Ask in spring, not in the middle of a heatwave
Most of what you will read about heat and older people was written for the northern hemisphere and lands in July. Here it needs to land in October, because by the time the first 42-degree run arrives in January the answers are already fixed: the plan either exists or it does not, the generator either runs the air conditioning or it does not, and the staff either know who to call or they are guessing.
This is a spring article. Six questions, asked before summer, are worth more than any amount of chasing in February.
Air conditioning is not the question — backup power is
Almost every Australian residential aged care home is air conditioned, which is why families skip straight past the subject. The failure mode here is different from Europe's: it is not the absence of cooling, it is the loss of it.
A heatwave and a power outage arrive together more often than anyone would like — network strain, storms at the end of a hot spell, bushfire damage to lines. Providers are required to have emergency and disaster management planning, and after the bushfire and heat emergencies of recent years the regulator has been explicit that this includes the practical detail, not just a folder.
So ask the narrow version of the question: if the power goes out on a 40-degree day, does backup power run the air conditioning — or only the lights, the lifts and the call bells? For how many hours of fuel? When was it last tested under load? Then: if it fails, what is the plan — where do residents go, and who decides? A provider with real answers has them ready. A provider that has to go and find someone has told you something too.
Ask the same about water, because a boil-water notice or a supply failure in summer is its own problem, and about how staff get to work when roads close.
The alerts are public and they are state-based
Heat health warnings are issued by state and territory health authorities using weather-district thresholds, alongside Bureau of Meteorology forecasts. They are public, and they are for the district where the home is — not necessarily where you are.
The useful question is therefore: at what warning level does your heat plan activate, what actually changes compared with a normal day, and who activates it on a Sunday in January? A plan nobody can name the trigger for is a document, not a plan.
Her room, not the foyer
The foyer is always cool. Ask about her room: which way does it face, does it get afternoon sun, what does it read at 4 p.m. and what does it read overnight? Rooms on the western side of a building behave completely differently from the ones you were shown on the tour.
And ask what happens to the outdoor areas. A resident who normally sits in the garden every afternoon and now cannot has lost something real; the answer should be a shaded or indoor alternative at a different time of day, not simply the loss of the routine. Immobility has its own cost.
The medications nobody reviews
The most neglected part and the easiest to fix. Several drug classes very common in aged care raise heat risk: diuretics, which worsen dehydration; antipsychotics and other psychotropics, which impair temperature regulation; anticholinergics, which reduce sweating; and some antihypertensives, which with heat-driven vasodilation drop blood pressure and cause falls.
That is not an argument for stopping anything — stopping medication is dangerous and is not a family decision. It means the GP should review the regimen before and during the hot months, adjusting doses and timing. Ask directly: has her medication been reviewed for summer, and by whom? In most cases the honest answer is no, and asking is usually enough to make it happen. If she is due a pharmacist medication review, summer is the right time to request it.
What should change on a hot day
- Supervised hydration — not a jug left with someone who cannot lift it, but rounds with a record of what was actually drunk. Thickened fluids in quantity for residents with swallowing problems.
- Temperature checks more often for at-risk residents, not only on request.
- Weight monitored — rapid loss over a few hot days is dehydration until proven otherwise.
- Activities moved to mornings and evenings rather than cancelled.
- Bedding and clothing changed — it happens that the winter blanket stays on because it is the one in the cupboard.
- A lower threshold for calling the GP or after-hours service, with written criteria: new confusion, unusual drowsiness, passing little urine, dry skin.
Heatstroke does not look like "feeling hot"
In an older person it looks like sudden confusion, drowsiness, weakness, sometimes hot dry skin with no sweating. That is not "a bit knocked about by the weather". It is an emergency, and it is 000.
Six questions to ask before December
- Does backup power run the air conditioning, for how many hours, and when was it last tested?
- At what warning level does the heat plan activate, and who activates it on a Sunday?
- What does her room read at 4 p.m. and overnight, and which way does it face?
- How do you record what she actually drank, and who reviews it?
- Has her medication been reviewed for summer, and by whom?
- What are staffing levels over the Christmas and January period compared with the rest of the year?
If you get nowhere
Put it in writing to the facility manager: one question, one date. If that fails, the Aged Care Quality and Safety Commission takes complaints from family members, including anonymously, and emergency planning and a safe environment are squarely within what it assesses. Free independent advocacy is also available through the national aged care advocacy network, and they will help you frame it and can attend meetings with you.
Keep copies. Photograph the room thermometer with the date visible. In a home where the manager changes every couple of years, the family with the folder is the only one with a memory.
Where to start
If your mother is already in a home, send these six questions in writing now, while it is still cool enough for someone to answer them properly. A written request in spring gets answers; the same request in the middle of a January heatwave gets a busy signal.
If you would rather not run it alone, we can. For A$109 we take down your mother's situation, look for the homes in your area that answer these questions properly, and report back what they told us, with names and dates. Start here
This article is for information and does not replace medical advice on your own situation. No medication should be stopped or changed without the prescriber. Heat health warning systems and emergency planning requirements differ between states and territories: check what applies where your mother lives. Curalune does not allocate beds and does not guarantee availability.