Essential information for caring for older people in the heat

This essential health information has been provided by Chief Clinical Officer, Dr Mandy Callary, at the Aged Care Quality and Safety Commission.

Heat-related illness can be very serious and progress quickly in older people – to confusion, clinical deterioration and even death – if not recognised early and responded to as a priority.

Older people are at increased risk of heat-related illness

Older people tend to be at increased risk of heat-related illness for several reasons. These include ageing-related physiological changes, the greater likelihood of having multiple chronic illnesses, and their use of certain medications. 

Certain groups of older people are at additional risk

• Those who are frail or have a low body mass – who may heat up more easily. 
• Those with dementia – who may not plan well or remember to drink regularly or recognise that they are heating up. 
• Those who struggle to maintain good hydration – such as those eating modified diets (including thickened fluids), on a fluid restriction and those taking diuretic medications to reduce fluid retention. 
• Those with mobility and other functional issues – such as those who cannot independently move into the shade or a cooler space, or who cannot remove their outer clothing or bedding when they are feeling hot. 

Environmental awareness and temperature changes

Providers should also be aware of environmental risks such as:  

• Buildings or internal areas which cannot be air-conditioned or easily cooled. 
• Indoor areas where the sun’s radiant heat shines through glass. 
• Outdoor areas which change from shade to full sun as the sun moves across the day or areas that don't benefit from cooling breezes. 
• Outdoor areas which are hidden from view. 
    

During the warmer summer months, people working with clients in aged care need to:  

• Monitor and ensure the adequacy of the fluid intake of vulnerable clients. 
• Encourage more frequent drinking of fluids. 
• Be aware of the signs of dehydration – including a dry mouth and tongue, heat rash, and less frequent toileting or less heavy incontinence pads. 
• Respond as a priority to clients who say they are, or appear to be, hot or thirsty. 
• Offer lukewarm (not cold) sponging or showering to assist in cooling if appropriate. 
• Remind and assist residents with sunscreen, hats and protective clothing if sun exposure is possible. 
• Avoid sun exposure on very hot days – particularly for older people who may be reluctant to return indoors when encouraged to do so.