🚨 Heatwave, indoor air, plate: the Care Home facing the climate
🌿🩺 Ecological transition in Care Homes: deprescribing, moving, breathing better and eating better are also green actions. 19 sheets to connect sobriety and the health of residents, with deadlines and funding.
📌 For those who support elderly people in establishments, this report connects two topics often treated separately: ecological sobriety and the health of residents. Deprescribing, adapted physical activity, air quality, nutrition against malnutrition, intimate life, welcoming animals: each "green" lever is also a health lever. The 19 sheets provide obligations, self-diagnosis questions and actions at 6 and 24 months. Useful for preparing an establishment project, a CVS, a heatwave plan or team training.
Source :
📒 The Green Care Home — Old Age and Ecological Transition
✍️ Katy Giraud, Aurélie Chotard and Marie Gaston-Raoul; National Agency for Health and Social Care Performance (Anap) and Think Tank Matières Grises — September 2026
1️⃣ Analytical summary
Two transitions intersecting within the walls of the Care Home
The report starts from a double observation: + 700,000 elderly dependent people expected between 2025 and 2050, and more frequent climatic episodes (pp. 6-7). According to the Shift Project, the independence sector emits 10 million tonnes of CO₂ per year (1.5% of national emissions), of which 60% is for establishments for elderly people (p. 8). The survey conducted for the report shows initiatives already launched: 88% of respondents on sustainable food, 77% on green cleaning, but only 21% on air quality. Nearly half (45%) do not yet see results. The cited barriers: lack of time (nearly two out of three), skills (one in two), contradictory injunctions (nearly a quarter) (pp. 8-9).
Four entry points and 19 ready-to-use sheets
The document organises action into four parts: a healthier living space (food, eco-care, green cleaning, air, digital), a sustainable building (summer comfort, energy, water, climate adaptation), a care home rooted in its territory (mobility, biodiversity, purchasing, openness) and "staying green" (physical activity, social connection, intimate life, alternative communication, animals). Each sheet follows the same structure: why act, autodiagnosis "Where are you?", quick actions (0-6 months) and structural actions (12-24 months), quantified gains, funding, tools and examples (pp. 22-88). Its main contribution to prevention: deprescribing, physical activity or therapeutic gardening are treated as both health and ecological levers.
2️⃣ Key points of the document
1️⃣ A real dynamic but poorly measured
45 % of respondents do not see visible results. However, 44 % observe a decrease in costs, 37 % better working conditions, and 32 % more comfort for residents. Only 9 % note an effect on attractiveness (pp. 8-9). Declarative data, 73 respondents.
2️⃣ Deprescribe: a health gesture and a green gesture
At the Vigeois nursing home (Corrèze), the prescription lines for sleeping pills, anxiolytics, laxatives, and analgesics have decreased by 43 to 60 % since December 2022, thanks to the revision of the medication circuit and non-drug activities (pp. 16-17). The "Reasoned Medication" sheet reminds us that reducing polypharmacy prevents at least 50 % of avoidable adverse drug events (p. 34). Monographic example, not evaluated.
3️⃣ Indoor air quality: a deadline of 1 January 2027
The decree of 27 December 2022 requires nursing homes and independent living residences: annual assessment of ventilation and CO₂, autodiagnosis at least every 4 years, pollutant measurements at key stages of the building, and an action plan before 1 January 2027 (pp. 18-19; sheet p. 28). Only 21 % of respondents have taken action on this topic (p. 8).
4️⃣ Adapt the building before air conditioning
The report places air conditioning as a last resort, after passive solutions: reflective roofs, solar protections, greening, insulation, night ventilation (pp. 38-39). The tertiary decree imposes a −40 % reduction in energy consumption by 2030 (pp. 40-41). Of the 1,586 establishments in the Mediterranean arc, almost half are exposed to flooding (pp. 44-45).
5️⃣ "Stay green": the vitality of residents at the centre
Adapted physical activity is not covered by Health Insurance and weighs on the accommodation budget (pp. 74-75). Only 8% of residents report a sexual or romantic life (pp. 76-77). The law of 8 April 2024 guarantees the right to keep one's pet, unless stated otherwise by the CVS (pp. 80-81). An instruction from 23 June 2025 supports the deployment of alternative and enhanced communication (pp. 78-79).
3️⃣ Action points for local stakeholders
1️⃣ Conduct a self-diagnosis in a multidisciplinary team
Use the questions "Where are you?" from each sheet with care, kitchen, hospitality and technical services, then select 2 or 3 quick actions. The Score.DD tools (waste p. 32, energy p. 46, purchases p. 64) provide a starting point. Limitation: the report does not propose a common health indicator for all sheets; to be developed locally.
2️⃣ Initiate a coordinated deprescribing approach
Bring together the coordinating doctor, pharmacist and nurse; systematise medication reconciliation upon entry; develop non-drug alternatives (physical activity, workshops, outings) (pp. 16, 24, 34). Involve the resident and their family in the decision to stop or adapt a treatment (p. 34).
3️⃣ Meet the air quality deadline of 1 January 2027
Measure the CO₂, conduct the self-diagnosis and formalise the action plan (p. 18). Eliminate synthetic fragrances and aerosols, install dilution systems, reduce the chemistry of bio-cleaning (pp. 26, 28). Note: the effect of the "pollutant-absorbing plants" recommended p. 28 is not demonstrated under real conditions.
4️⃣ Address malnutrition and waste together
Weigh the leftovers, track the intakes, create a liaison sheet kitchen–care, gather residents' likes and dislikes (p. 22). The report estimates the gain at €0.89 per meal, or about €65 000 per year for 100 residents (p. 22). Vigilance: any reduction in meat must ensure the protein intake of malnourished residents.
5️⃣ Prepare for summer with the blue plan
Appoint a heatwave referent, identify south-facing rooms, top floors and isolated residents, train teams in managing windows and shutters (p. 52). Prioritise passive solutions before any heavy investment (pp. 38, 52).
6️⃣ Make residents active participants in the process
Animate a lively residents' council (example from Crès, pp. 78-79), use AAC to collect choices and consent (p. 86), co-design the therapeutic garden (p. 66), appoint a personal life referent and put up a ‘Do Not Disturb’ sign (p. 84). Unmet need: no simple language support is provided to explain the ecological approach to residents.
4️⃣ Additional references
On the blog Health Practices
One Health – One Health: from concept to field practices - https://www.pratiquesensante.com/une-seule-sante-one-health
External references (published after 2024)
1️⃣ ARS Auvergne-Rhône-Alpes — Ecological and environmental transition in health: tools and best practices for health and medico-social establishments (11 September 2025)
Directory of tools in 13 themes (energy, waste, EGalim, indoor air, mobility, eco-care, Score.DD). Completes the sheets with a regional entry. Consult the page
2️⃣ HAS — Supporting the intimate, emotional and sexual life of people in ESSMS, component 1: transversal foundation (February 2025)
Recommendation of good practices. Provides the methodological framework (consent, prevention of violence, posture) that is missing in chapter 4.2 of the report. Consult the recommendation
3️⃣ WHO — From loneliness to social connection (« From loneliness to social ties »): report of the WHO Commission on social ties (30 June 2025)
Source of the observation cited pp. 76-77 on loneliness. Proposes intervention strategies at different scales, useful for the component « creating connections ». In English. Page of the Commission
5️⃣ Frequently asked questions
1️⃣ What are our obligations regarding indoor air quality?
Evaluate each year the ventilation and CO₂, conduct a self-diagnosis at least every 4 years, measure pollutants during work and adopt an action plan before 1 January 2027 (pp. 18, 28).
2️⃣ Must a care home serve vegetarian meals?
The nutrition sheet mentions the vegetarian alternative within the regulatory framework, and the text specifies that the diversification of proteins is only mandatory beyond 200 covers. The EGalim law requires 50% of sustainable products, including 20% organic, and the display of these shares (pp. 12, 14, 22).
3️⃣ How does deprescribing relate to ecological transition?
It reduces iatrogenesis, wasted medications and pharmaceutical residues in water, while giving meaning back to practices (pp. 16, 24, 34).
4️⃣ Should all rooms be air-conditioned?
No. 96% of care homes already have a mandatory cooled space (DREES 2023). The report first recommends passive solutions: sun protection, reflective roofs, greening, night ventilation (pp. 38, 52).
5️⃣ Who can technically assist us?
The energy and ecological transition advisors in health (CTEES): 165 positions funded from 2021 to 2025, 70 new ones announced, usually shared between establishments (p. 44). Each sheet also refers to the Anap grant platform.
6️⃣ Can a resident bring their pet?
Yes, since the law of 8 April 2024, unless otherwise advised by the CVS. Please provide a veterinary certificate of less than 3 months, insurance, admission procedure and support in case of hospitalization or death (pp. 80, 88).
7️⃣ How to fund adapted physical activity?
It is not reimbursed by health insurance and weighs on the accommodation budget. The report directs towards regional project calls and the pooling of a physical activity teacher; it also requests a physical activity referent (pp. 74, 82).
6️⃣ Rewriting in Easy to Read and Understand (FALC)
What is this document about?
This document is about care homes.
A care home is a house for elderly people who need help.
The climate is changing. Summers are getting hotter.
There will also be more elderly people in the coming years.
Care homes must protect nature.
They must also protect the health of the people living there.
What care homes are already doing
Many care homes have already started to take action.
Ils achètent de la nourriture plus saine.
Ils nettoient avec moins de produits chimiques.
Mais beaucoup de directeurs ne voient pas encore les résultats.
Ils manquent de temps.
Ils manquent aussi de personnes formées.
Les idées importantes
Donner moins de médicaments peut aider les résidents. Bouger et sortir aide aussi à mieux dormir.
L'air dans l'Ehpad doit être propre. Il faut ouvrir les fenêtres. Il faut mesurer l'air chaque année.
Quand il fait très chaud, il faut d'abord fermer les volets et mettre de l'ombre. La climatisation vient après.
Les résidents peuvent garder leur chien ou leur chat. C'est la loi depuis 2024.
Les résidents ont droit à une vie amoureuse. Ils ont droit à l'intimité.
Les résidents doivent pouvoir donner leur avis. Certains ont du mal à parler. Des images peuvent les aider.
Ce que le document propose
Le document donne 19 fiches pratiques.
Chaque fiche pose des questions à l'équipe.
Chaque fiche donne des actions à faire en 6 mois.
Elle donne aussi des actions à faire en 2 ans.
7️⃣ Analyse transversale — valeurs de Pratiques en Santé
Littératie : Les fiches visent les professionnels ; seuls les pictogrammes et repères visuels de la CAA (p. 86) s'adressent à des niveaux de compréhension variés.
Empowerment : La partie 4 fait du résident un acteur ; la décision d'arrêter un traitement est co-construite avec lui et sa famille (p. 34).
Participation : CVS active report (pp. 78-79), intimate life charter developed with residents and relatives (p. 84), co-designed gardens (p. 66) ; the survey, however, only collects the voices of management.
Community health : The care home is designed as a prevention platform for seniors in the area, with third places and meal delivery (pp. 62-63).
Ethics : The report advocates a "right not to be monitored" (pp. 20-21) and prioritises the resident's choice over ecological logic for their room (p. 70) ; social and territorial biases are not analysed.
Human rights : Intimate life, consent and dignity are linked to the 2002 law and the charter of rights (p. 84) ; the CAA is presented as a right (p. 86).
Intersectorality : Water agencies, ADEME, local authorities, LPO, schools, health-sport clubs and health-sport houses are cited as partners (pp. 42, 66, 82).
Partnership : Shared market for biowaste in the GHT of Charente (p. 32), shared CTEES positions between establishments (p. 44), agreements with a veterinarian (p. 88).
Fight against discrimination : The label "Grey Pride" commits to a non-judgmental listening of the intimate life of seniors and respect for everyone's choices (p. 84) ; the income inequalities between residents and between establishments are not addressed.
8️⃣ Evaluation of the reliability of the resource
Scientific relevance : average.
Strengths : institutional sources cited in notes (Shift Project, DREES, CNSA, ADEME, WHO, HAS) ; precise and dated regulatory framework ; recent data (2024-2026).
Limitations : declarative survey of 73 respondents, without sampling methodology ; examples of unassessed establishments ; journalistic tone (wordplay) that sometimes mixes observations and opinions.
Claims to be nuanced: the effect of depolluting plants is not demonstrated in real conditions ; the distance from Wi-Fi terminals (p. 28) is a precaution, with no established risk in the document ; the figure of + 29 % excess mortality (heatwave 2026, p. 52) is cited without detailed source.
Operational relevance: high.
19 sheets with identical framework, with self-diagnosis, 6 and 24 month calendar, quantified gains, funding and Anap tools.
Directly usable by management and referents; less suitable for animation with residents without adaptation.
9️⃣ Strategic hashtags
#healthpractices #GreenCareHomes #EcologicalTransition #HealthPromotionForElderly #Deprescribing #IndoorAirQuality #OneHealth #MediSocial
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