Steps to Be Taken By Adult Care Facilities In Cold Weather

1. Maintain heating systems in good working order in accordance with program regulations [Adult Homes 487.11(k)(9), Enriched Housing Program 488.11(g)(9) and Residences for Adults 490.11(i)(9)].
2. Routinely monitor the temperature in the facilities when the outdoor temperature is below 65 degrees Fahrenheit (18 degrees Celsius) to assure the inside temperature in residents' bedrooms and all common areas is maintained at the temperature stated in regulation [487.11(m), 488.11(i) and 490.11(n)] for your type of ACF.
3. If there are areas that fall below the required indoor temperature required by regulation, residents must be moved to common areas that meet the proper temperature. The area must be of sufficient size to safely accommodate the residents.
4. If the minimum temperature is not sustained, the emergency plan must be activated.
5. All staff should be familiar with the policies and procedures and know when to implement them.
6. All staff should be familiar with the symptoms of cold-related conditions and their management.
7. Check all doors/windows for drafts. Eliminate drafts when possible by drawing curtains/shades on days when the temperatures are below freezing. Encourage residents to sit away from windows/drafts.
8. Encourage residents to wear appropriate winter clothing while indoors and to dress in layers with appropriate outerwear when leaving the building. Residents should always wear a hat or ear covering and gloves when going outdoors.
9. Encourage residents not to partake in outdoor activities for extended periods of time.
10. Offer warm fluids/beverages to residents during the winter months.
11. The whereabouts of all residents must be accounted for as required by each program's regulations [Adult Homes 487.7(d)(i)(1), Enriched Housing Program 488.7(b)(i)(1), and Residences for Adults 490.7(d)(i)(iv)].

Steps to Prevent Hypothermia and Frostbite

1. Avoid prolonged outdoor exposure on very cold days. Do not stay outdoors for extended periods.
2. Increase your activity level according to the temperature. Avoid activities that cause physical exhaustion.
3. Dress in layers. Layers of clothing are warmer than one thick layer of clothing.
4. Avoid tight clothing as it reduces blood circulation.
5. Wear clothing to protect your ears, face, hands and feet in extremely cold weather.
   • Boots should be waterproof and insulated
   • Wear gloves
   • Wear a hat; it will keep your whole body warmer (hats reduce the amount of body heat that escapes from your head).
6. Drink large amounts of non-alcoholic and decaffeinated warm fluids.
7. Replace wet or damp clothes as soon as possible during the winter months.
8. If you feel cold or begin to shiver, add a layer of clothing and/or notify a staff person.

Symptoms of Cold Exposure and Management

Cold-Related Conditions	Signs and Symptoms	Management
Hypothermia	Shivering Fatigue Drowsiness Exhaustion Blue skin and/or numbness Confusion/disorientation Loss of coordination Memory loss Slurred speech Glassy stare Slow, irregular pulse Decreased level of consciousness	Remove all wet clothing. Place resident in dry clothing or blanket. Move resident to warm environment inside. If conscious, give resident warm nonalcoholic beverage. Seek medical attention to determine if further treatment is needed.
Frostbite	Any discoloration of the skin; bluish, pale, flushed, white or yellow Skin appears waxy Lack of feeling, numbness, tingling, stinging or aching.	Move resident into warm area. Handle the frostbitten area gently. DO NOT RUB THE AREA. Immerse affected area into warm-(not hot) water or place the affected area against a warm body part (e.g. armpit). Seek medical attention to determine if further treatment is needed.