Public Health England is warning that this week’s heatwave could prove fatal if care home operators fail to protect residents.
Severe heat is dangerous to everyone, especially older and disabled people, and those living in care homes, the organisation warns. “During a heatwave, when temperatures remain abnormally high for longer than a couple of days, it can prove fatal.”
In one hot ten day period in southeast England in August 2003, there were nearly 2,000 extra deaths. The biggest increase in risk of death was among those in care homes, according to government statistics.
Planning is vital, PHE adds, but immediate action today could also save lives. “The effects of heat occur rapidly, and to be effective preparatory action has to be taken,” it states.
A comprehensive document from PHE explains plans that should be in place well ahead of a heatwave (click here to download the advice), but on a day like today, there are still measures that will help, listed as:
- Activate plans to maintain business continuity – including a possible surge in demand for services
- Increase outside shading – spraying water on the ground outside helps to cool the air (avoid creating slip hazards, check local drought water restrictions before using hosepipes)
- Keep curtains and windows closed while the temperature outside is higher than it is inside
- Once the temperature outside has dropped lower than the temperature inside, open the windows – this may not be until very late at night or the early hours of the morning
- Discourage residents from physical activity and going out during the hottest part of the day (11am to 3pm)
- Check indoor temperatures are recorded regularly during the hottest periods for all areas where patients reside
- Ensure staff can help and advise clients and patients
- Make the most of cooler night-time temperatures to cool the building with ventilation
- Reduce internal temperatures by turning off unnecessary lights and electrical equipment
- Consider moving visiting hours to mornings and evenings to reduce afternoon heat from increased numbers of people
- Monitor residents’ body temperature, heart and breathing rates, blood pressure and hydration levels
- Watch for any changes in behaviour, especially excessive drowsiness
- Watch for signs of headache, unusual tiredness, weakness, giddiness, disorientation or sleeping problems
- Encourage residents to remain in the coolest parts of the building as much as possible
- Move residents so that each spends time in the cool room/area (below 26ºC) – give priority and extra time to high-risk residents or any showing signs of distress (including increased body temperature); for patients who can’t be moved, or for whom a move might be too disorienting, take actions to cool them down (eg liquids, cool wipes) and enhance surveillance
- Monitor residents’ fluid intake, providing regular cold drinks, particularly if they are not always able to drink unaided; remember the importance of increasing fluid intake during periods of high temperature to reduce the risk of blood stream infections caused by Gram-negative bacteria. Oral rehydration salts may be suggested for those on high doses of diuretics; bananas, orange juice and occasional salty snacks can also help replace salts lost due to sweating
- Advise residents to avoid caffeine (coffee, tea, colas), very sweet drinks and alcohol
- Encourage residents to wear light, loose cotton clothes to absorb sweat and prevent skin irritation
- Regularly sprinkle or spray cool water on exposed parts of the body – a damp cloth on the back of the neck helps with temperature regulation
- Arrange cool showers or baths if possible.