The role of formal and informal networks in supporting older people’s care during extreme weather events

Jonathan Wistow, Lena Dominelli, Katie Oven, Christine Dunn, and Sarah Curtis, from Durham University, discuss their latest article from EPSRC-funded research, “The role of formal and informal networks in supporting older people’s care during extreme weather events”. This article is now available on fast track.

Image by West Midlands Police [CC-BY-SA-2.0 (], via Wikimedia Commons
Local residents and police officers in Balsall Heath clearing snow from the pathway of an older persons home (2013). Image courtesy of West Midlands Police [CC-BY-SA-2.0 (, via Wikimedia Commons
Climate change and demographic projections point, respectively, to more frequent occurrences of extreme weather and an ageing population.  Taken together these provide new dynamics to which health and social care systems need to respond.  Firstly, demographic change will lead to a growth in the population group that relies most on services within health and social care systems.  Secondly, the increased frequency of extreme weather events can have serious effects on the services, buildings, communication routes and utilities that are important for health and social care of older people.

This article is an output from an Engineering and Physical Sciences Research Council funded research project under the Adaptation and Resilience in the Context of Change programme, called Built Infrastructure for Older People in Conditions of Climate Change. The project brought together a team of researchers from different disciplines to understand how systems of care can stand up to the challenges of climate change.  The paper draws on interviews and focus group discussions with older residents in the UK, age 66-81 years, and local health and social care service providers.   We were interested in exploring both older people and service providers’ perceptions of how local networks of formal and informal health and social care interfaced with some recent extreme weather events.

The paper draws attention to the importance of local history and context for the emergence of ad hoc networks of care during emergencies.  Authors of the study recommend that formal and informal systems of care need to be integrated in order to better prepare for emergencies and associated risks involving extreme weather. Local cooperation between family support and public sector providers can mitigate those health and social care network discontinuities that potentially harm older people’s health and sense of well-being. Involving all parties in preparing for extreme weather, including service providers, infrastructure providers, and older people themselves, could allow for better delivery of health and social care services to older people during extreme weather events. Views of both older people and health and social care service providers can help to identify the resilience of infrastructures and service agencies.  Consequently, the accumulation of local knowledge by professionals in care agencies and service planners can aid local preparation for a changing climate.   Connections between formal and informal networks of care are very important. Finally, the paper poses some questions about the impact of on-going austerity measures in the United Kingdom and the potentially negative impact these might have on local capacity to prepare for and respond to extreme weather events.

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