News & Views

16th September 2015

'Be safe in the heat – lessons for care homes’

By Sue Burton

Sue Burton, Governance manager with Montreux Living, is a registered nurse with over 30 years’ experience in healthcare, as a care manager and care home inspector.

 

August is upon us, and all care homes should be prepared for when another hot spell or two before the summer is out.

At Montreux Living, we’ve recently reviewed our policies for dealing with hot weather, and it’s clear that as well as the obvious issues – sunburn and dehydration – there are factors that specifically affect older people.

Research [link: http://phys.org/news/2009-08-stress-older-people-chronic-diseases.html] shows that people over the age of 60 are more vulnerable to heat waves, with 82% to 92% more deaths than average occurring in this age group. Medical conditions and the medicines used to treat older people can affect how their bodies might regulate temperature.

This study in the Canadian Medical Association Journal showed older people find detecting heat more difficult. The body’s normal response, improved blood distribution and sweating, takes longer as people age. The elderly take longer to feel thirsty, and longer to rehydrate.

Some drugs have specific effects which change reactions to heat. Antidepressants and antihistamines act on an area of the brain that controls the skin’s ability to make sweat. Heart tablets like beta blockers reduce the heart and lungs ability to cope with stresses. Fluid tablets (often prescribed for kidney problems) are diuretics, which can speed dehydration. Opioids and sedatives can make people less aware of physical discomfort.

Sometimes residents themselves may not be aware of the effects, or be able to communicate their distress. The onus is on staff to be alert for signs and know how to help.

The most obvious signs are tiredness, paleness, and sweating but others might include muscle cramps, headaches, dizziness, faster breathing, accelerating pulse, and nausea.

The sooner these symptoms are picked up, the easier they are to treat with some straightforward practical measures:

  • Cool, non-alcoholic drinks. Cool is better than ice-cold, which can cause cramps. We have installed water cooler dispensers in all our homes to enable readily available drinks. Insulated jugs of cold water work well and can be kept beside the bed. Tempting as a chilled beer or wine might be, alcohol contains anti-diuretic hormones (ADH), so toilet visits become more frequent, losing crucial electrolytes like calcium, magnesium, zinc and phosphorus. The caffeine in tea and coffee has much the same effect. If fluid intake is limited for medical reasons, staff should always get advice from the doctor.
  • Rest in the shade.
  • A cool shower, bath, or even just a foot wash will help. A clean, cool, damp face cloth to the forehead can help too.
  • Air conditioning. We are more likely to have central heating than air conditioning in the UK, but standalone units can be hired.
  • Encourage people to wear less. When the body’s ability to detect temperature change is decreased, removing extra layers of cardigans and jackets may not feel like the obvious reaction.
  • Encouraging the use of sun hats when outside, though they should never be shared to prevent infection.
  • Providing extra choices on the menu such ice lollies as well as ice-cream


As care home professionals, we can make sure we are prepared:

Our review of our hot weather policy to ensure the safety and well-being of our residents and staff has resulted in some simple, practical changes such as water coolers and encouraging people to choose de-caffeinated drinks. Measures like this can help staff at all our homes understand how they can ensure everyone has a happy and healthy for the rest of the summer.

 

Source: http://www.montreuxliving.co.uk/news/be-safe-heat-%E2%80%93-lessons-care-homes%E2%80%99-sue-burton

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