OCAV response to heatwaves

Heatwaves during Australia’s summer put health workers on alert. Staff at Liscombe House, OCAV’s aged care facility at St Helena, are no exception. They are very conscious of the affect of extreme heat on residents and implement a heatwave policy to ensure all necessary steps are taken.

Bini Biju, one of Liscombe House’s two Clinical Care Coordinators, said older people could be particularly vulnerable during a heatwave, due to normal aged-related changes to the body.

The Victorian Department of Health in its report, The health impacts of the January 2014 heatwave in Victoria, found that there were 621 heat-related presentations at Victorian public hospital emergency departments during the week (January 12-18) of the 2014 heatwave, higher than the 105 expected and 40% were for people aged 75 years and older.

Bini said older people might not recognise that they are overheated and therefore may not complain about being hot, or request additional fluids. The Department of Health report also found that older people are more likely to have “poor cardiovascular fitness, essential for regulation of body temperature and they are more likely to be taking medications that interfere with the way the body reacts to heat”.

However, OCAV’s heatwave policy, distributed widely to staff across all four villages, outlines what needs to be done to prevent the onset of heat-related illnesses in residents.

OCAV is alerted to the threat of a heatwave via a monitoring system developed by the Department of Human Services and activated through local councils. A heatwave is deemed to occur when a temperature threshold is reached, namely when a daily average of 30°C is reached (i.e an average over 24 hours of at least 30°C). DHS will monitor the Bureau of Meteorology website for 7-day minimum and maximum temperatures and will issue an alert when a threshold is forecast.

Bini said Liscombe House’s air conditioning systems greatly assists in managing heatwaves, but other steps are also followed, including alerting residents themselves to the heatwave. She said all older people should take care, not just those in an aged care facility. She suggested many elements of the OCAV policy be followed by people in all OCAV villages.

“We encourage our residents on lovely warm days to sit outside with their sunglasses, hats, long sleeves and sunscreen on. OCAV provides sunscreen lotion to all our residents. On heatwave days we recommend residents to stay indoors and not go on outings,” Bini said. “During a heatwave we would ensure all residents remain in cooler areas and dress appropriately.”

Some key actions during a heatwave:

· Extra drinks are offered to all residents. Residents are also offered alternative forms of fluid such as jelly, ice cream or fruit juice blocks and discouraged from drinking alcoholic or caffeinated beverages. Small amounts of fluids are readily available and offered, rather than large amounts of fluids less frequently.

· Staff ensure the temperature in residents’ rooms and within Liscombe House is kept comfortable, keeping curtains and blinds closed to reduce the excess heat.

· Staff check and respond to signs and symptoms of heat stroke, such as fatigue, headache, dizziness, nausea, vomiting, red, hot and dry skin, rapid heartbeat, muscle cramps, muscle weakness, rapid shallow breathing, and severe confusion.

· Particular attention is paid to residents who are unable to communicate.

· Residents are offered a tepid shower or sponging.

· There is a review/assessment of residents whose medications may cause dehydration or electrolyte imbalance, likely to reduce renal function, or may interfere with the production or regulation of heat.