Heat Health Advice for Healthcare and Residential Care Facilities

Periods of hot weather can increase the risk of illness, particularly among vulnerable individuals receiving healthcare or residential care services. Heat stress, heat exhaustion and heatstroke are potentially serious health risks for people during a heatwave and deaths have occurred at home, in residential care facilities and in hospitals.

Healthcare and residential care facilities should have plans in place to minimise the health impacts of hot weather on patients, residents, visitors and staff.

Key messages

• Identify those most vulnerable to heat-related illness.
• Monitor indoor temperature and maintain cooler areas where possible.
• Ensure adequate hydration.
• Recognise the signs and symptoms of heat exhaustion and heatstroke.
• Review preparedness arrangements before periods of hot weather.

Identify those most at risk

Consider those who may be particularly vulnerable, including:

• Older adults (>65 years old)
• Infants and young children
• Pregnant women
• Those who live on their own, and who may not be able to care for themselves, or are socially isolated
• Those living in a residential care facility
• People with cardiovascular, respiratory, renal or neurological conditions
• People with behavioural limitations, such as people with cognitive impairment (dementia/Alzheimer’s), restricted mobility, or those with drug and/or alcohol addictions
• People taking medications that may increase susceptibility to heat-related illness e.g. those that affect heart or kidney function, their ability to sweat, or their cognition or behaviour
• Individuals who are unable to independently regulate their environment or fluid intake
• Patients fasting for procedures or other reasons
• Patients with vomiting/diarrhoea/poor oral intake or other conditions that increase the risk of dehydration

Ensure vulnerable patients and residents are identified and monitored appropriately during periods of hot weather.

Planning and preparedness

Facilities should have arrangements in place before periods of hot weather occur.

Actions may include:

• Monitoring Met Éireann forecasts and weather warnings.
• Identifying patients and residents at increased risk from heat.
• Reviewing local hot weather response plans.
• Ensuring staff are aware of procedures for managing heat-related illnesses.
• Communicating relevant advice to patients, residents, families and carers.
• Reviewing business continuity arrangements for prolonged periods of hot weather.

Managing indoor temperatures

Maintaining a cool indoor environment is an important measure for protecting vulnerable individuals.

Facilities should:

• Draw up a plan for measuring and monitoring indoor temperatures throughout the day and night, particularly in areas occupied by vulnerable patients or residents. Room temperature should be about 20^o
• Identify cooler areas (<20^oC) that can be used during periods of high temperature.
• Prioritise vulnerable patients and residents for cooler areas where feasible.
• Reduce direct sunlight by using blinds, curtains or shading.
• Ensure adequate ventilation.
• Turn off unnecessary lights and electrical equipment where possible.
• Use fans or air conditioning where available and safe to do so. Do not point electric fans directly at a person, as this can lead to dehydration. Natural ventilation that promotes gentle air circulation is preferable to fans.
• Keep windows closed when air conditioning in use.
• Consider alternatives to plastic pads and mattresses which can make a person warmer.
• Consider whether any areas are prone to overheating and implement measures to reduce temperatures.

Support hydration

Dehydration is one of the most common health risks during hot weather.

Facilities should:

• Encourage regular fluid intake among patients and residents.
• Ensure drinking water is readily available and easily accessible.
• Diluted squash or lower fat milks are also good choices for hydration. Fruit juice, smoothies and soft drinks can be high in sugar which dehydrates the body.
• Monitor individuals who may be unable to request fluids independently.
• Consider additional hydration rounds during periods of hot weather.
• Ensure adequate supplies of drinking water and ice are available.
• Monitor patients at increased risk of dehydration.

Clinical considerations

Healthcare professionals should remain alert to:

• Dehydration
• Heat exhaustion
• Heatstroke
• Exacerbations of cardiovascular and respiratory disease
• Acute kidney injury
• Medication-related complications associated with dehydration

Particular care may be required for patients taking medications that effect fluid balance, thermoregulation or cardiovascular function.

Recognising heat-related illness

Staff should be familiar with the signs and symptoms of heat exhaustion and heatstroke and follow local clinical pathways for assessment and management.

Heat exhaustion symptoms may include:

• Headache
• Dizziness
• Excessive sweating
• Muscle cramps
• Nausea
• Weakness or fatigue

Move the person to a cool environment, encourage fluids (water, and/or sports/rehydration drinks) and monitor closely.

Heatstroke is a medical emergency and requires urgent treatment.

Symptoms may include:

• Confusion or altered mental state
• Drowsiness
• Loss of consciousness
• Seizures
• Hot, dry skin
• Very high body temperature
• Little / No urine output
• Hyperventilation, hypotension and shock

Heatstroke must be manged as a medical emergency. Treatment includes cooling as quickly as possible – spray with cold water, place ice packs on neck/armpits/groin. Do not give aspirin or paracetamol.

Medications

Certain medications have increased risks during hot weather and need to be monitored more carefully.

• Diuretics (especially loop diuretics): can lead to dehydration and electrolyte abnormalities
• Medications that interfere with cardiovascular responses such as antihypertensivesand antianginal drugs
• Medications that interfere with sweating, such as anticholinergicsor beta blockers
• Drugs that cause diarrhoea or vomiting, such as colchicine, antibioticsand opiates, which can lead to dehydration
• Medications that can impair renal function, such as certain antimicrobials, immunosuppressants, non-steroidal anti-inflammatories (NSAIDS), anti-ulcer agentsand chemotherapies
• Agents with levels affected by dehydration, such as lithium, digoxin, antiepileptics
• Drugs that alter states of alertness, such as hypnotics, anxiolyticsand analgesics
• Medications that can interfere with central nervous system thermoregulation, such as neurolepticsand serotoninergic agonists
• Drugs that increase basal metabolic rate such as thyroxine

Storage of medicines
Most medicines should be stored below 25°C and in a cool, dry place. Keep medicines out of direct sunlight, and do not leave on windowsills. Medicines should only be stored in the fridge where specified. Contact your pharmacist for further guidance.

Care delivery considerations

Facilities may wish to consider:

• Rescheduling physiotherapy, exercise programmes and other physical activities to cooler times of day.
• Reducing strenuous activities during peak temperatures.
• Monitoring vulnerable patients more frequently.
• Reviewing staff arrangements during prolonged periods of hot weather.
• Ensuring sufficient staffing capacity to respond to increased care needs.

Staff welfare

Employers should take reasonable measures to reduce heat exposure among staff.

• Ensure access to drinking water.
• Encourage regular breaks.
• Provide access to cooler rest areas.

Updated 22/06/2026