On the eve of the nor’easter that hit New York in late September, Lee and her colleagues at Queens Community House monitored the storm’s path. If warranted, they were prepared to make over 200 wellness calls, as they had during a three-day heat wave in July and a blizzard in February.
Their clients are seniors who live in some of the most flood-prone zones in Queens: parts of Forest Hills, Rego Park, Elmhurst and Corona. Many live alone. About half of Lee’s caseload — 70 to 75 people at any given time — speak only Korean, Lee’s native tongue, which might otherwise make it harder for them to access emergency resources. Most are in their 70s, 80s or 90s.
“For me, this weather call is not just a safety check,” said Hyun Soo Lee, a QCH geriatric case manager. “It is also a way to maintain that human connection and let older adults know that they’re still connected to the community.”
Those connections matter as the weather gets more dangerous in New York City. Extreme temperatures and severe storms are becoming more common. During a cold snap last year, a 90-year-old woman with dementia who lived alone in Crown Heights wandered outside and died. She was among several older New Yorkers who died of hypothermia.
Three in 10 New York City residents ages 65 and older lived alone in 2023, according to an estimate from the state comptroller’s office, compared with 1 in 10 residents younger than 65.
The city has a network of warming and cooling centers that provide respite during extreme weather. It also partners with community organizations that serve seniors to provide free air conditioner units and flood preparedness kits to eligible New Yorkers. On Monday, Mayor Zohran Mamdani announced a $25 million expansion of Code Blue, the city’s cold-weather emergency response. It includes more than 300 additional canvassers who will check on everyone they encounter on the street.
But such interventions only work for the people they reach. That means that check-in visits or calls by neighbors can be a lifeline for this vulnerable population before, during and after a severe weather event.
At Queens Community House (QCH), that outreach ranges from drivers checking in during daily home meal deliveries to staff making wellness calls before extreme weather events. The goal is to help older adults feel safe, reduce loneliness and foster belonging.
Why seniors are hit harder by extreme weather
Older adults are disproportionately vulnerable to isolation and weather-related deaths. Nearly half of the 52 New York City residents who died during Hurricane Sandy were 65 and older. And those who live alone are even more vulnerable: In September 2021, the two New Yorkers 65 or older who died during Hurricane Ida were both found alone in their basement apartments.
Older adults are particularly vulnerable to isolation and the impacts of severe weather. People 65 and older are at higher risk during extreme heat because it’s harder for their bodies to regulate temperature. They’re also more likely to be managing chronic conditions that extreme heat can worsen, including heart, lung and kidney disease. When the body works to cool itself, dehydration, changes in blood pressure and added strain on the heart can make those conditions harder to manage.
Mobility limitations can add to that risk when people who are already more vulnerable are unable to reach cooling centers, get supplies or leave a dangerously hot or cold home. When extreme weather hits, not everyone has a safe, comfortable place to escape the heat, cold, rain or snow — at home or elsewhere.
And unlike floods or hurricanes, which offer visible warning signs, extreme heat can feel less urgent at first and escalate quickly, according to advocates who spoke at an August environmental justice panel organized by the Waterfront Alliance.
All of this might make a neighborly check-in more crucial for older adults who live alone or in what some researchers call “gathering deserts” — areas that lack accessible places to connect with others — during and after severe weather events.
How the safety net works
It’s the preferred approach at Queens Community House. QCH is one of hundreds of older adult centers the city’s Department for the Aging contracts with to support older adults. About 300 can serve as cooling or warming centers for people of all ages. Dozens also offer some form of case management, including regular monthly calls and special check-ins during storms, extreme heat, extreme cold and poor air quality.
In Lee’s experience, “How are you?” calls can still go far in assessing risk and needs — and in developing a degree of trust that makes it that much more likely that a client will take her advice, take her up on a resource or share more than what she’s asking.
Take one client, a German man in his 70s who has lived alone for decades: “When I call him, it isn’t simply to ask whether he’s OK during the heat wave or snowstorm, but I also want to maintain connection,” Lee said, adding that the calls also help reduce his loneliness.
Doing so can also elicit concrete needs case managers can directly address, such as some clients’ lack of working AC units in 90-degree weather. QCH and other groups serving older adults partner with the Department for the Aging to deliver free AC units.
Case managers stay in touch with clients through monthly calls and regular in-person visits. That ongoing contact helps people like Lee triage and prioritize higher-risk clients based on their conditions during weather emergencies. That’s especially true for unsafe air quality, which she says her clients tend to be less aware of than severe snow or rainstorms or hurricanes, which they learn about on the news. Her clients aren’t exactly checking air quality index apps on their phones regularly. So she’ll call clients with respiratory issues first, since they’re more vulnerable to the effects of poor air quality. Lee will advise those clients to stay indoors on those days.
That familiarity means case managers can often tell when they need to loop in their supervisor and possibly call 911 if they’re concerned about a high-risk client.
What the research shows
Research on wellness calls during weather emergencies is limited, but promising. One 2021 observational study in Rome found that neighborhoods with an anti-isolation program for adults over 80 saw a smaller spike in deaths during heat-wave summers than other neighborhoods. The program used phone calls during heat waves to identify isolated or sick older residents, reinforce heat-safety advice and connect them with practical support, including home visits, food or medication delivery, referrals or help from relatives and neighbors.
Public health researchers have argued that, because social isolation compounds heat risk, programs should identify socially isolated residents in advance, then increase phone calls and visits during extreme heat events. That’s why organizations like QCH take this approach.
What gets asked on those calls matters. A small pilot study of older adults receiving meal services in 2024 found that more structured calls — designed to move beyond a general “How are you?” conversation — uncovered more unmet needs and connected people with more referrals and services than those making casual check-in calls.
Where the approach falls short
Still, an AC isn’t useful if someone can’t install it or afford to run it. Over the summer, the city’s annual AC unit distribution to New Yorkers in need also included installation. City workers found that more than 20 recipients already had AC units sitting on their floors because they hadn’t been installed, according to Department for the Aging Commissioner Dr. Lisa Scott-McKenzie. A native New Yorker, she attributes it in part to “that New York thing of, ‘I have it, but I’ll wait, I’ll save up to be able to install it.’”
“They try to get through this without burdening anyone,” she said.
Another reason is the cost of electricity. Because of financial circumstances and rising utility bills, some seniors choose not to turn on their AC units even during a heat wave, according to Blanca Goris, the division director of homebound services at QCH. In those cases, if clients are eligible and open to it, case managers can refer them to resources such as the Cooling Assistance benefit or make a request on their behalf.
And, no check-in, no matter how friendly, can force a client — all of whom are either relatively independent or have home health assistance — to follow advice. And the information gleaned from phone calls is limited to what the client or family member shares, or whether they pick up at all.
How to check in on your neighbor
Lee said neighbors can play a similar role by checking in on older adults, particularly during severe weather.
“Community support is becoming more important — and I know that it doesn’t replace family support, but it helps fill the gap,” she said. “When people look out for one another, like during an extreme heat wave or snowstorm, that really can help.”
Lee said those community connections can help older adults remain safely at home and age in place. And for Dr. Lisa Scott-McKenzie, that means getting beyond the New Yorker mentality of minding your own business and avoiding eye contact when someone’s unwell.
“We’re not telling you to go and delve into someone’s personal life,” she said, but rather to notice when someone’s in need and offer help. “You want to be tactful, you want to be respectful, but we have to be able to support one another.”
Here are other resources to help older New Yorkers during severe weather:
Getting the alert
Tell or show an older adult in your life how to sign up for the city’s emergency alert system: They can text NOTIFYNYC to 692-692. They can also create a Notify NYC account.
Finding help
NYC Aging’s Aging Connect can connect older adults with a live representative at 212-244-6469 (212-AGING-NYC). They can help people find cooling centers, older adult centers, shelters and other services before, during and after severe weather.
For emergency preparedness, NYC Emergency Management’s Ready New York has information on evacuation zones, go bags, flooding, coastal storms and other emergencies. Find more tips on the Be Ready New York website.
Where to find warming and cooling centers
During a Code Blue emergency, New Yorkers out in the cold can find the nearest warming center on 311’s website or call 311. New Yorkers ages 60 and above can also call Aging Connect for referrals to warming centers.
During heat emergencies, NYC’s network of older adult centers can serve as cooling centers. NYC’s cooling center finder can help residents find a location. The city also deploys mobile cooling resources, including Cool Vans, in neighborhoods where they’re needed.
Help with heating bills and air conditioners
New Yorkers can get help heating their homes through the Home Energy Assistance Program (HEAP). Applications are open now and regular benefits are first-come, first-served until funds run out. Households with a member 60 and older may receive an additional benefit. Emergency HEAP, which opens Jan. 4, and closes April 16 or until funds run out, can help tide you over if your primary heating source is shut off or scheduled to be shut off.
Older New Yorkers who need help getting or using an air conditioner can learn more and apply when the application period opens. The city can provide air conditioners with installation, as well as fans.
Checking on neighbors
The city’s Be a Buddy program connects older adult neighbors and other community members to help people stay informed and supported during emergencies.
For older adults who receive home-delivered meals or need help with groceries, check out QCH’s Queens case management and home-delivered meals program. Programs that offer similar services can be found here.
If you see someone outside in freezing weather, here’s what you can do to help, including when to call 311 or 911.
Preparing for power outages
Older adults who rely on electrically powered medical equipment can register with Con Edison’s Life-Support Equipment program. This can help the utility identify customers who depend on life-support equipment during an outage.
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This article was written with the support of a journalism fellowship from the Gerontological Society of America, the Journalists Network on Generations and the Commonwealth Fund.
