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While most people look forward to the warmer weather it is important to be aware of the danger it can pose to those who are most vulnerable to heat. The hottest two days of last year (July 19th and 20th) saw temperatures of over 40° in the UK. During this 48-hour period, there were 1134 additional deaths with many of these being in the over 65 years age group.
As we get older, we don’t adjust as well to sudden changes in temperature. Older people are also more likely to have a chronic medical condition that impacts on normal body responses to heat. Other people who are at greater risk during hot weather include those with existing health conditions and young children. The biggest cause of death during heatwaves are cardiovascular and respiratory illnesses.
Other heat related health concerns
Dehydration can result from excess sweating during hot weather. Symptoms include, extreme thirst, dark yellow, strong-smelling urine, urinating less often than usual, feeling dizzy or lightheaded, feeling tired, a dry mouth, lips and tongue and sunken eyes.
Heat rash – this is uncomfortable but not serious. Patches of the person’s skin may develop small, raised spots, an itchy, prickly feeling and/or mild swelling.
Heat exhaustion occurs as a result of water or sodium depletion. Symptoms include tiredness, dizziness, headache, nausea or vomiting, excessive sweating, skin becoming pale and clammy or getting a heat rash, cramps in arms, legs and stomach, fast breathing or heartbeat, a high temperature, being very thirsty and weakness.
Heatstroke is a serious condition and can occur if heat exhaustion isn’t treated. When heatstroke sets in, the body can no longer control its temperature. The body’s temperature will quickly rise, the sweating mechanism shuts down and the body is unable to cool down.
Preparing for hot weather
With advances in science and technology, we are given advance warning of hot weather and when a heatwave will occur. This gives care settings time to get prepared. However, there is no need to wait for such weather to be forecast. As the summer months are approaching it helps to prepare anyway. Ideally, buildings will have air conditioning but unfortunately, that isn’t often the case. Preparations can include:
- Making sure that windows can be shaded.
- Ensuring that windows can be opened.
- Identify rooms that are the easiest to keep cool and those which are the most difficult.
- Create cool rooms or cool areas.
- Indoor thermometers should be installed in each room.
- Ensure you have a supply of fans and water sprays.
- Increase outside shading, in the form of canopies, pergolas, umbrellas, trees or leafy plants.
- High risk service users should be identified through risk assessments.
- Check that service users have light, loose fitting cotton clothing to wear.
- Make sure that service users who go outside have hats, sunglasses and sunscreen.
During hot weather
Once the hot weather has started it is important to keep the care environment as cool as possible. Windows should be kept closed while the temperature outside is higher than it is inside. When the weather is really hot, curtains should be closed. It is important to make the most of cooler periods during the night to ventilate the building. Windows can be opened when it is cooler outside than in. This may not be unit late at night and during the early hours of the morning. Temperatures inside the building should be monitored at least 4 times a day.
Tips to help service users to stay cool
- Service users should be discouraged from doing too much physical activity during the hottest part of the day (11am -3pm)
- Encourage service users to wear loose lightweight cotton clothing.
- Encourage service users to remain in the coolest parts of the building with priority given to those at highest risk.
- Service users should be offered plenty of fluids ensuring that those who need support with drinking get this. Food with high water content such as fruit, salad, vegetables and ice lollies can help them stay hydrated.
- Service users can be given bowls of cool water to put their feet in or to apply water to their wrists.
- Exposed areas of the skin can be sprayed with cool water.
- Applying a damp cloth on the back of the neck helps with temperature regulation.
- Cool showers or baths should be offered.
Monitoring service users
- Regularly check body temperature, heart and breathing rates, blood pressure and hydration levels.
- Observe for any changes in behaviour such as excessive drowsiness and/or confusion.
- Other signs to observe for include headache, tiredness, weakness, dizziness, disorientation or skin rashes.
Staff working in hot weather
Working in hot weather can be challenging for anyone but especially for those working in a physically demanding role such as care work. Risk assessments should be carried out to ensure the welfare of staff during hotter weather. There is no legal maximum workplace temperature, but employers have a duty to ensure indoor workplaces remain at a reasonable temperature. The advice above regarding keeping the environment cool will of course benefit staff as well as those who use the service.
Staff uniforms may need to be revised during hotter weather into something that is cooler and looser. Where PPE needs to be worn for long periods, adaptations to working practice may need to be made such as staff taking more shorter breaks during the shift to give them a break from wearing PPE. Staff should also be encouraged to spend time in the coolest parts of the building when they can.
Whilst staff will be encouraging service users to stay hydrated it is important that they ensure that they drink plenty of fluids themselves. Employers can support this by keeping jugs of cold water for staff in the fridge and ice lollies for them to have on their breaks.
Heat-Health Alert Service
The Met Office Heat-Health Alert Service provides warnings of periods of high temperatures, which may affect the health of the public. This service is for health and social care professionals and anyone who has a role that aims to reduce the risk of heat to others.
