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Supporting vulnerable people in a heatwave Advice for health and social care workers
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The effects of a heatwave Severe heat is dangerous to everyone and during a heatwave when temperatures remain abnormally high for more than a couple of days, it can prove fatal. This information in this document is designed to help you plan in advance of a heatwave and to provide advice of what to do in the event of one.
High risk groups The heat can affect anyone but some people run a greater risk of harm, these include: • older people, especially those over 75 • people with serious mental health problems • people on certain medication • people with a serious chronic condition, particularly breathing or heart problems, Parkinson’s disease, renal conditions, diabetes • people who already have a high temperature from an infection • people who misuse alcohol or take illicit drugs • people with mobility problems.
Reducing the risk before a heatwave Heatwaves can happen suddenly, and a rapid rise in temperature can affect vulnerable people very quickly. If you are working with someone who you think might be at risk, it is important to make use of existing care plans to identify what extra help they might need. Where possible involve their family and informal carers in these arrangements.
Organisation • Check that extra care and support is in place if required • Check that the person has the contact details for the primary care team if their family or informal carers are unavailable • Check their care plan has contact details for their GP, other care workers and informal carers • Check that there are adequate arrangements for food shopping to reduce having to go out in hot weather.
Facilities • Check that fridges and freezers are working • Check the person has loose-fitting cotton clothing available to wear • If you plan to move the person, make sure you have the equipment or help you might need.
Surroundings Immediate, where required • Consider moving the person to a cooler room. People living in top floor accommodation may be more at risk. More routinely • Check that the person’s home or room can be properly ventilated without causing any additional health risk, discomfort or security risk • Check that south facing windows can be shaded, preferably with curtains with pale, reflective linings. Where possible • Consider outside shutters, overhead external shade and using reflective paint • Plant trees or leafy plants to provide shade and cool the air around the building – indoor plants can also help keep the environment cool.
During a heatwave - top tips for keeping people cool Stay out of the heat: • Advise the person to avoid the sun between 11am and 3pm • If they do need to go outside advise them to wear sunscreen, walk in the shade and wear a hat and light scarf • Advise the person to avoid doing anything too physically demanding like gardening • Get them to wear loose fitting cotton clothing.
Keeping cool: • Ensure the person drinks plenty of water or fruit juice and avoid hot drinks, caffeine and alcohol • Monitor their daily fluid intake, particularly if they have several carers or are not always able to drink unaided • Eating cold foods, particularly salads and fruit helps • Suggest they take cold or cool showers or baths • Sprinkling water over the skin or clothing or keeping a damp cloth on the back of your neck can help.
Providing extra care • Keep in regular contact during a heatwave, and try to make sure that someone visits at least once a day • Keep giving advice on what to do to keep cool • Encourage people over 65 to increase their fluid intake to reduce the risks of blood stream infections.
Heat exhaustion and heatstroke Look out for symptoms of Heat Exhaustion and Heatstroke
Heat exhaustion Symptoms include:
• Very hot skin that feels flushed • heavy sweating • dizziness • extreme tiredness • nausea • vomiting • rapid heartbeat • mental confusion • urinating less often and much darker urine than usual. A person with heat exhaustion should be moved to somewhere cool and given fluids, preferably water. They should start to feel better within half an hour.
Heatstroke
Symptoms can develop over several days in elderly people and those with longterm health problems. These include: • high body temperature (40 degrees Celsius and above) • heavy sweating that suddenly stops (if the body is unable to produce any more sweat, it is a major warning sign that the body has become overheated and dehydrated • rapid heartbeat • rapid breathing • muscle cramps • mental confusion • lack of co-ordination • fits • restlessness • problems understanding or speaking to others • seeing or hearing things that are not real • loss of consciousness.
Taking action Heatstroke is a medical emergency, so if you suspect someone might have it, call 999. While waiting for the ambulance: • take the persons temperature • if possible, move them somewhere cooler • cool them down quickly – give them a cool shower, sprinkle them with water, wrap them in a cool sheet • encourage them to drink fluids, if they are conscious • do not give aspirin or paracetamol.
Further information The Heatwave Plan Public Health England have a detailed heatwave plan which outlines the responsibilities of health and social care organisations at different stages during a heatwave. www.gov.uk/government/publications/heatwave-plan-for-england-2013
NHS Choices NHS Choices can provide additional advice of Heatstroke and other health related issues www.nhs.uk/summerhealth
Weather and air quality Up-to-date weather forecasts and information about air quality can be found on the BBC website www.bbc.co.uk/weather
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