must “maintain functional air conditioning” on any day when the outside temperature is, or is forecasted to be, 26 C or higher.
Premier Doug Ford says he’s considering making air conditioning mandatory in long-term care homes after CBC’s Lisa Xing asked about families who are concerned about their loved ones.
Stall said the research was important, not only because climate change is resulting in more frequent extreme heat events, but because of the unique limits on residents during the pandemic, when they were restricted to their rooms and unable to congregate in air conditioned common areas.
The $200-million investment by the province was worth it, said Stall, who noted the policy change was implemented quickly over a short period of time.
“It’s important to understand the return on investment … which is very clear and it’s lifesaving,” he said.
‘We need national standards,’ expert says
The study authors noted other Canadian provinces don’t have a similar policy in place, and are urging policymakers to consider it.
Stall said Ontario’s efforts could be used as a model for other places in the country, especially since the effects of heat could be even worse on a vulnerable population.
He points out his team only looked at the most “severe outcome” and does not include emergency department visits or hospitalizations.
Other experts agree, like Pat Armstrong, an LTC researcher and professor emeritus at York.
“We need national standards and standards that are enforced,” she said, adding the effects of heat on LTC staff should also be studied.
She says policymakers need to remember “just like heating, we need cooling,” since people aren’t just susceptible to one kind of extreme temperature.
A spokesperson for Ontario’s Ministry of Long-Term Care told CBC News in an email every home is inspected at least once per calendar year with inspectors conducting an average of five visits to each Ontario nursing home this year.
Since the regulations came into effect, the ministry has issued 37 sanctions, the spokesperson said. LTC homes can be penalized up to $25,000 in fines.
