Energy efficiency

per day, seven days per week. For that reason, care homes inevitably consume more energy, with a benchmark that is 2.5 times higher than for use in an average British family home.4 A report by the Nottingham Energy Partnership estimated the cost of utilities for the whole country from 2008-2009 at 2.4 million tons of CO2

at a cost of £468.5 million.5 Consequently, it

suggests reducing the room temperature to 21˚C to reduce environmental impact. With the projected increase in the elderly population, there is a need to prioritise energy saving in care homes and introduce strategies to meet the challenge of achieving economic and environmentally sustainable development.6

In line with the results of the survey, the benchmark for heating in care homes in the UK is 420 kWh/m2

and 387 kWh/m2

the Edinburgh care home mentioned previously was used as a benchmark for comparison. This figure is almost three times the 102 kWh/m2 average residential flat.7

level given for an Apart from the

continuous heating provision and longer heating season, the study reveals that this was due to a higher than normal temperature setting. Based on a standard energy assessment tool – RdSAP8 - an annual saving of 44,267 kWh of fossil thermal energy was predicted - about £1,300 in cost savings - with a 2˚C drop in set temperature in a care home with 25 beds in the Heriot-Watt study.9

Dry air

Opening windows daily or leaving trickle vents open is a good way to keep the air in a room fresh. A certain amount of infiltration is also considered beneficial. However, this comes at a cost. As cold winter air holds very little moisture, especially in the early morning, when it enters a room it removes not only the heat but also the moisture. The lost heat is compensated for by normal heating systems, but the air in the room becomes very dry. This can become a serious problem in rooms with powerful heating devices and other issues such as drafty windows and fireplaces. The Heriot-Watt University study showed that relative humidity in many care homes was much lower (Figure 2) than the 40-70 per cent recommended for comfort.10

Another Herriot-Watt

study on the effects of using a domestic humidifier on skin conditions also indicated the increased dryness in the room if no humidification was provided. The relative humidity was about 31 per cent on average and could fall below 20 per cent.

46 ;

70 60 50 40 30 20 10


Adults in winter

Older people

B10 B12 B16 B18 B1 B3 B4 B8 B9 B14

Conservatory Lounge

14 16

18 20 22 24 26 28 30 32 34 Temperature (˚C)

Dining room

Figure 2. The measured data (temperature and relative humidity) during occupied hours. The winter comfort zone for younger adults (orange box) and for older people (yellow box]

In addition to increased heating bills, the other problem seen in care homes is low relative humidity, which causes dryness and discomfort and effects such as dry nose, throat, eyes and skin and itchiness as well as chapped lips, nosebleeds and compulsive scratching. These symptoms are known as ‘winter itch’, which although they can be experienced by anyone, are often more severe in older people.

Dry skin related discomfort, itch and eczema are seen in 70 per cent of the elderly population in the UK and have become a major barrier to wellbeing in later life due to associated problems such as compulsive scratching, sleep disorder and skin damage.11


measures are recommended, from frequently applying moisturiser and eating a diet rich in healthy fats to keeping residents hydrated and humidifying rooms. Vapour therapy has also been recommended by geriatric nursing specialists to ease dryness related discomfort.12

A number of ways of humidifying rooms have been tested at Heriot-Watt University. These range from placing different numbers of pot plants of differing sizes and species in rooms to hanging damp towels of different sizes

Opening windows daily or leaving trickle vents open is a good way to keep the air in a room fresh

in bedrooms instead of in en-suites.13 However, the increase in humidity levels seen was insignificant. A recent Heriot-Watt study of student dormitories showed that using a humidifier was an easy and effective way to raise relative humidity and consequently improve skin hydration. An ultrasonic humidifier with a five litre water capacity, which was refilled every three days, was shown to be capable of maintaining relative humidity at 40-50 per cent at a cost of 30 pence per day. This study also revealed a high correlation between relative and skin hydration in participants, suggesting that humidification improves skin moisture levels. It therefore seems likely that care home residents could also benefit from the use of humidifiers.

There might be some concern with regard to the growth of bacteria due to use of humidifiers.9

The Chartered Institution of Building Services Engineers,10

As suggested by this normally

happens when relative humidity in a room remains above 70 per cent constantly and there is a lack of air movement. However, this is often associated with poor insulation, insufficient heating and low room temperature and the risk can be eliminated by keeping relative humidity below 65 per cent.


As illustrated by the various studies discussed in this article, there are two problems that result from overheating when provision is based on the simple assumption that older people prefer a warmer room. Overheating in care homes leads to high energy consumption and high levels of carbon emissions, which result in increased economic and • November 2018

Relative humidity (%)

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