14 February 2023

Institutionalising Net-Zero Care

The climate crisis is an area that all foundations, irrespective of sector, should attempt to address in one way or another. At first glance, a foundation which focusses on the social welfare of the elderly doesn’t have an obvious entry-point for proactive work addressing climate issues. And yet, a warming climate, and heat in particular, has an outsized effect on poor, marginalised and vulnerable elderly.

Heatwaves in Athens for example, (where the TIMA Charitable Foundation funds programs), often hospitalise and even kill elderly individuals. The reasons range from the biological (naturally lower hydration) to the structural, where the vulnerable have little or no way of protecting themselves from the heat of a concrete jungle. This will only get worse as summer temperatures continue to rise.

On the other hand, we are currently facing an extreme cold-weather front in Greece with gale force winds having reached 9 Beaufort in places, towns and villages having been cut off due to heavy snow, and public sector staff and schools shut down. Growing energy poverty and energy insecurity make the elderly and those caring for them even more vulnerable.

With all this in mind, TIMA developed a strategy that would benefit both vulnerable elderly, the operators caring for them, and the country’s CO2 footprint, by transforming care-homes from carbon-heavy institutions to sustainable energy consumers.


In Greece, there is a distinct lack of government institutions caring for the elderly. The majority of care homes in the country are run by non-profit organisations (both Church and private), which provide services typically paid for by the resident’s pension and/or by their family. According to a European Social Policy Network report published in 2018:

“In Greece, long-term care (including prevention and rehabilitation services) continues to be an underdeveloped policy area, given that there are no comprehensive formal long-term care services guaranteeing universal coverage. The state’s involvement is rather limited and consequently long-term care remains a ‘family affair’. In 2014, Greece allocated only 2% of overall health spending to long-term care, which is far lower than the EU-27 average of 15%. Long-term care is based on a mixed ‘quasi-system’ of services comprising formal (provided by public and private entities) and informal care, with primary responsibility for the financial and practical support of dependents resting firmly on the family…informal care is estimated to cover the lion’s share of the need for long-term care among the Greek population; it makes up for the weaknesses and inadequacies of the Greek health and social care system.”

Although the State has recently tried to formalise the sector of care-homes, including ensuring safety features that are necessary, this has nevertheless added to the financial burden care-homes have to carry.

This pilot, carried out with INZEB (Initializing Energy Balance Towards Zero), intends to showcase how care-homes, whilst providing an ever-growing and ever-more-demanding social service for the elderly in place of the State, need to nevertheless be supported by the State. The State can provide that aid by supporting their transition to net-zero. This can be done by making them eligible for National and/or European subsidy programs. This has a variety of benefits for all partners involved.

The scope of our pilot project therefore, is to showcase the benefits of supporting the transition of care-homes to net-zero, or near net-zero energy buildings.

Why care homes?

As noted above, care-homes have stepped in to meet a social gap not currently provided by the State. And even though home-care is a better overall solution, institutionalised care for the elderly is still projected to grow in the years to come.

Care-homes are also by their nature heavy energy consumers, typically housing between 30-60 elderly residents and hosting between 15-30 members of staff. Most elderly care-homes are old, not properly insulated and therefore require elevated energy consumption to warm the buildings up during the winter months, and cool them down in the summer months. All care-homes also require heavy consumption of hot water throughout the year and thus typically use electricity (until recently mostly lignite based), to warm their water, light the building and run their cooking stoves.

Rising energy costs place an unwarranted and unnecessary burden on the care-homes’ operational overheads and, therefore, their ability to provide better services. By reducing their financial costs, care-homes can use their savings to provide better services.

A non-profit care home usually charges a resident their ability to pay through their pension. This is often insufficient to cover the full cost of services, upkeep etc. that an institution is required to provide. Many NGOs therefore solicit further support through donations, which is not always a viable and sustainable option. Income fluctuations make running a care-home even harder, and during periods where care-homes may require more in donations (e.g. – during the pandemic when PPE, disinfectants and Covid-19 self-tests significantly raised their operational costs), they are, conversely, able to solicit less.

By significantly lowering energy costs, operational savings can be turned to upgraded operational services.*

The “Net Zero-Care” pilot therefore, intends to show the multiple benefits of supporting non-profit care-homes in becoming net-zero (or close to net-zero), energy consumers.

These benefits include:

  1. Refurbishing buildings that house vulnerable elderly as fit-for-purpose institutions through the climate crisis
  2. Transforming heavy fossil-fuel energy consumption to sustainable and energy-efficient consumption
  3. Reducing high operational costs for non-profit care homes, and improving their capacity to provide better services.
  4. Reducing the need for donations for operational expenses in care homes
  5. Providing a better standard of living for elderly residents of non-profit care-homes (lower costs lead to better services, better insulation leads to better health)
  6. Reducing the institutional footprint of carbon-heavy buildings and providing a model for other non-profit institutions (e.g.- institutional care for the disabled)

With a single investment covering for example insulation, sustainable electricity and heating, and a typical payback period of 5-7 years, the financial, environmental and social benefits of the pilot, are stark.

*This could even be a stated requirement by donors, whereby based on the estimated savings accrued, the care-home would have to stipulate the additional services it would provide over the next few years – e.g. an additional full-time nurse, two part-time physiotherapists etc.

Looking ahead

An analysis by INZEB has shown that our pilot care home has a total surface area of 2,235.16 m2 and was built between 1991-1992.

The current average building’s energy consumption is 564.40 kWh/m². Based on their electricity bills for the reference year 2021, the annual energy cost of its operation amounted to €40,332.99 euros, which corresponds to 20.33 euros/m2 of heated/cooled surface per year.

Through a series of interventions including envelope and roof insulation, changing the windows and windowpanes, adding net meters to heaters and heat pumps, we can improve the energy efficiency of the building from 564.40 kWh/m² to 164.10 kWh/m². That is a 71% improvement in energy consumption.

The next phase of the program will be to add photovoltaic panels and through net metering, the care home will reach complete energy independence, sustainability and security.

The total investment for the project is an estimated €300,000, which by today’s high energy costs will be recouped within an estimated 5 years.

It is incumbent, not only in Greece, but in all the EU countries to encourage State actors to provide incentives for organisations that provide shelter to vulnerable people, to transform their buildings to net-zero energy emitters. The science is clear. Insulate first. Produce energy next. The multipliers and social return on investment that span across sectors from the climate to social welfare, should encourage all foundations throughout the EU to look at the benefits of adopting such programs and showcasing the results for the State to take action.

If any of the above is of interest, please do not hesitate to contact me through PHILEA, or else feel free to visit the Net Zero Care website.

The pilot is being realised with the technical support of INZEB and the current phase of the project is being financed with the support of the TIMA Charitable Foundation, Bodossaki Foundation, The John S. Latsis Public Benefit Foundation, and The Hellenic Initiative Canada and through significant price discounts of the construction materials offered by several companies.


Paul Kidner
Advisor, TIMA Charitable Foundation