Summer clinical alert 2025-26 – Preventing heat stress in older people

Summer is nearly here, and it’s always a time of higher heat-related risk for older people. For aged care providers and workers, now is the time to prepare for the heat, and take steps to stop heat-related illness.

Heat causes more people to die each year in Australia than any other natural hazard. When heatwaves occur, the death toll routinely reaches into the hundreds.

People over 65 are at highest risk from the heat

Older people’s bodies don’t cope with sudden stresses as quickly or as well as younger people’s bodies. For example, an older person’s skin doesn’t sweat and cool the body down as efficiently as a younger person’s does.

Heat-related illness can get worse very quickly in older people. This can lead to rapid clinical deterioration (a fast decline in their health) and even death. That’s why it’s important to recognise and respond to heat-related illness in older people early and urgently.

If you see these signs in the older people in your care:

a sudden rise in body temperature
confusion or altered mental state
seizures
nausea and vomiting
loss of consciousness
a weak, rapid pulse

it’s a medical emergency that requires immediate first aid to cool the person down and a call to emergency services.

Heat stress can also make existing health conditions worse. This includes conditions that are common in older people, such as diabetes, kidney disease and heart disease. Many heat deaths are recorded as heart attacks.

Other risk factors in the heat

Older people more at risk of heat-related illness include those who:

are frail or have a low body mass – they can heat up more easily
have dementia – they may not plan well, remember to drink regularly or realise they’re getting hot
have difficulty staying hydrated – for example, people:
with modified diets (including thickened fluids)
on restricted fluids
taking medications to reduce fluid retention
have mobility problems and other physical challenges – for example, people who can’t:
move into the shade or a cooler space by themselves
remove their own clothing or bedding layers when they feel hot.

Know your environment and how the temperature changes

Residential aged care providers need to know about environmental risks in their facilities buildings -such as:

indoor areas in care homes that can't be air-conditioned or easily cooled
indoor areas where the sun shines through the glass
outdoor areas that change from shade to full sun during the day
outdoor areas that are hidden from view

and ensure that residents are not left for prolonged periods in these areas where temperatures fluctuate over the day.

Workers at residential aged care homes should always:

know the temperatures in different parts of the home and its outdoor areas
know where residents are at all times
make sure people are wearing suitable clothing for the conditions.

Fluid intake and preventing dehydration

When it’s warm, remind your workers to:

Monitor vulnerable people and make sure they have enough fluids.
Encourage people to drink fluids more often.
Know the signs of dehydration, such as:
dry mouth and tongue
heat rash
going to the toilet less often or having less heavy continence pads
Urgently attend to older people who say they’re hot or thirsty, or who look like they are
Offer people lukewarm (not cold) sponging or showering to help them cool down
Remind people to wear sunscreen, hats and protective clothing if they could be in the sun and help them to do this
Keep people out of the sun – particularly older people who might not want to come back inside when encouraged to do so.

Providing home care in the heat

Home care providers should:

Have a heat action plan for each vulnerable person. This should include:
strategies for reducing their exposure to extreme heat
information about who to contact if they become unwell and need medical attention.
Make sure that the people you care for:
spend as little time as possible outside during extreme heat events
wear the right clothing for the conditions
have access to enough fluids, such as water
have cooling devices that work and are switched on. If they don’t have air conditioning, a fan blowing with a wet sheet or towel in front of it (not over it) can also work well.
Educate workers how to:
recognise signs of heat-related illness
respond in an emergency
provide first aid for heat stress, dehydration and heat stroke.