Analysis of heatwave response plans and adaptation to cope with heatwaves now and in the future in aged care facilities

Heatwaves result in significant excess mortality, particularly amongst the elderly, and increases in the frequency and duration of heatwaves are projected in the coming decades. This thesis examines heatwave response planning and adaptation with a focus on the health of the elderly in aged care facilities. Three related pieces of research were conducted to explore different aspects of this topic, these being a comparison of heatwave response plans from an aged care facility perspective, strategies for adaptation to climate change impacts in aged care facilities, and heatwave preparedness and planning in aged care facilities in Victoria, Australia. Selected heatwave response plans at national, state/provincial, and municipal levels were examined, with a particular focus on specific responses aimed at residents of aged care facilities. Heatwave response plans were sourced from several countries that are experiencing demographic transition that features growing ageing populations. A total of 23 heatwave response plans were obtained. Most of the plans were from Australia, with only three plans each available from Canada and the United Kingdom, and only two available from the United States. Key components found across the plans were analysis of temperature thresholds, heat stress prevention measures, and communication strategies. Only three heatwave response plans analysed included specific guidance for aged care facilities. These results underline the need for governments to implement effective guidelines that include specific provisions for aged care facilities. The exploration of adaptation strategies focussed on potential adaptive categories of primary, secondary and tertiary preventions: divided into short-term and long-term adaptation measures. These measures include adaptations such as heat-alarm sensor detectors, client's care plan review schedule, increased staffing during heatwaves, families and carer's involvement, active and passive air-conditioning, and backup power supplies. Victorian aged care facilities were invited to complete an online survey containing 50 questions on heatwave preparedness and planning. Thirty-nine surveys were completed. Eighty-seven percent had a heatwave policy in place, and 92% had a heatwave response plan. Chi squared (χ2) test statistics found a strong statistically significant relationship between facilities having heatwave response plans and their healthcare assessment process including consideration of the risks and prevention of dehydration. The study found 92% of sampled aged care facilities use air-conditioning to cool residents during heatwaves. These and other results suggest living in the sampled Victorian aged care facilities is not a risk factor for direct heat-related illnesses during heatwaves. However, ongoing staff heatwave education, training, and communication must continue to reduce heat-related illnesses associated with residents of aged care facilities.