The summer season with its potential high temperatures is once again approaching. Long-term health care facilities are reminded that the elderly and other health compromised individuals are more susceptible to extremes in temperature and dehydration.

Facilities must have contingency plans in place to deal with either the loss of air conditioning or, in the case when no air conditioning is available, to take measures to ensure patients and residents are kept as cool as possible. Portable fans and other temporary cooling devices should be used when indicated.

We recommend that the following measures be implemented to keep residents and clients comfortable during extremely hot weather:

• Dress in lightweight loose fitting clothing.
• Keep well hydrated with a particular attention to dependent residents.
• Physical activities should be kept to a minimum during the hottest parts of the day.
• Keep indoors and out of the sun during the hottest parts of the day.
• Use fans as appropriate.
• Open windows where feasible and if screens are intact, to allow fresh air to circulate.
• Use cool compresses, misting, showers and baths.
• Avoid hot foods and heavy meals.
• Encourage frozen treats such as “Popsicles” between meals.
• Keep a hydration station readily available to residents, family and staff.
• Staff should also be alert to adverse changes in patient and resident conditions that may be heat related. Develop and implement a system to monitor hydration status and their overall condition and be prepared to take appropriate interventions.

Also please remember that with the hot weather brings mosquitoes, and the risk of contracting West Nile Virus (WNV). If mosquitoes are abundant, Long Term Care residents and clients should remain indoors in the early morning and at twilight, when mosquitoes are most active. The most common repellent products contain the chemical DEET. It has been in use for more than 40 years and is still considered the most effective product according to Consumer Reports.

Repellents should be used cautiously especially in children and the elderly. For additional information on the use of chemical repellents, administrators or infection control practitioners should consult the Centers for Disease Control and Prevention (CDC) West Nile Virus website.

Questions about WNV infection and control measures should be referred to Jon Rosenberg MD at jrosenbe@dhs.ca.gov or Chris Cahill MS, RN, Infection Control Consultant at ccahill@dhs.ca.gov.

Sincerely,

Original Signed by Patricia DeWan-Duran for Brenda Klutz

Brenda G. Klutz
Deputy Director