Geriatrician calls for heatwave response plan for the elderly

Temperature control for hospitals and nursing homes will become an urgent priority as temperatures increase due to climate change, a leading geriatrician has said.

In its 2019 annual review, the climate advisory council said rising carbon emissions would result in increased extreme weather events such as the heatwave in summer 2018 and Storm Emma in March 2018.

The council raised concerns about how increasing temperatures will affect patients in hospitals as a result of the “nature of the hospital building stock”.

Desmond O'Neill, a consultant geriatrician, and a professor of medical gerontology at Trinity College Dublin, said frailty and living alone were "key risk factors" when it comes to the dangers posed by heatwaves or droughts.

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“Older people generally have less reserve,” Prof O’Neill said. “Their ability to bounce back from traumas, injuries, etc is reduced. This reduced reserve becomes more pronounced in frail, older people because there’s less fat stores, there’s less spring in their tendons, there’s less reserve in their kidneys.”

Prof O’Neill said there was a range of measures that would need to be implemented to ensure the lives of elderly people were not at risk due to rising temperatures.

“Public health nurses will need increased vigilance during this time and, in particular, the attention to hydration and making sure people have adequate access to proper drinking water needs to increase,” he said.

“Currently in hospitals, there is quite a challenge with using fans from an infection-control point of view. Looking at climate control for hospitals and nursing homes will become an urgent priority. Just like people get grants for insulation for their homes, I think soon people will be looking for grants for air conditioning for their homes,” he added.

Education plan

Prof O’Neill also recommended that the country establishes a heatwave response plan, a public education plan and the establishment of an outreach programme to high-risk individuals.

Nursing Homes Ireland, a representative body, has issued guidelines to more than 300 nursing homes to ensure that elderly residents are protected from any risks associated with increased temperatures.

“Electric fans may provide some relief, if temperatures are below 35C,” a resource issued by the body to nursing homes said. “Use of fans at temperatures above 35C fans may not prevent heat-related illness.”

The pamphlet added: “Additionally fans can cause excess dehydration; the advice is to place the fan at an appropriate distance from people, not aiming it directly on the body and to have regular drinks; this is especially important in the case of sick people confined to bed.”