Summer clinical alert 2024 / 2025

Summer is around the corner – and aged care providers and staff need to be alert to the greater risks of heat-related illness among older people in their care.

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.

Additional risk factors

Certain groups of older people are at additional risk, including:

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/or taking diuretic medications to reduce fluid retention
Those with mobility and other functional problems - 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 airconditioned 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 and/or are not able to benefit from cooling breezes
Outdoor areas which are hidden from view

Staff working in residential aged care homes should be mindful of the temperatures in their surroundings at different times and locations within the home and its grounds, the locations of residents at all times, and of the suitability of clothing that the older person is wearing

During the warmer summer months, staff should be reminded to:

Monitor and ensure the adequacy of the fluid intake of vulnerable residents
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/less heavy incontinence pads
Respond as a priority to residents who say they are, or appear to be hot or thirsty
Offer lukewarm (not cold) sponging or showering to assist in cooling residents
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

The Department of Health and Aged Care has checklists about caring for older people in warm weather – specifically for residential aged care and for home services providers.