Coping with extreme heat in long-term care and assisted living

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What’s Happening?

  • Extreme heat continues in our region with high temperatures forecast throughout the week of June 27, 2021.
  • We are currently seeing a significant increase in the number of people seeking emergency care for heat-related conditions. Many people seeking care are our residents and tenants, for whom hot temperatures can be especially dangerous.
  • Staff are also suffering from heat stress at some long-term care (LTC) and assisted living (AL) sites. It is imperative that heat stress prevention measures are provided for staff.

Taking Care of Yourself:

    • Report any symptoms of heat-related illness to your supervisor as soon as possible:
      • Changes in oral cavity – insufficient saliva or unusual dry mouth, difficulty speaking and/or swallowing, nausea and vomiting
      • Changes in behavior – headaches, unusual fatigue, sleepiness, weakness
      • Skin moisture – signs of heat rash, fungal rash
      • Difficulty breathing
      • Changes in level of responsiveness
    • Risk factors
      • Physical factors and chronic diseases, such as: heart conditions, diabetes, respiratory or renal insufficiency, Parkinson’s Disease, obesity, and skin disorders that impact sweating
      • Multiple medication particularly anticholinergics, vasoconstrictors, antihistamines, diuretics, atihypertensive and psychoactive drugs
      • Older adults, in particular, women over the age of 75
    • Stay hydrated and cool at work and at home
      • Drink water even if not thirsty
      • Take cool baths or showers
      • Visit your local municipality website for list of cooling centres (Abbotsford Cooling Centres) that are open in their community, especially if they are unable to adequately cool their home.

How This May Affect You in caring for residents/tenants?

  • Set-up hydration rounds and cooling-off stations – eg: applying cool water mist or wet towels prior to sitting in front of a fan as a quick way to cool off. At current temperatures, fans alone are not effective.
  • Create individualized care plans to assess and treat all residents for signs, symptoms, and risk for heat-related illnesses
  • Host huddles each shift to educate staff and care of residents during extreme heat
  • Watch for residents/tenants at risk where special attention may be needed, including those:
    • Unable to adapt behavior to keep cool, eg – those with cognitive losses or immobility
    • With physical factors and chronic diseases, such as; heart conditions, diabetes, respiratory or renal insufficiency, Parkinson’s Disease, obesity, and skin disorders that impact sweating
    • On multiple medications particularly anticholinergics, vasoconstrictors, antihistamines, diuretics, antihypertensive and psychoactive drugs
    • Who are older (especially women over 75 years old)
  • Watch for signs and symptoms of heat stress, including:
    • Decreased fluid intake or thirst
    • Changes in behavior – headaches, unusual fatigue, sleepiness, weakness
    • Skin moisture – signs of heat rash, fungal rash
    • Difficulty breathing
    • Changes in level of responsiveness
    • Changes in oral cavity – insufficient saliva or unusual dry mouth, difficulty speaking and/or swallowing, nausea and vomiting

Prevent and manage heat stress by:

  • Cooling-off strategies:
    • Use cool clots for face and hands, and/or back of neck
    • Consider loosely applying wet sheets to the body and reapply Q10-15 minutes
    • Regularly misting residents
    • Provide an additional shower or bath
    • Have residents wear lightweight clotting and/or coverings
    • Relocate resident to a cooler location if possible during the day or periods of the day. If common areas are on main floor and cooler rotate and schedule residents to this area
    • If going outside is a must for residents, have them wear sun protection, hat and sunglasses and encourage them to stay in the shade
  • Hydration strategies:
    • Provide additional cool fluids and foods high in water content such as fruits and salads
    • Provide ice cubes and popsicles to help with fluid intake
    • Proactively offer hydration during medication administration and during daily care – ie: AM care, PM care
  • Have family and visitors provide additional support needed for hydration rounds and cooling stations
  • Have HCAs report any signs or symptoms of dehydration to the nurses, as soon as possible